How Nerve Signals Affect Bowel Function
The intestines move stool through the bowel using a process called peristalsis, which is controlled by nerves. If the nerves are damaged or missing, the signals that tell the bowel to contract and push stool forward do not work correctly. This can cause stool to move too slowly, leading to constipation, or too quickly, leading to diarrhea or incontinence. Without proper nerve signals, the rectum may not empty completely, and stool can build up over time.
Neurogenic Bowel Management
While neurogenic bowel cannot be cured, it can be managed with different treatments to help children stay clean, comfortable and healthy. Common management options include:
- Diet and hydration: A high-fiber diet and plenty of fluids can help soften stool and promote regular bowel movements.
- Medications: Stool softeners or laxatives may be used to help move stool through the intestines.
- Scheduled toileting: Encouraging regular trips to the bathroom at the same time each day can help establish a routine.
- Digital stimulation and manual evacuation: In some cases, a caregiver may need to stimulate the rectum to trigger a bowel movement.
- Enemas and suppositories: These can be used to help clear the bowel on a regular basis and prevent accidents.
- Transanal irrigation: A special system that flushes out the bowel using water, reducing the risk of accidents.
- Surgical options: Some children benefit from procedures such as the Malone Antegrade Continence Enema, or MACE, where a small opening is created in the abdomen to allow for easier bowel flushing.
Each child’s bowel program is tailored to their needs and may require adjustments over time.