Objective
To evaluate changes of colon transit time according to prokinetic medication and characteristics of the anorectal manometry in patients with neurogenic bowel due to spinal cord injury.

Method
Twelve patients with cervical and thoracic cord injury were enrolled, and classified into complete and incomplete spinal cord injury according to the severity of injury. The colon transit time before and after prokinetic medications were measured. The anorectal manometry was performed after the first study of colon transit time.

Results
The colon transit time of pre-prokinetic medications were 17.1⁑12.6 hours for the right colon, 26.9⁑13.2 for the left colon, 21.5⁑14.0 for the rectosigmoid colon, and the total transit time was 65.5⁑5.3 hours. The time of post-prokinetic medications was 14.3⁑7.6 hours for the right colon, 25.8⁑10.3 for the left colon, 7.4⁑5.3 for the rectosigmoid colon, and the total transit time was 33.1⁑11.5 hours. The rectosigmoid colon transit time and total colon transit time were significantly different between pre- and post-prokinetic medications (p＜0.05). In the anorectal manometry, mean resting anal pressure was 33.3⁑10.7 mmHg and maximal resting anal pressure was 99.0⁑43.4 mmHg. There were no difference in the colon transit time and anorectal manometry between complete and incomplete injured patients.

Conclusion
The difficulties of defecation in spinal cord injured patients were not only due to uncontrolled anal sphincter but also due to dysfunction of colon motility. The prokinetic medications were effective in reducting the rectosigmoid and total colon transit time.