Similar to the bladder, the bowel has reflexes that signal when the rectum is full so you know to use the restroom. A neurogenic bowel occurs when there is damage to the part of the nervous system that controls these reflexes. Also similar to the bladder, some people have a neurogenic bowel that becomes spastic or hyperactive. When their bowel gets full, it will spontaneously empty small amounts at random times. In other people, the bowel is flaccid, which means feces will fill the bowel and not empty which may lead to infection or a bowel obstruction, both dangerous conditions.
Just as in neurogenic bladder, neurogenic bowel can be caused by the following:
- Spinal Cord Injuries
- Spina Bifida (and other spinal abnormalities present at birth)
- Multiple Sclerosis
- Transverse Myelitis
- Stroke
- Other forms of neurologic damage
Management of Neurogenic Bowel
Your doctor will diagnose and recommend techniques for managing your neurogenic bowel based on your body and needs. A term you may hear when discussing neurogenic bowel is bowel routine or bowel program. A bowel program or routine consists of diet, timing, medications, and other techniques. The goal of this routine or program is to have consistent, scheduled, normal, healthy, bowel movements. See Model Systems Knowledge Translation Center Bowel Function After Spinal Cord Injury Factsheet for more information on exactly what a bowel routine or program is.
Treatment
Medications
There are medications that you can take to help control your bowel, whether it is spastic or flaccid.
Pelvic Floor Exercise
Your doctor may refer you to someone who will teach you pelvic floor exercises to try to strengthen your pelvic floor.
Record Keeping
Your doctor may ask you to keep track of what you eat and drink, noting episodes of incontinence or leakage and constipation. Recording what you eat and drink and how your bowel responds to these foods can help you to determine “trigger” foods or those that affect your bowels, both good and bad.
Surgery
Sometimes, your doctor may recommend surgery to help you manage your neurogenic bowel. There are multiples surgeries he or she may suggest so again, don't be afraid to ask questions to determine what is best for you!
