Regaining Control with a Bowel Program after a Spinal Cord Injury

Regaining Control with a Bowel Program after a Spinal Cord Injury

Living with a spinal cord injury can be overwhelming and challenging. The injury can significantly impact the normal functioning of the body, leading to various difficulties, including bowel incontinence. This condition can be pretty distressing and make you feel like you’ve lost control over your body. But what if we told you there’s a way to regain control and live a more normal life? 

Does Bowel Function Get Impaired After a Spinal Cord Injury?

We all take the Bowel function for granted until it stops working as it should. For people living with spinal cord injuries, bowel function can be a major concern, as these injuries can often lead to complications with bowel management.


The spinal cord is a bundle of nerves that runs from the brain down the back. It is responsible for transmitting messages between the brain and the rest of the body. When the spinal cord is injured, these messages are disrupted, which can cause a range of problems, including bowel dysfunction.


Bowel dysfunction can take many forms, including constipation, incontinence, and an inability to empty the bowel. These problems can be both uncomfortable and embarrassing, and they can significantly impact a person’s quality of life.


One of the main reasons that bowel function can be impaired after a spinal cord injury is that the nerves that control bowel function are located in the lower part of the spinal cord. When the spinal cord is injured in this area, the nerves that control bowel function can become damaged or disconnected from the brain.


As a result, the muscles that control bowel movements may not function properly, leading to issues with constipation, incontinence, or incomplete bowel evacuation.


There are several treatment options available for people living with bowel dysfunction after a spinal cord injury. These include dietary changes, medications, and bowel management programs that involve regular bowel emptying using manual or mechanical methods.

What is a Bowel Program?

When people experience a spinal cord injury, it’s common for them to prioritize improving bowel function. This is because the loss of bowel control that follows spinal cord injuries can greatly affect someone’s daily life and overall wellbeing.


Many complications can arise from the loss of bowel control, including constipation, fecal incontinence, abdominal pain or discomfort, autonomic dysreflexia, and an increased risk of developing pressure ulcers.


Fortunately, many strategies and methods can help effectively manage bowel problems and reduce their negative impact. Individuals with spinal cord injuries can implement a bowel program that’s specifically designed to address their needs and focus on achieving regular bowel movements, preventing constipation, and avoiding any accidents related to waste elimination.


Various approaches can be taken when implementing a bowel program, and it’s important to identify the best methods for each individual’s unique needs and circumstances. For example, some people may succeed using medication or specialized equipment, while others may benefit from dietary changes or increased physical activity.


Regardless of the specific methods used, individuals with spinal cord injuries need to prioritize their bowel health and take steps to manage any bowel-related complications that arise. 

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Critical Elements of a Spinal Cord Injury Bowel Rehabilitation Program

Regaining Control with a Bowel Program after a Spinal Cord Injury

Living with certain medical conditions or spinal cord injuries may impact bowel function, requiring individuals to adopt a structured approach known as a bowel program.

Initiating the Bowel Program

A bowel program is a structured routine designed to manage bowel movements in individuals with difficulty controlling them independently. This program becomes particularly relevant for those with spinal cord injuries, neurological conditions, or other medical issues affecting bowel function. The goal is to establish a predictable and controlled pattern for bowel movements, offering both physical and emotional benefits.

Frequency and Timing

One of the key components of a bowel program is establishing a consistent schedule for bowel movements. This regularity helps regulate bowel function, making it more predictable and manageable.

Individuals often work with healthcare professionals to determine their bowel program’s optimal frequency and timing based on factors like diet, medications, and overall health. By adhering to a set routine, individuals can reduce the risk of unexpected bowel accidents and gain a sense of control over this aspect of their daily lives.

Oral Medications

One of the most common side effects of these medications is bowel problems. Patients may experience constipation or diarrhea, which can be extremely uncomfortable and painful. To manage these symptoms, doctors may prescribe laxatives to help promote bowel movements. 

