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Chapter 9 - Neurogenic bowel management

from Section 2 - Evaluation and management

Published online by Cambridge University Press:  06 December 2010

Clare J. Fowler
Affiliation:
The National Hospital for Neurology and Neurosurgery, Queen's Square, London
Jalesh N. Panicker
Affiliation:
The National Hospital for Neurology and Neurosurgery, Queen's Square, London
Anton Emmanuel
Affiliation:
University College London
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Summary

Evidence to support management of neurogenic bowel dysfunction remains sparse in comparison to other areas of care; such evidence as is available arises mostly from the spinal cord injury arena. This chapter discusses the clinical and investigational assessment, management of fecal impaction, gastrocolic reflex, abdominal massage, rectal stimulation, and feces evacuation methods. Dysfunction of the bowel has considerable implications for quality of life. Assessment of an individual for neurogenic bowel management is a multidisciplinary activity. Anorectal manometry tests can quantify more precisely the functional status of the anorectum. Irregular or too infrequent management is associated with incontinence and constipation. The majority of individuals with neurogenic bowel dysfunction will use the conservative methods to manage their bowel dysfunction. Biofeedback, Transanal irrigation, surgical interventions, and antegrade continence enema (ACE) are some useful options when conservative methods are not effective.
Type
Chapter
Information
Pelvic Organ Dysfunction in Neurological Disease
Clinical Management and Rehabilitation
, pp. 138 - 152
Publisher: Cambridge University Press
Print publication year: 2010

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