If you have a spinal cord injury (SCI), a reliable bowel management routine is vitally important. Bowel movements require more time, thought, and planning as usually SCI people cannot feel when the stool is ready to come out. Establishing a well-designed bowel programme and a bowel care routine is essential in gaining the confidence and freedom needed to live an active life and can help prevent bowel accidents and avoid constipation.
Remember, there is no single infallible method to suit everyone – you may need to experiment to find a method which suits your own needs and lifestyle. If you have severe problems, it would be wise to discuss the matter with your own GP, District Nurse, Spinal Unit Community Liaison Nurse or Consultant before trying anything drastic as there may be another medical reason why you are having problems.
How will my SCI affect me?
After a spinal cord injury, the messages sent by the nerves located in your bowel are not able to reach your brain as before your injury. This means you will not get the message that tells you the bowel is full and it’s time to go to the toilet. Another change is that you may not be able to move the muscle at the opening of your back passage that controls when you have a bowel movement.
A bowel programme is a personalised plan designed to help you regain control of your bowel after your cord injury and improve your quality of life. Consideration is given to timing; privacy; position; diet; fluid intake; activity level; assistive techniques and medication used.
Bowel care is the term for assisted elimination of stool and is part of your bowel programme. It begins with starting a bowel movement, which is frequently done with digital stimulation and/or with using a rectal stimulant (suppository or mini-enema).
Diet plays a very important role in establishing a good bowel routine.
What you eat and drink will affect your bowel movements. Stool consistency is often a key factor in the success or failure of a bowel programme. An important part of your diet is the amount of fibre you eat. Foods that contain a lot of fibre can absorb and retain liquids and help make your stool more soft and easy to pass. Try to eat well-balanced meals at regular times each day.
Fibre provides the bulk necessary for stool evacuation and helps to increase movement through the bowel. Because fibre absorbs water, it’s important that you drink enough fluids. The recommendation is between 1.5 – 2 litres (6-8 glasses) of fluid each day. To find out about which foods contain fibre, please click here to view our fibre chart. However, eating too much fibre can also have an adverse effect and could cause bowel accidents.
You may find that particular foods and beverages disturb you bowels more than others, such as;
- Onions, cabbage and beans form gas, inducing bloating and excessive flatus
- Spices and alcohol can be responsible for diarrhoea and bowel accidents.
- Coffee and tea are bowel stimulants and can contribute to diarrhoea or faecal incontinence.
- Cold carbonated beverages can cause loose motion and bloating.
Keeping a food record is a good way for you to understand and learn how different foods affect your bowel. For about three weeks, you could write down what you eat and drink each day and describe your bowel movements. If your food record shows that some of these foods or beverages cause problems, consider eliminating them from your diet.
This information has been provided in association with the Spinal Injuries Association.
For detailed information regarding SCI and how it can affect your bowels, please visit the Spinal Injuries Association’s website on www.spinal.co.uk You can also contact them via their advice line on 0800 980 0501.
If you are concerned about your bowel problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems. You can also call our specialist helpline on 0845 345 0165 (24 hour answerphone) for medical advice, or call our office.