Bowel management and continence in adults with spina bifida: Results from the National Spina Bifida Patient Registry 2009-15.
John S Wiener, Kristina D Suson, Jonathan Castillo and 7 others
PMID 29125526WHAT IT FOUND
Bowel continence was reported by 58.3% of adults with spina bifida in a national registry, with higher rates in less severe non-MMC forms.
Employment was the only factor still linked to continence after other factors were considered.
Key findings
01After excluding people with colostomy or ileostomy, 2707 individuals of all ages (53.5%) reported bowel continence at their last clinic visit.
02Among adults, bowel continence was 58.3% overall, with 74.9% in non-MMC and 55.6% in MMC; the difference was significant (p < 0.0001).
03For adults aged 25 years and older, full- or part-time employment was the only variable with a statistically significant association with bowel continence on multivariable analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study describes people who attended selected spina bifida clinics, so adults who do not attend such clinics may differ from those included. The adults in the registry may have more severe spina bifida than adults with spina bifida in the wider community. The age distribution of adults studied was skewed towards young adults, so findings may not apply to older adults. Bowel continence definitions changed during the data collection period and were converted into a yes/no outcome. People with colostomy or ileostomy were excluded from continence outcomes, so results do not describe that group's continence. The study found associations with employment and education, but it cannot show whether bowel continence affects those outcomes or those outcomes affect bowel continence.
Declared interests
The registry is funded through the Centers for Disease Control and Prevention, and the authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that bowel continence improves employment or that employment improves bowel continence. This was a registry analysis, and the authors state that the direction of the relationship is not known.