Neurogenic Bowel and Management after Spinal Cord Injury: A Narrative Review

People with spinal cord injury (SCI) often experience neurogenic bowel, leading to complications like constipation, fecal incontinence, and gastrointestinal symptoms. Neurogenic bowel involves defecatory disorders and motility dysfunction in the colon and GI tract. Management involves individualized plans with pharmacological, mechanical, and surgical interventions. The goal for people with SCI and neurogenic bowel dysfunction is to maintain health, well-being, promote a good quality of life and support active, fulfilled lives.

• 1
  SCI results in neurologic dysfunction characterized by dysmotility of the GI tract, weakness of the pelvic floor and rectal sphincters, and impaired sensation.
• 2
  Suprasacral SCI typically results in colonic hyperreflexia and rectosphincter dyssynergia, leading to constipation and intermittent fecal incontinence.
• 3
  Conal and subconal SCI cause hyporeflexia or flaccidity of the colon, rectum, and sphincters, resulting in low pressure but uncontrolled fecal incontinence.