National survey reveals shifting professional attitudes favoring colostomy for neurogenic bowel dysfunction after spinal cord injury, highlighting a need for updated clinical guidelines.
Background: Neurogenic bowel dysfunction significantly affects those living with spinal cord injury (SCI). Guidelines position colostomy as a last resort, but this is not reflected in current practice. Pathways and professional attitudes are inconsistent. Aim: Explore the attitudes of health professionals towards colostomy as an option for people living with SCI. Methods: Online questionnaire for health professionals; descriptive statistics and thematic analysis. Results: 122 responses. Indications for colostomy: increasing independence (87%), intractable bowel difficulties (82%), patient choice (80%). Concerns regarded complications (71% overall), decisional regret (35% overall) and access to specialist nursing/lack of patient education (each 32% overall). Free-text analysis revealed themes of ‘Lives transformed’, ‘Patient-centred choice’, ‘Right services, right reasons’, ‘Colostomy concerns’, ‘Health professionals’ knowledge gaps’, ‘Differing perspectives’ and ‘Patient education is key’. Conclusion: Attitudes to colostomy are shifting, however concerns and inconsistencies in pathways, knowledge and support persist. Guidance needs to evolve to reflect current practice and incorporate patient perspectives.
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Michelle Boucher (2026) studied this question.
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