Rectal pressure response to a meal in patients with high spinal cord injury.

Objectives: To determine whether there is a postprandial increase of rectal pressure in patients with spinal cord injury (SCI) and to compare their rectal pressures with those of healthy volunteers.

Design: A before-after trial comparing SCI and control subjects.

Setting: Patients were recruited from the register of an SCI unit at a rehabilitation medicine department, and the study took place at the university hospital laboratory in Sweden.

Participants: Ten patients with high traumatic SCI and 9 healthy volunteers. Eight patients had a lesion above level T5.

Intervention: Continuous anorectal manometry was performed. Rectal activity was calculated before and at regular time intervals after a 1000-cal test meal.

Main Outcome Measure: Rectal activity measured as area under the pressure curve.

Results: There was a significant increase in rectal activity of 46% after 10 minutes in the patients but of 72% after 5 minutes in the volunteers. There was no difference in fasting rectal activity, but patients had a stronger mean rectal postprandial response during 60 minutes compared with volunteers.

Conclusions: These results support the theory that the colonic response to food is preserved in patients with high SCI.