spinal cord injury (SCI) generally affects the process
of eliminating waste from the intestines. This can result in a:
- Reflexive bowel, which means you cannot control when a bowel
- Flaccid bowel, which means you cannot have a bowel movement. If
stool remains in the
mucus and fluid will sometimes leak out around the
stool and out the anus (fecal incontinence).
You or a caregiver can manage both of these types of 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
When choosing a way to deal with bowel problems, you
and your rehabilitation (rehab) team will
discuss such factors 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 usually
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 the
one that works best for you.
For a flaccid bowel, you usually use
digital stimulation and manual removal (disimpaction) 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
For some people with SCI, eating more fiber can help with
managing 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, although you should pick the most
convenient time. After you have picked a time, 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 that you practice cleanliness and be
gentle while 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 will not work. Take the wrapper off the suppository and insert it
as high as you can.
- See a picture of
inserting a suppository .
Note: Bowel problems can trigger
autonomic dysreflexia, a syndrome in which there is a
sudden onset of very
high blood pressure and headaches. If not treated
promptly and correctly, it may lead to
stroke, and even death. Although autonomic dysreflexia
rarely leads to these more serious complications, it is important to know the
symptoms and watch for them. Autonomic dysreflexia is more common in people
with an injury to the
thoracic nerves of the spine or above (T6 or above).