Neurogenic Bowel Dysfunction

Need Neurogenic Bowel Treatment In Orange County? You’ve Come To The Right Place.

For those with a spinal cord injury, dysfunction in the spinal cord, pelvic floor dysfunction or other issues that interrupt the transmission of nerve impulses to the pelvic region, neurogenic bowel can seriously impact your life, making you feel less social, less outgoing and reluctant to do what you once loved. But with Hoag in your corner, there’s hope.

As the highest-volume digestive health treatment center in Orange County, Hoag is making important new strides against serious conditions of the lower bowel every day, including neurogenic bowel. Hoag is committed to helping patients with bowel related issues find their way back to health, confidence and a better quality of life.

So don’t wait. Contact us today.

What is Neurogenic Bowel Dysfunction?

Neurogenic bowel dysfunction (neurogenic bowel or NBD) is a medical condition that occurs when a person loses the ability to control their bowel movements due to a neurological disorder, spinal cord damage or other issue that impacts the autonomic nervous system. 

Neurogenic bowel often affects spinal cord injury patients or those with central neurological diseases that can cause a lack of coordination between their central nervous system and the muscles that allow for gastrointestinal and anorectal function.

Patients with spinal cord injuries and other neurological disorders often experience impaired bowel function. This can result in chronic gastrointestinal problems like chronic constipation and fecal incontinence that seriously impact patients’ quality of life and normal bowel function. These issues can also cause bladder control problems, resulting in a condition known as neurogenic bladder.

What is Neurogenic Bladder?

As with neurogenic bowel dysfunction, spinal cord injury patients and those with spina bifida, multiple sclerosis, spinal cord lesions and other conditions that affect the transmission of nerve impulses between the brain and pelvic region sometimes experience pelvic floor dysfunction that can lead to issues with control of the bladder (urinary incontinence).

Collectively, these issues are known as “neurogenic bladder.” In addition to problems with controlling the release of urine from the body, neurogenic bladder can lead to other complications, including recurring urinary tract infections or an inability to empty the bladder voluntarily.

What Are The Types Of Neurogenic Bowel Dysfunction?

There are two types of neurogenic bowel, with which type a person has depending on which nerves are affected. The two types are:

• Reflexic bowel (spastic bowel): This type of neurogenic bowel dysfunction occurs when a spinal cord injury or other nerve-related issue makes it impossible for a person to relax their anal sphincter voluntarily. This type of neurogenic bowel disorder is usually caused by a disruption in nerve impulses between the colon and brain. Because patients don’t have control of their anal sphincter, issues like constipation and fecal incontinence can sometimes occur with this type of neurogenic bowel dysfunction.
• Flaccid Bowel: This type of neurogenic bowel dysfunction involves the colon not moving as much as it should, slowing or halting the wavelike involuntary muscle contractions that push digested food and feces through the lower GI tract so it can eventually exit the body during a bowel movement. In some cases, bowel symptoms due to the issue can include chronic constipation, fecal impaction or fecal incontinence.

What Are The Symptoms Of Neurogenic Bowel Dysfunction?

The symptoms of neurogenic bowel vary from patient to patient, including the level and extent of the neurological impairment. Common symptoms of neurogenic bowel include:

• Difficulty having a bowel movement (constipation)
• Loss bowel control (fecal incontinence)
• A slowing or stoppage of bowel function
• Abdominal pain
• Bloating and discomfort
• Reduced overall quality of life

Neurogenic bowel can also lead to other serious medical complications, including:

• Urinary tract infection (UTIs)
• Hemorrhoids
• Rectal bleeding
• Rectal prolapse
• Anal fissures
• Autonomic dysreflexia, a condition that can cause headaches, perspiration and feeling of general uneasiness during bowel movements.

How is Neurogenic Bowel Dysfunction Diagnosed?

Diagnosis of neurogenic bowel dysfunction usually involves collecting a thorough medical history, followed by a physical examination which might include a digital rectal examination.

Depending on the outcome of this exam, your doctor may order diagnostic tests to confirm or rule out a neurogenic bowel diagnosis. These tests may include: norectal manometry, colonic transit studies and defecography, which are conducted to assess colorectal function and anorectal function.

What Causes Neurogenic Bowel Dysfunction?

