There are a number of longer term problems that can arise, particularly if bowel management is not carried out well and regularly: Prolonged evacuation Constipation and constipation with overflow Pain Abdominal distension Haemorrhoids Rectal bleeding Autonomic Dysreflexia If you want to understand any of this in more detail, do speak to one of the specialists.
Interventions
Each person’s bowel programme should be individualised, taking into account the diagnosis or nerve damage, as well as other factors. It is important to establish a routine There are 4 principles to bear in mind when putting together the routine: Take into account pre-injury bowel habits Set up a schedule of either daily or alternate days Take into account the …
Needs and aims
Why learn about bowel care? Because the bowel is one of the organs that is affected after SCI no matter what the level of injury is To stay in control of your bowel and avoid accidents….. To open your bowels regularly, at a time that suits you….. So you don’t spend too long on the toilet every day….. To avoid …
Bristol Stool scale
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Injury L1/T12 and below
A spinal cord injury to L1 / T-12 and below may damage the defecation reflex and relax the anal sphincter muscle. This is known as a lower motor neuron or flaccid bowel. Management of this type of bowel may require more frequent attempts to empty the bowel and manual removal of stools, as not being able to control the sphincter …
Injury above T-12
If the injury is above the T-12 level, the ability to sense a full rectum may be lost. The anal sphincter remains tight, however, so bowel movements will occur on a reflex basis. This means that when the rectum is full, the defaecation reflex will occur. This is called an upper motor neuron or reflex bowel. Injuries to T12 and …
Why is BM important?
Paralysis often damages the nerves that control the bowel The best way to prevent bowel accidents is to follow a schedule. You need to teach your bowels when to have a movement. “Establishing an effective bowel program is critical, because incontinence may interfere witha patient’s physical, psychological, social, recreational and sexual function”(DeLisa + Kirshblum 1997) Psychological impact “After loss of …
