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Neurogenic bowel is the loss of normal bowel function. It’s caused by a nerve problem. A spinal cord injury or a nerve disease may damage the nerves that help control the lower part of your colon. This is the part of the body that sends solid waste out of the body. This problem gets in the way your normal ability to store and eliminate waste. It often causes constipation and bowel accidents.
The food you eat goes to your gastrointestinal tract (GI tract) for digestion. You might think of your GI tract as a long tube. Muscles around the GI tract push the food by contracting and squeezing the tube in a wave-like pattern. This is called peristalsis. Starting at the mouth, food travels down the esophagus to the stomach, and then into the intestines or bowel. The first part of the intestines absorbs the nutrients. The food your body can’t use then travels onward into the large intestine (colon). Your colon reabsorbs excess water from the undigested food which is called stool. The stool is stored in the last part of the GI tract called the rectum. Eventually, your body expels the stool through the anus during a bowel movement (BM). A ring of sphincter muscles keeps the stool inside the rectum until you have a BM.
The muscles and nerves around your rectum and anus need to work together for your bowels to work properly. Nerves control the muscles of the rectum, and they signal when the rectum is full. Damage to these nerves can interfere with bowel control. The damage may reduce the peristalsis in the muscles around the colon. The damage may block signals to or from the rectum and anus. This means you may not feel when you need to have a BM. Or you may not be able to have a BM when you want.
There are two main kinds of neurogenic bowel, depending on the nerves affected.
Nerve damage may lead to neurogenic bowel. This can happen from:
Neurogenic bowel causes a loss of normal bowel function. Damaged nerves disrupt the ability of your rectum to store and get rid of waste. Because of disrupted signals between the colon and the brain, you may not feel the urge to have a BM. This often causes constipation and BM accidents. Reflex bowel problems may cause a sudden, unplanned BM when the rectum is full. Flaccid bowel problems may lead to frequent leaks of stool because the sphincter does not close as tightly. Neurogenic bowel may cause:
Doctors will ask about your medical history, recent symptoms, past medical conditions, and family medical history. The doctor may ask how often you have BM accidents or constipation. You may need to fill out a stool diary to record when you have BMs. Doctors generally do a physical exam, including a rectal exam and testing of your reflexes. You may need other tests such as:
You may get the diagnosis from a gastroenterologist or other specialist.
People with neurogenic bowel need to have a routine bowel management program. This includes scheduled routines to remove the stool from the rectum on a regular basis. This helps prevent accidents, constipation, and bowel blockage. A bowel program also includes diet changes, medicines, and other methods. Your medical team can help you develop a bowel management program. Your bowel care may include:
By following a bowel management program, you may need less help from others. You may also avoid related problems, such as hemorrhoids or bowel blockage. Good bowel care practice helps avoid BM accidents. It also helps to prevent hemorrhoids, serious constipation, and intestinal blockage. You can work with your medical team to create and maintain the best bowel care program for your situation.
Tips to help you get the most from a visit to your healthcare provider:
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