Bowel Dysfunction and Management In SCI

For individuals living with a spinal cord injury (SCI), maintaining proper bowel function
is a crucial aspect of daily life. An SCI can disrupt the natural neurological control of
the bowel and bladder, leading to challenges like constipation and incontinence. However, with
tailored strategies and support, individuals with SCIs can regain control and enhance
their overall quality of life.

Understanding Bowel Dysfunction in SCI

A spinal cord injury alters the communication between the brain and the nerves
below the level of the injury. This disruption often results in neurogenic bowel
dysfunction, where the muscles and nerves responsible for bowel function no longer
operate as they should. This can give rise to a range of bowel management issues that
significantly impact an individual’s daily life.

Common Bowel Dysfunction Issues in SCI

Constipation: One of the most prevalent problems in neurogenic bowel dysfunction is
constipation. The slowed movement of stool through the colon due to weakened or
paralyzed muscles can lead to infrequent, hard-to-pass bowel movements.
Incontinence: Some individuals with SCI may experience loss of sensation and muscle
control in the rectal area, resulting in involuntary bowel movements. This can be
emotionally distressing and may require extra care and management.
Impaction: In severe cases, stool can become impacted in the rectum, causing
discomfort, pain, and further complications. This condition may necessitate more
intensive interventions to resolve.

Risk Factors and Severity

The extent of bowel dysfunction in SCI can vary widely depending on factors such as
the level and severity of the injury, as well as the individual’s overall health. Those with injuries higher up on the spinal cord (closer to the head) typically experience more pronounced bowel dysfunction, as the nerves controlling bowel function originate higher up in the spinal cord.

Management and Treatment

Diet and Hydration: A balanced diet rich in fiber, along with sufficient water intake, is
crucial in managing bowel dysfunction. Fiber helps regulate bowel movements, while
staying hydrated softens stool, making it easier to pass.
Scheduled Bowel Care: Establishing a regular bowel care routine can help train the
body to have predictable bowel movements. This often involves techniques like digital
stimulation, suppositories, or enemas.
Medications and Supplements: Depending on the specific needs of the individual,
healthcare providers may recommend medications or supplements to regulate bowel
function.
Adaptive Equipment: Specialized tools and equipment, like bidets or assistive devices,
can assist with bowel management and improve comfort and hygiene.
Physical Activity: Engaging in regular, safe physical activity within one’s abilities can
help maintain overall health and support bowel regularity.
Consultation with Healthcare Providers: Working closely with healthcare
professionals, including specialists in SCI care and dietitians, is essential. They can
provide personalized guidance and address any complications or concerns.

Bowel dysfunction is a common and significant aspect of life for individuals with SCI.
However, with proper care, management, and support, it’s possible to mitigate its
impact and lead a fulfilling life.

By Virendra Vikram Singh(PT)