Neurogenic bowel dysfunction is usually caused by neurological conditions like spinal cord injury, incomplete spinal cord injury, spina bifida, multiple sclerosis, lower motor neuron lesions or other neurological diseases that can impact the spinal cord, bowel function and the nervous system’s control over the internal anal sphincter and other muscles of the lower GI tract.

Is Neurogenic Bowel Dysfunction Dangerous To A Person’s Health?

If left unmanaged, neurogenic bowel can lead to complications involving the colon, rectum and anal sphincter, potentially including fecal impaction and bleeding from the rectum. It can even lead to potentially life-threatening conditions like bowel obstruction. 

In adults with spinal cord injuries or problems that impact the nervous system, the bowel symptoms related to neurogenic bowel dysfunction can significantly impact a person’s quality of life. Sometimes neurogenic bowel can even lead to social isolation due to embarrassment about the condition and fear of bowel accidents in public places.

Are There Any Serious Complications Of Neurogenic Bowel Dysfunction?

Serious complications include fecal impaction, bowel obstruction, and rectal bleeding. Long-term constipation can also lead to hemorrhoids and anal fissures.

What Medical Exams Or Tests Are Used To Diagnose Neurogenic Bowel Dysfunction?

• MRI or CT scans to view the internal structures involved in having a bowel movement
• Ultrasound imaging for real-time views of the bowel and internal anal sphincter
• Electromyography to evaluate the health of the muscles and nerves that may be hindered in patients with spinal cord injury.
• Anorectal manometryy, which measures the pressure of the external anal sphincter muscles and the rectum to evaluate the coordination needed for a normal bowel movement

Treatment and Management of Neurogenic Bowel Dysfunction

Approaches to treatment and management of neurogenic bowel dysfunction often aim to restore as much normal bowel function as possible to improve quality of life. Neurogenic bowel management is often accomplished through individualized bowel management programs.

Always consult your healthcare provider, but in general, strategies for the management of neurogenic bowel dysfunction may include:

• Bowel training programs
• Abdominal massage
• Medications to treat and control constipation and diarrhea
• Dietary modifications
• Physical therapy
• Bowel-routine coaching
• Implantation of a sacral anterior root stimulator, a medical device that uses electrical impulses for sacral nerve stimulation
• Digital rectal stimulation, which uses a finger to trigger the sphincter muscle
• Patient training on good bowel evacuation procedures

In severe cases, treating neurogenic bowel dysfunctions may require bowel surgery, with surgical interventions like colostomy potentially being considered.

Can Neurogenic Bowel Dysfunction Be Cured?

There’s no cure for neurogenic bowel dysfunction, but management of neurogenic bowel is possible in those with the condition — including spinal cord injury patients and those with spina bifida, multiple sclerosis and other conditions — by sticking to a well-structured neurogenic bowel management program. Conservative bowel management under the guidance of specialists can allow patients to have more control over bowel movements, reduce the risk of complication, avoid fecal incontinence and lead to a greatly increased quality of life.

Are There Medications To Treat Neurogenic Bowel Dysfunction?

Medications like laxatives, stool softeners, and antidiarrheal drugs that can regulate stool consistency and improve bowel evacuation can be used as part of a conservative bowel management plan.

Who Is Most At Risk To Develop Neurogenic Bowel Dysfunction?

Those with spinal cord injuries or neurological disorders like spina bifida, multiple sclerosis, enteric nervous system issues and other disorders that impact communication between the nervous system and the colon, rectum and anal sphincter are at a higher risk to develop neurogenic bowel dysfunction.

Are There Any Ways To Reduce My Risk Of Developing Neurogenic Bowel Dysfunction?

Reducing the risk of neurogenic bowel dysfunction largely involves managing and treating any underlying neurological conditions you might have and maintaining a healthy lifestyle. For those with neurogenic bowel dysfunction, this is usually accomplished through what’s known as a bowel management program.

Always follow the instructions of your healthcare provider. But in general, here are some recommendations for ways to potentially reduce your risk of developing neurogenic bowel dysfunction:

• Seek early and regular medical care for neurological conditions
• Engage in exercises that strengthen the abdominal and pelvic floor muscles
• Maintain a balanced diet rich in fiber to promote regular bowel movements
• Stay hydrated to support normal bowel function
• Avoid activities that could result in a spinal cord injury