ABSTRACT
This chapter discusses bowel dysfunction management, with an emphasis on patients with spina bifida and spinal cord injury. The principles outlined can, however, be applied to all neurogenic bladder patients with bowel dysfunction, including those with degenerative spinal cord pathology, multiple sclerosis, diabetic autonomic neuropathy, or other etiologies. Bowel dysfunction is a serious condition very often seen in patients with neurogenic bladder. Practitioners working with neurogenic or neuropathic patients should actively assess and manage bowel dysfunction, as bladder control is of little value if fecal incontinence remains a problem. Improper management of neurogenic bowel may also adversely affect other organ systems, such as with recurrent urinary tract infections and ventrico-peritoneal shunt malfunction. Patient assessment and education on bowel care need to be initiated as early as possible in the disease process. There are no specific measures to assess the cumulative consequence on Quality of life compounded through the effects of fecal incontinence and bowel difficulty in conjunction with bladder problems.
