NEUROGENIC BOWEL-PROGRAM

SUMMARY

1. Goals: initially aim for daily bowel movement, subsequently can be performed daily-every third day; consistent and complete evacuation of the bowel at a specified time, in a relatively short time period, without incontinence between programs (no bowel accidents).

2. Utilize the gastrocolic reflex: when feasible, SCI patients should be instructed to perform their bowel programs 30 to 60 minutes after a meal. Increased colonic activity occurs in the first 30 to 60 minutes after a meal (usually within 15 minutes).

3. Utilize the rectocolic reflex: suppositories and digital stimulation cause the bowel wall to stretch and thus help with evacuation. Note this reflex can be utilized by digital stimulation of the rectum.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.