However, the overuse of laxatives can lead to tolerance, which can make them ineffective in the long run. Moreover, excessive laxative use can result in negative side effects, such as dehydration and electrolyte imbalance.

Apart from laxatives, there are other oral medications available to treat bowel problems after a spinal cord injury. Bulking agents are drugs that help add bulk to fecal matter, making it easier to pass. On the other hand, stool softeners make the stool softer and easier to pass. Some doctors may also recommend enemas, liquids inserted into the rectum to stimulate bowel movements.

Dietary Considerations

Fiber-rich foods, plenty of fluids, and a well-balanced diet contribute to regular and healthy bowel movements. Adequate hydration softens stools, making them easier to pass, while fiber adds bulk and promotes regularity. Individuals often collaborate with dietitians to tailor their diet to specific needs, ensuring a nutrition plan that supports optimal bowel function and overall wellbeing.

Hydration and Fluid Intake

Ample fluid intake supports overall health and helps maintain adequate stool consistency. For individuals with specific dietary restrictions or concerns, healthcare professionals can offer guidance on fluid intake tailored to their unique needs. Hydration acts as a natural lubricant for the digestive system, facilitating the passage of stools and minimizing the risk of constipation.

Regaining Control with a Bowel Program after a Spinal Cord Injury

Medications and Suppositories

Individuals may sometimes incorporate medications or suppositories into their bowel program to enhance bowel control. Medications can help regulate bowel movements by altering stool consistency or stimulating bowel contractions.

Typically inserted into the rectum, suppositories provide a localized effect to soften stools and promote more effective elimination. Healthcare professionals work closely with individuals to determine the most suitable medications or interventions based on their specific conditions and needs.

Physical Activity

Regular physical activity contributes to overall health and can positively impact bowel function. Engaging in exercise, as appropriate for an individual’s abilities, helps stimulate the digestive system and maintain healthy bowel motility.

Healthcare professionals, including physical therapists, may guide tailored exercise routines that support optimal bowel health while considering an individual’s overall physical condition and abilities.

External Factors

Accessible and well-equipped bathrooms, adaptive tools, and proper seating contribute to the program’s overall success. Individuals may work with occupational therapists to adjust their living spaces to ensure ease of access and enhance independence during the bowel program.

Digital Stimulation

It is a technique that helps individuals who have experienced spinal cord injuries to have regular bowel movements. Essentially, relaxing and expanding the anal muscles is key to making this happen.

To perform digital stimulation, a person manually opens the anus by making circular motions with their finger. Doing this triggers a bowel reflex, and stool can exit the body.

Although this technique can be quite effective, it’s important to note that certain risks, such as tearing or bleeding, are associated with it. Other risks include triggering a condition called autonomic dysreflexia, which can lead to a rapid increase in blood pressure and other serious health complications.


People who have incurred spinal cord injuries often experience weakness or paralysis in their legs, core, and arms. Due to this, it becomes imperative to find alternative methods to aid them in using the toilet.

In order to provide convenience as well as ensure safety, adaptive tools like commode chairs or raised toilet seats can be used. These tools are designed to assist individuals to get on the toilet easily and sustainably and can immensely help those with limited mobility.

While defecating, sitting is the most appropriate posture, as gravity’s pulling force assists in moving the stool down the colon. Individuals who cannot sit can lie flat on their left side, as it aligns with the direction of the colon. 

This position makes it easier for people recently undergoing surgery to undergo bowel movements without exertion, minimizing discomfort and pain. It’s important to ensure the posture is comfortable, as straining or forcing can lead to various complications, such as hemorrhoids or rectal prolapse.


A bowel program is more than a routine; it is a structured approach to regaining control and improving the quality of life for individuals facing challenges in bowel management. From establishing regularity to considering dietary factors, medications, and emotional wellbeing, a comprehensive bowel program addresses various facets of an individual’s health.


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