Intestinal issues are not fun for anyone. As a registered dietitian and someone living with a spinal cord injury, conversations about bowel habits are very common whether I like it or not.
Constipation has many causes, from lack of fluid or fiber in the diet, inflammatory bowel disease, irritable bowel syndrome, medications and much more. However, people living with neurological conditions like spinal cord injuries, spina bifida, multiple sclerosis, and other conditions may also have a condition called neurogenic bowel. Neurogenic bowel occurs when certain areas of the nervous system are disrupted or damaged. Signals from the brain to the intestines are interrupted, which results in an inability to control bowel movements.
Neurogenic bowel can be managed by following a scheduled bowel program. People may rely on various combinations of suppositories, enemas, and digital stimulation. This is often done on a regular schedule, such as daily or every other day. In some cases, surgical intervention may be necessary which require more specialized nutrition recommendations. Also, presentation can vary among individuals and others may struggle more with diarrhea, but for this post I am focusing on those using more conservative management that are dealing with constipation.
How can neurogenic bowel cause constipation?
Because the intestines are moving slower, stool takes longer to move through your intestines. This allows more water to be reabsorbed into your body. As water is removed from your intestines, the stool becomes harder resulting in constipation. And this can be very frustrating!
But don’t worry, there are things you can do to prevent issues with constipation.
Hydrate.
Drinking enough fluid throughout the day is an important part of preventing constipation. Your body is very picky about the amount of water it needs. If you’re not drinking enough fluid throughout the day, your body will pull water from your intestines resulting in harder stool. You’ve probably heard you need eight glasses of water a day. However, exact fluid needs can vary greatly from person to person and are based on things like weight, age, and activity. A good place to start for most people is being aware of your thirst signals and even checking your urine color! It should be a clear or pale yellow, anything darker could indicate dehydration. Something I also do to stay hydrated is to never leave the apartment without my water bottle.
In addition to water, stay hydrated by drinking other fluids like milks, tea, and even eating foods with a high water content such as watermelon, cucumbers, and carrots.
Eat Fiber.
Consuming a combination of both soluble and insoluble fiber helps increase stool bulk and help in its movement through your intestines. This is because fiber is not digested in your small intestine, but passes through both small and large intestines before being excreted. It is recommended to get 25-30g of fiber a day. But be careful! Increasing fiber too quickly can result in unwanted GI side effects. This can also backfire if you don’t drink enough fluid.
Good fiber sources:
- Oats and whole grains
- Legumes
- Fruits and vegetables
Get moving.
Whether you are walking or rolling, being active can help with constipation.
Medical management
If nothing else works, medications may be needed to help maintain your desirable stool consistency. These can include laxatives, fiber supplements, and stool softeners. Ideally these are only used for short amount of time, as long term use can result in dependence on these medications or other side effects. Your doctor will be able to tell you if this is something you should consider.
What works for you may not work for someone else. Also, keep in mind that severe constipation can cause major issues within your body. If you notice any changes in your bowel habits, speak to a medical professional.
Such an important topic to address with any population, but specifically in those with neurological injuries. Great comprehensive list. Thanks!