Managing your bowels efficiently is one of the most important aspects of living with a SCI, which is true no matter how old you are or how long you have been injured. If things go wrong with your bowel routine it can take over your every waking thought, disrupt your working life and affect your social life.
The human digestive system:
The ageing bowel
With the advancing of the years your bowels will become sluggish and this affects the speed at which food passes through the gut, slowing the whole process down, which can then result in constipation. Constipation can be a short or long-term problem which may require you to alter your bowel management regime.
There is more than one way to manage your bowels and the method you choose is most likely to be influenced by your level of injury; keep in mind that over time the method that best suits you could change.
The mention of bowels at a social gathering has the tendency to kill the conversation: Why? Bowel movements are a perfectly natural function that we all perform most days of our lives.
The process of defaecation (passing a stool) involves several organs. Partially digested food passes from the small intestine into the large intestine (colon), where water is reabsorbed from the stool to make it more solid. The action of the gut wall then passes the stool along until it reaches the rectum where signals tell you of the need to open your bowels: following SCI this signal is lost.
Disruption to bowel routine
Your bowel routine can be affected by many things, such as:
Causes of bowel accidents:
Bowel problems associated with ageing
Constipation and diarrhoea
Causes of constipation:
Causes of diarrhoea:
Changing your bowel regime
What options may be available:
Anal irrigation system:
There are several different products available on the market, which vary in administration techniques. Technical information and support is available by contacting the companies directly and/or healthcare services. You/your carer will require training to use this method of bowel management from a healthcare professional, but from then on it can be self-administered.
People consider this option for a variety of reasons, but if you choose this system it will require a period of adjustment. You may have to alter your diet a little until the bowel settles down, but people have reported that it is the best thing they ever did and wish they had done it sooner. The main advantages of the colostomy seem to be the time saved and the maintaining of your independence. On the down side, some feel conscious of a smell, so finding the right products is essential; the adhesives can be messy and can cause skin irritation at first.
If you decide the colostomy is right for you, it is important to talk to someone who has successfully managed the transition. It is also important that you have easy access to a specialist Stoma Care Nurse who can offer advice and support.
Seek the best advice available. This could be from healthcare professionals or you may have access to SCI forums where you can exchange views and information with other SCI people, or charities supporting people living with SCI.
Some medication, taken over a long period of time, may alter bowel function; you may need to discuss alternatives with your medical team.
Altering your bowel regime will require the exercise of patience and perseverance, it will probably take at least 2 weeks to establish your new regime effectively. Try to change just one thing at a time, this will allow you to observe more easily where any problems arise.
This fact sheet has been prepared by ESCIF and contains general information and guidance which we hope will assist you in ageing well with your spinal cord injury. The information should not be used as a substitute for professional or medical advice. ESCIF does not accept any liability arising from its use. Please note that the inclusion of named agencies, websites, companies, products, services or publications in this fact sheet does not constitute a recommendation or endorsement by ESCIF.
Date of publication: March 2018