Detailed interviews of 127 consecutive patients seen by our spinal cord injury service were performed in order to determine the prevalence and characteristics of chronic gastrointestinal problems in spinal cord injury (SCI) patients. Chronic gastrointestinal problems were defined as recurring symptoms that were significant enough to alter lifestyle or require chronic treatment. Thirty-four (27%) of the patients had a significant chronic gastrointestinal problem. The limited manner through which SCI patients can manifest symptoms resulted in complaints which were characteristically quite vague. The most common problems that impaired quality of life were poorly localized abdominal pain (14%) and difficulty with bowel evacuation (20%). Hemorrhoids (74%), abdominal distention (43%), and autonomic hyperreflexia arising from the gastrointestinal tract (43%) were also very common, but had a lesser impact on lifestyle. Twenty-three percent of our population required at least one admission to the hospital for a gastrointestinal complaint following their injury. The prevalence of chronic gastrointestinal symptoms increased with time after injury, suggesting that these problems are acquired, and may therefore be avoided by the adoption of certain chronic care routines. Chronic gastrointestinal problems in SCI patients merit more study because they are: 1) very different from those in the general population, 2) responsible for a disproportionately great amount of morbidity in these patients, 3) potentially preventable.