A neurogenic bowel is when your bowel malfunctions (it does not do what it is supposed to do) because of a disease or an injury to the nervous system. The bowel includes both the small and large intestine (also called the colon).
Causes for Neurogenic Bowel
The most common diseases and injuries that cause a neurogenic bowel are:
- Spinal cord injury (SCI)
- Lou Gehrig’s disease (ALS)
- Spina bifida
- Multiple Sclerosis (MS)
- Parkinson disease
- Diabetes mellitus
Any of these causes may result in your losing normal sensory or motor control of your bowel. In other words, you may not feel (sense) that your bowel is full and ready to be emptied, or, in the case of loss of motor control, the bowel may feel full, but you are unable to empty it voluntarily.
These changes often result in one or more of the following:
- Stool staying in the bowel for too long,
- Constipation, or
- Unwanted/involuntary release of the stool (incontinence)
- Treatment for Neurogenic Bowel
Having a totally uncooperative bowel can play havoc with your life. Individuals with a neurogenic bowel should work with their healthcare provider(s) and create a personalized bowel program that fits your lifestyle. The program should: 1) help reduce or stop bowel accidents; 2) help create a predictable (regular), easier, and sufficient stool elimination; 3) improve quality of life.
Because each person’s situation is unique, a program needs to take into consideration many factors, and your healthcare provider will help you do that. You may be asked about the following:
- What and how much you eat
- What and how much you drink, including alcoholic beverages
- Your daily and physical activities and your work schedule
- Medications, herbal supplements or drugs you may take – including street drugs
- Bowel care – how often do you need to eliminate stool, and if there is any assistance required
- Supplies and equipment you use – this might also include a discussion on reimbursement or insurance coverage
After all these things have been discussed (and probably more!), your healthcare team will help you create a personalized program to fit your needs and lifestyle. When you begin your program, you will need to keep a Bowel or Stool Diary. In this diary, you will enter details regarding your bowel movements. It’s also a good idea to keep a Food Diary for at least a month, because how each of us digest food is different. These two diaries will let you and your healthcare team know if the program is really helping you, or if you need to made adjustments to the program. Because this is your personal program, enter as much detail in your diaries as you can to ensure the best possible results for you. Always make sure to bring these diaries with you so they can be reviewed and discussed at each checkup.
Do alert your healthcare professionals right away if you notice any unwanted or unexpected changes, and especially if you notice blood or discoloration (too light or too dark) in your stool. This could be a signal that there is a problem that needs immediate medical attention. If you have any doubts about what you are experiencing, always call and discuss your concerns with your healthcare team.
Make sure that you continue to review your program with your healthcare professional at least once a year. You will want to confirm that your bowel care program is continuing to provide you with a healthy bowel and as much control over it as possible. If your healthcare professional has asked you to keep a Bowel Care Record beyond a year, bring that with you so that it can be reviewed and discussed at your checkup. Remember to take a list of any questions you have, and discuss any changes you have noted along with any changes you may have had in medications, your lifestyle, or in your diet.
Having a neurogenic bowel does not mean that your bowel has to completely rule your life. Creating a bowel care program with your healthcare professional, even though it will take up some of your time to implement and follow it, should help put you back in the driver’s seat.
Neurogenic Bowel: What You Should Know. A Guide for People with Spinal Cord Injury. (Clinical Practice. Consumer Guide: Neurogenic Bowel). Consortium for Spinal Cord Medicine. March 1999.
Bowel Care – How Can We Help? Bladder and Bowel Foundation (UK). Web page: www.bladderandbowelfoundation.org/bowel/
Medical Reviewer: Nancy A. Faller, RN, MSN, PhD, CWOCN
Dr. Faller is a board certified ET Nurse Clinical Specialist. She received her PhD in nursing from the University of Massachusetts, and her ET nursing education from the Harrisburg Hospital ETNEP. Dr. Faller is a member of various professional and allied organizations, both national and international. She has lectured extensively and published numerous articles regarding the practice of ET Nursing. Nursing for Continence, which she co-edited with Dr. Katherine Jeter, was selected for a Book-of-the-Year award by the American Journal of Nursing. She is currently in private practice and is especially interested in the delivery of ET nursing CARE in all settings … Clinical, Administrative, Research, & Education. She has a strong commitment to ET nursing. She has a particular regard for: tube management, clean vs. sterile technique for both wound care & intermittent catheterization, the etiologies of altered skin & tissue integrity, and overflow voiding & incontinence. In addition, she has a keen sensitivity for the cost effective use of resources, both human and natural.