Neurogenic bowel occurs when the body has problems storing and removing stool from the intestines due to nerve damage.
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The digestion process is partly managed by messages sent between the brain and digestive system. These messages are sent through nerves. When these nerves are damaged, messages between the brain and digestive system are 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 along the spinal cord the damage occurs.
This happens when there is damage around the neck or chest. Messages between the colon (large intestine) and the brain are interrupted. As a result, 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 causing the rectum and colon to react, leading to a bowel movement without warning.
This happens when there is damage around the lower end of the spinal cord. When these lower nerves are damaged, a person is unable to feel when he needs to have a bowel movement. Also, the reflex may be reduced, so the rectum has a difficult time emptying stool. This can lead to constipation.
Talk with your doctor about the best treatment plan for you. Treatment options include:
Your doctor will work with you to set up a bowel program. This program will help by:
- Providing effective ways to have a bowel movement
- Preventing bowel accidents
- Establishing a predictable bowel movement schedule
With the program, you may:
- Follow a certain diet and physical activity plan
- Be given a combination of medicines to promote bowel function
to cause a bowel movement
- Work with your healthcare team to find an ideal time for going to the bathroom and position to use when having a bowel movement
- Participate in other methods to encourage bowel movement (eg, doing push-ups, massaging the abdomen, deep breathing, drinking warm fluids, sitting in a forward-leaning position)
The main types of medicines to treat neurogenic bowel include:
- Stool softeners—soften the stool to make bowel movement easier
- Colonic stimulants—stimulate the colon to move the stool through the digestive tract faster
- Osmotic laxatives—pull water into the intestines to increase stool bulk
- Bulk formers—increase stool bulk
The types of medicines you will take will depend on certain factors, such as the type of neurogenic bowel you have, other medicines you may be taking, and your diet.
Digital stimulation is done to encourage movement of the bowels by stimulating the rectum. With this procedure, the doctor will insert his gloved and lubricated finger into your rectum. He will slowly move his finger in a circle. Other types of stimulation include:
- Suppositories—stimulate the nerves in the rectum lining
- Enemas—stimulate the nerves and soften stool
Sometimes surgery may be needed, such as:
- Colostomy—An opening is made from the colon to the surface of the body. The opening acts like an anus where solid waste is removed.
- Ileostomy—An opening is made from the small intestine to the surface of the body.