How does bowel function change after SCI?

Authors: SCIRE Community Team | Reviewer: Bonnie Nybo | Published: 20 March 2018 | Updated: 23 October 2024

After an SCI, the nerve signals that would normally allow the brain and bowel to communicate with one another cannot get through. This can contribute to a number of bowel changes that are known as neurogenic bowel dysfunction.

Spinal cord injury can also interrupt nerve signals travelling from the brain to the anal sphincter muscles. This can lead to a loss of the ability to control when the anal sphincters tighten or relax, which cause difficulties emptying the bowel if they remain tightened all the time (stool retention) or leaking and accidents if they relax unexpectedly. The types of changes depend on whether you have spastic bowel or flaccid bowel (see below). SCI can also cause a loss of control over the pelvic floor and abdominal muscles, which also affects bowel control.

Charlie speaks about his initial fears of having a bowel accident while living in the community.

After an SCI, food continues to be digested and moved through the bowel. However, this movement happens at a much slower pace because signals from the brain that help coordinate this movement are blocked by the SCI. Slow movement through the bowel means that food takes much longer to digest, which can lead to dry, hard stools and constipation.

Normally, nerve signals are sent to the brain when there is a sensation that the rectum is full. When the signal are blocked by an SCI, this can reduce the ability to feel when the bowel is full or recognize other sensations from the bowel, like discomfort.