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    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 accidents.

    A 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 movement occurs.
    • Flaccid bowel. This means you can't have a bowel movement. If stool remains in the rectum, mucus and fluid will sometimes leak out around the stool and out the anus. This is called fecal incontinence.

    Bowel programs

    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 eat.
    • 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.
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