Background/Aims: Colon dysmotility is generally considered to be the main cause of chronic constipation in patients with spinal cord injury. This study was performed to evaluate small bowel dysmotility such as orocecal transit time (OCTT) in patients with chronic spinal cord injury. Methods: Thirteen patients with chronic spinal cord injury and thirteen control subjects were matched for age and sex. The OCTT was measured by serial determination of breath hydrogen after administering a semisolid meal and 20 g of lactulose diluted in 100 ml of water. Results: In comparison with con- trols, the OCTT was significantly delayed in the group with chronic spinal cord injury (159.2+58.5 min vs. 79.2+8.6 min, p<0.001). The delay of OCTT was observed in all thirteen (100%) patients. There was no significant difference in OCTT between the patients with cervical spinal cord injury and the patients with thoracic spinal cord injury. Conclusions: We conclude that small bowel dysmotility as well as colonic dysmotility are related to the pathophysiology of chronic constipation in patients with chronic spinal cord injury. Moreover, this study can provide a theoretical background for the use of prokinetics in treating constipation of patients with chronic spinal cord injury. (Kor J Gastroenterol 1998;32:586 - 590)