{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:29:17Z","timestamp":1775129357707,"version":"3.50.1"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006812","name":"Center for Integrated Healthcare, U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["B9212-C & B2020-C"],"award-info":[{"award-number":["B9212-C & B2020-C"]}],"id":[{"id":"10.13039\/100006812","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Persons with spinal cord injury (SCI) have neurogenic bowel disorders characterized by difficulty with evacuation (DWE), fecal incontinence, and discoordination of defecation. Six medically stable in-patients with SCI with a mean age of 57 \u00b1 10 years (range: 39\u201366 years) and time since injury of 18 \u00b1 17 years (range: 3\u201347 years) were investigated. Standard of care (SOC) for bowel care was followed by two weeks of SOC plus neostigmine (0.07 mg\/kg) and glycopyrrolate (0.014 mg\/kg) administered transcutaneously by iontophoresis thrice weekly for two weeks while patients continued to receive SOC. The primary endpoint was time to bowel evacuation. Body weights and abdominal radiographs were obtained. Ten questions related to bowel function and the Treatment Satisfaction Questionnaire for Medication were acquired after each arm. Bowel evacuation time decreased after the dual drug intervention arm (106.9 \u00b1 68.4 vs. 40.8 \u00b1 19.6 min; p &lt; 0.0001). Body weight decreased (2.78 \u00b1 0.98 kg; p &lt; 0.0001), a finding confirmed on abdominal radiograph. Both questionnaires demonstrated improvement after the dual drug intervention arm. No major adverse events occurred. The addition of neostigmine and glycopyrrolate by transcutaneous administration to SOC for bowel care in persons with SCI and DWE resulted in the safe, effective, and predictable bowel evacuation with subjective improvement in bowel care.<\/jats:p>","DOI":"10.3390\/jcm10051135","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T23:04:39Z","timestamp":1615244679000},"page":"1135","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Addition of Transdermal Delivery of Neostigmine and Glycopyrrolate by Iontophoresis to Thrice Weekly Bowel Care in Persons with Spinal Cord Injury: A Pilot Study"],"prefix":"10.3390","volume":"10","author":[{"given":"William A.","family":"Bauman","sequence":"first","affiliation":[{"name":"Veterans Affairs Rehabilitation Research and Development Service\u2019s National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Departments of Medicine and Rehabilitation and Human Performance, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Sabiev","sequence":"additional","affiliation":[{"name":"Veterans Affairs Rehabilitation Research and Development Service\u2019s National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahzad","family":"Shallwani","sequence":"additional","affiliation":[{"name":"Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann M.","family":"Spungen","sequence":"additional","affiliation":[{"name":"Veterans Affairs Rehabilitation Research and Development Service\u2019s National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Departments of Medicine and Rehabilitation and Human Performance, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Cirnigliaro","sequence":"additional","affiliation":[{"name":"Veterans Affairs Rehabilitation Research and Development Service\u2019s National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Korsten","sequence":"additional","affiliation":[{"name":"Veterans Affairs Rehabilitation Research and Development Service\u2019s National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Medical Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA"},{"name":"Departments of Medicine and Rehabilitation and Human Performance, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1016\/S0003-9993(97)90416-0","article-title":"Neurogenic bowel dysfunction after spinal cord injury: Clinical evaluation and rehabilitative management","volume":"78","author":"Stiens","year":"1997","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1038\/sc.2010.14","article-title":"Neurogenic bowel management after spinal cord injury: A systematic review of the evidence","volume":"48","author":"Krassioukov","year":"2010","journal-title":"Spinal Cord"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/RNJ.00024","article-title":"Characteristics of neurogenic bowel in spinal cord injury and perceived quality of life","volume":"37","author":"Pardee","year":"2012","journal-title":"Rehabil. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"873","DOI":"10.23736\/S1973-9087.18.04991-2","article-title":"Assessment of neurogenic bowel dysfunction impact after spinal cord injury using the International Classification of Functioning, Disability and Health","volume":"54","author":"Pires","year":"2019","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1111\/j.1572-0241.2005.41587.x","article-title":"Infusion of neostigmine-glycopyrrolate for bowel evacuation in persons with spinal cord injury","volume":"100","author":"Korsten","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2710","DOI":"10.1007\/s10620-008-0216-z","article-title":"Intramuscular neostigmine and glycopyrrolate safely accelerated bowel evacuation in patients with spinal cord injury and defecatory disorders","volume":"53","author":"Rosman","year":"2008","journal-title":"Dig. Dis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"450","DOI":"10.4103\/0970-9185.169049","article-title":"Topical anesthesia","volume":"31","author":"Kumar","year":"2015","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1038\/s41393-017-0018-2","article-title":"Delivery of neostigmine and glycopyrrolate by iontophoresis: A nonrandomized study in individuals with spinal cord injury","volume":"56","author":"Korsten","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1038\/sj.sc.3101058","article-title":"Bowel dysfunction following spinal cord injury: A description of bowel function in a spinal cord-injured population and comparison with age and gender matched controls","volume":"38","author":"Lynch","year":"2000","journal-title":"Spinal Cord"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1477-7525-2-12","article-title":"Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease","volume":"2","author":"Atkinson","year":"2004","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.4103\/1673-5374.160112","article-title":"Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction","volume":"10","author":"Ozisler","year":"2015","journal-title":"Neural Regen. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1089\/neu.2017.5343","article-title":"A Community Perspective on Bowel Management and Quality of Life after Spinal Cord Injury: The Influence of Autonomic Dysreflexia","volume":"35","author":"Inskip","year":"2018","journal-title":"J. Neurotrauma"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1097\/DCR.0b013e31823dfd6d","article-title":"Economic cost of fecal incontinence","volume":"55","author":"Xu","year":"2012","journal-title":"Dis. Colon Rectum"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1682\/JRRD.2004.01.0053","article-title":"Effects of neostigmine and glycopyrrolate on pulmonary resistance in spinal cord injury","volume":"41","author":"Radulovic","year":"2004","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1038\/sc.2014.45","article-title":"Autonomic dysreflexia during bowel evacuation procedures and bladder filling in subjects with spinal cord injury","volume":"52","author":"Faaborg","year":"2014","journal-title":"Spinal Cord"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1080\/003655202317316060","article-title":"Efficacy and tolerability of prucalopride in patients with constipation due to spinal cord injury","volume":"37","author":"Krogh","year":"2002","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1053\/j.gastro.2006.06.004","article-title":"A randomized, controlled trial of transanal irrigation versus management in spinal cord-injured patients","volume":"131","author":"Christensen","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1038\/sc.2012.66","article-title":"The impact of stoma for bowel management after spinal cord injury","volume":"50","author":"Coggrave","year":"2012","journal-title":"Spinal Cord"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/5\/1135\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:35:07Z","timestamp":1760160907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/5\/1135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,8]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10051135"],"URL":"https:\/\/doi.org\/10.3390\/jcm10051135","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,8]]}}}