Neurogenic bowel occurs when the body has problems storing and removing stool from the intestines. It happens due to a problem with the nervous system.

Intestines

Normal Anatomy of the Large and Small Intestine

Causes

Digestion is partly managed by messages sent between the brain and digestive system. These messages are sent through nerves. Damage to these nerves can cause messages between the brain and digestive system to be blocked. This prevents the bowels from working properly.

The spinal cord runs from the base of the brain to the lower back. There are two main types of neurogenic bowel, depending on the location of damage in the spine.

Reflexic Bowel

This happens when there is damage around the neck or chest. Messages between the colon and the brain are blocked. A person may not feel the need to have a bowel movement. However, stool is still building up in the rectum. The build-up triggers a reflex. This causes the rectum and colon to react, leading to a bowel movement without warning.

Areflexic Bowel

This happens when there is damage around the lower end of the spinal cord. When lower nerves are damaged, a person is unable to feel when a bowel movement is needed. The reflex may also be reduced. The rectum has a difficult time emptying stool. This can lead to constipation.

Risk Factors

Spinal cord injury is the main risk factor.

Symptoms

Problems may be:

Trouble having a bowel movement
Repeated bowel accidents
A swollen belly
Feeling full quickly
Loose stools or very hard stools
Bleeding from the rectum
Belly pain

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. A rectal exam may also be done.

Your waste products may be tested. This can be done with stool tests.

Treatment

The goal of treatment is to manage symptoms. Choices are:

A bowel program to regularly remove stool
Dietary changes to improve stool consistency
Medicines to increase stool bulk or make stool pass more easily

People who are not helped by these methods may need surgery. An opening may be made to the surface of the body. This will allow stool to exit.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

National Association for Continence
http://www.nafc.org

United Spinal Association
http://www.unitedspinal.org

CANADIAN RESOURCES:

HealthLink BC
http://www.healthlinkbc.ca

Canadian Spinal Research Organization
http://www.csro.com

References:

Cotterill N, Maderbacher H, et al. Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incotinence Committee of the Fifth International Consultation on Incontinence 2013. Neurourol Urodyn. 2017; doi: 10.1002/nau.23289.

Neurogenic bowel. Cedars Sinai website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/neurogenic-bowel.html. Accessed January 26, 2021

Spinal cord injury—chronic management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury. Accessed January 26, 2021.

Sweis R, Biller J. Systemic Complications of Spinal Cord Injury. Curr Neurol Neurosci Rep. 2017 Feb;17(2):8.

Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 1/26/2021

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