There are 15.000 people living in the Netherlands with a Spinal Cord Injury (SCI). Every year another 600 new patients are treated in the Dutch spinal cord injury rehabilitation centers. 80% of these patients suffer from neurogenic bowel dysfunction. These impairments have a huge negative influence on their quality of life. Patients complain of abdominal distension, faecal incontinence, constipation, shame and social isolation.
In the acute phase, SCI patients are given advise about their nutrition by a dietician, but the focus is preservation of muscle. In the chronic phase there is no specific nutrition counseling for SCI patients.
There is a relation between nutrition, fiber-intake, bowel function and microbiome in the healthy population. There is no knowledge on the fiber-intake of SCI patients. A recent review article concludes that a diet could lead to less neurogenic bowel problems in SCI patients. Furthermore, there is some proof that probiotics could influence the function of neurogenic bowel problems.
To investigate the relation between nutrition, fiber-intake, microbiome and neurogenic bowel problems in SCI patients
Sub-objectives:
What is the percentage of patients wit SCI not satisfied with their bowel management?
What is currently known on the microbiome of patients with SCI or MS?
Can probiotics influence neurogenic bowel problems in patients with SCI?
What is the dietary and fiber-intake of patients with SCI? Is there a relation with neurogenic bowel problems?
We will look at the satisfaction of SCI patients with their bowel function. To do this we will use the bowel topic of the Dutch Spinal Cord Injury Data Set (NDD).
We will do an assessment of nutrition and fiber-intake of SCI patients and look at the relation with bowel problems. We will ask 30 patients with a (chronic) SCI about their nutrition and fiber-intake, using “the Eetscore”. Furthermore, we will ask about neurogenic bowel problems.
A systematic review will be done on what is currently known on the microbiome of spinal cord injury patients and patients with MS.
We want to examine if the microbiome in SCI patients influences neurogenic bowel problems. We have started a double-blind randomised placebo-controlled trial on the effect of a multispecies probiotic on the incidence of antibiotic-associated diarrhoea in persons with spinal cord injury.
The study is performed by Willemijn Faber (rehabilitation physician of Heliomare). She is supported by Prof. dr. B.J.M. Witteman (Wageningen University), dr. R. Winkels (Wageningen University), dr. J. Stolwijk-Swuste (De Hoogstraat) en dr. J. Nachtegaal (Heliomare).
Heliomare
Wageningen University
De Hoogstraat
Reade
The project is financed by Heliomare
Faber W, Stolwijk-Swuste J, Van Ginkel F, Nachtegaal J, Zoetendal E, Winkels R, Witteman B. Faecal microbiota in patients with neurogenic bowel dysfunction and spinal cord injury or multiple sclerosis-a systematic review. Journal of Clinical Medicine 2021, 10(8), 1598.
Start: january 2017
Planned end: 2023