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.


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 camera.gif.

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 seizures, stroke, and even death. These complications are rare, but it is important to know the symptoms and watch for them.

WebMD Medical Reference from Healthwise
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