Bowel-related changes are common among victims with spinal cord injuries. Many spinal cord injured clients have said that after loss of mobility, loss of bowel control is the next most distressing aspect of SCI. These changes can affect your social, emotional, physical well-being, recreational and sexual function and they can lead to life-threatening complications. However, bowel problems can be managed to prevent complications. Dr. Groah, a well known physiatrist who specializes in spinal cord injury, helped our firm provide excellent advice and contribution to the issue of understanding bowel changes and spinal cord injuries.
To understand the bowel changes you might experience, it helps to understand the digestive system. Your gastrointestinal tract includes your mouth, esophagus (swallowing tube), stomach, small intestine, and large intestine. Together, the small and large intestines make up your bowel. The digestive system breaks down food and liquid into nutrients for your body to use. Water and nutrients are absorbed back into the body and waste products are eliminated from your body in your stool.
For the most part, your body’s ability to absorb water and nutrients is unchanged because of your spinal cord injury. On the other hand, your body’s ability to move the stool through the colon and eliminate waste products from your body through a bowel movement is affected. Normally, when you feel stool is in your rectum, you have the sensation that you are going to have a bowel movement. You squeeze the muscle called the “anal sphincter” that functions to keep stool in your body.
Then, when you are ready to move your bowels, you relax the sphincter and the stool leaves your body resulting in a bowel movement. However, as we’ve learned already, sensation and muscle function (including the muscles around the anus) can change after spinal cord injury, and you may develop what doctors call a neurogenic bowel. Your rehabilitation team may have suggested that you follow a bowel care program so that you can gain control of your bowel function again. The overall goal of your bowel care program is the safe, predictable, and efficient elimination of stool with few to no bowel accidents, which, in turn, will go far in preventing any other bowel-related complications.
Important components of a bowel care program are to:
Maintain a Consistent Schedule – This means making sure that you follow your bowel care program regularly and without failure, usually daily or every other day.
Find the “Right” Time During the Day – You may tend to have bowel movements more in the morning or at night. Listen to your body because it might be best to schedule your bowel care during those times.
Find the Best Position (Lying Down or Sitting Up) – Gravity often helps move things along, so if you can, you may want to consider being upright for your bowel care.
Eat a Healthy Diet – Make sure you are getting enough fiber in your diet and pay attention to foods or spices that disrupt your bowel care.
Drink Enough Water – Fluids help move things along, but you need to balance this with your bladder management. Find out if you need medications, and if so, which one(s) work for you.
Learn the Right Way – You need to do manual evacuations of stool, digital stimulation, and put in suppositories and/or enemas.
Bowel care may not seem like the most important aspect of recovery after your spinal cord injury, but as time goes on, most people report that bowel and bladder function are sometimes more important to them than being able to walk. Also, bowel problems can be a cause of social isolation and increase the need for assistance from others. People with SCI report that the three major bowel complaints are constipation, pain, and incontinence. So, as you go forward following your SCI, you will want to make sure that you take good care of your bowels to avoid these problems.
Finally, it’s always a good idea to revisit and reevaluate your bowel program periodically. Ask yourself the following questions:
Ask yourself these questions above every so often to head off small problems before they become larger ones. Because of the impact that bowel problems have on people after SCI, researchers are currently conducting experiments in which electrodes are implanted around the nerves controlling the bowel and bladder so that you can just push a button on a remote control to cause you to have a bowel movement or empty your bladder.
Sometimes, either immediately after SCI or even years down the road, you may hear about a colostomy for bowel care. “Ostomy” means an artificial, or surgically created, opening from the urinary or digestive tract to the outside of the body. A “colostomy” is either a temporary or permanent opening made by a surgeon in which a portion of the large intestine, or colon, is brought to the skin of the abdomen, forming an opening through which stool passes. The stool is then collected on the outside of your abdomen in a collection bag, which is hidden by clothing.
Having a colostomy sometimes makes what has been difficult bowel care easier because there is no need to insert a suppository, perform digital stimulation, or wait sometimes hours for a bowel movement. Some recent studies have shown that people with long-term SCI who choose a colostomy are satisfied and report that their quality of life has improved as a result. If you feel that you’ve tried everything (changing the time, frequency, position, your diet and fluids, medications, etc.), you may want to speak with your health care provider to see if a colostomy is a good option for you. Also, it’s always helpful to speak with other people who are living with a colostomy to find out what it’s like.
Remember, the cost of living with living with a spinal cord injury can be an enormous burden on the victim and his/her family. It’s important to have the resources necessary to be able to obtain proper equipment, rehabilitation, training, services, and other items necessary to achieve personal goals and to both enhance and maintain a satisfying quality of life. In addition, although your family members may now chose to help you and provide personal care support, the long-term availability of appropriate care cannot be guaranteed and is essential for your health and well-being to plan financially for your future. If you have been hurt as a result of the negligence or carelessness of another person, contact us today by filling in contact form or calling us at 905-333-8888. We have been helping spinal cord injury victims since 2003 and understand that dealing with insurance companies can be particularly frustrating. If someone is at fault for your injuries, we will fight to obtain the compensation you deserve, and ensure that you have the financial resources to be able to access the necessary health care and other essential components which will assist you in maintaining an acceptable quality of life.