Living With a Spinal Cord Injury - Bowel Care
You or a caregiver can manage your bowel
problems to prevent unplanned bowel movements, constipation, and diarrhea.
Although this often seems overwhelming at first, knowing what to do and
establishing a pattern makes bowel care easier and reduces your risk of
spinal cord injury generally affects the process
of eliminating waste from the intestines, causing a:
- Reflexive bowel. This means you cannot control when a bowel
- Flaccid bowel. This means you can't have a bowel movement. If
stool remains in the
mucus and fluid will sometimes leak out around the
stool and out the anus. This is called fecal incontinence.
When choosing a way to deal with bowel problems, you
and your rehab team will
discuss such things as the type of bowel problem you
have, your diet, whether you or a caregiver will do the program, and any
medicines that may affect your program.
- For a reflexive bowel, you may
use a stool softener, a
suppository to trigger the bowel movement, and/or
stimulation with your finger (digital stimulation). There are many stool
softeners and suppositories available. You will have to experiment to find what works best for you.
- For a flaccid bowel, you may use
digital stimulation and manual removal of the stool. At first,
you do this program every other day. Later, you may need to do it more often to
prevent accidents. You may also have to adjust how much and when you
- Eating more fiber can help some people who have spinal cord injuries manage their bowel habits. Good sources of fiber include whole-grain breads
and cereals, fruits, and vegetables.
For best results:
- Do your program at the same time every day. Most people do
their bowel program in the morning. Doing it after a meal can take advantage of a natural bowel reflex that happens after eating. Choose the most
convenient time for you, and stay with it.
- Sit up if possible. This can help move the stool down in the
intestine. If you cannot sit up, lie on your side.
It is important to be clean and gentle when inserting anything into the anus.
- Always wash your hands and use gloves. Lubricate the finger of
the glove with K-Y jelly or a similar product.
- For digital stimulation, gently insert the finger in the anus
and move it in a circular motion for no more than 10 to 20 seconds every 5 to
10 minutes until you have a bowel movement.
- To remove stool, gently insert the finger and remove stool.
Continue to do so until none comes out. Wait a few minutes and then try again
to see if any more stool has moved down.
- To insert a suppository, first remove stool. Otherwise, the
suppository won't work. Take the wrapper off the suppository and insert it as high in your rectum as you can .
Note: Bowel problems can trigger
autonomic dysreflexia, which causes sudden very
high blood pressure and headaches. If not treated
promptly and correctly, it may lead to
stroke, and even death. These complications are rare, but it is important to know the
symptoms and watch for them.