Neurogenic Bowel
Condition
(Bowel, Neurogenic)
Definition
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.
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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 where the spine is damaged.
Risk Factors
Spinal cord injury is the main risk factor.
Symptoms
A person with a neurogenic bowel may have:
- Trouble having a bowel movement
- Repeated bowel accidents
- A swollen belly
- A feeling of being full quickly
- Loose stools or very hard stools
- Bleeding from the rectum
- Belly pain
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done. A rectal exam may also be done.
Stool tests may be done to check a person's waste products.
Treatment
The goal of treatment is to manage the symptoms of neurogenic bowel. Choices are:
- A bowel program to regularly remove stool
- Diet changes to help stool consistency
- Medicines to add 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 outside of the body to allow stool to exit.
Prevention
Neurogenic bowel cannot be prevented.
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. As stool builds up in the rectum it triggers a reflex. This causes the rectum and colon to react, leading to a bowel movement without warning.
National Association for Continence
United Spinal Association
CANADIAN RESOURCES:
HealthLink BC
Canadian/American Spinal Research Organization
National Association for Continence
United Spinal Association
CANADIAN RESOURCES:
HealthLink BC
Canadian/American Spinal Research Organization
References
- Bowel management. Christopher & Dana Reeve Foundation website. Available at: https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/bowel-management.
- Cotterill, N., Maderbacher, H., et al. Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013. Neurourol Urodyn, 2018; 37 (1): 46-53.
- Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury.
- Sweis, R. and Biller, J. Systemic complications of spinal cord injury. Curr Neurol Neurosci Rep, 2017; 17 (2): 8.
Contributors
- Rimas Lukas, MD
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