SOME IMMEDIATE CONCERNS FOR PEOPLE WITH SPINAL CORD INJURY: BOWEL AND BLADDER CARE

Some people find the loss of control of basic bodily functions – urination and bowel movements – one of the most difficult and frustrating aspects of their injury. Use of a urinary catheter becomes part of the daily routine for many people with spinal cord injury. The catheter is a rubber tube that is inserted into the bladder through the urethra, the opening through which urine leaves the body. Going to the bathroom is part of daily human life, and a private one at that. It is not usually a planned part of the day. Now you may have to empty your bowel or bladder on a timed schedule to prevent incontinence.
Your level of injury dictates whether you’ll be able to manage the insertion, emptying, and cleaning of the catheter yourself. Many people with paraplegia can care for themselves, but people with damage higher in the spinal cord cannot and they require the help of a family member or attendant. Some patients use a Foley or indwelling catheter, which empties into a drainage bag that can be taped to the leg or hang over the bed rail at night. An external catheter (sometimes called a condom catheter) can be used by some men whose bladder empties spontaneously but unpredictably.
Bowel movements usually require stimulation of the anal sphincter with a suppository or a gloved finger. Stimulation of the bowel on a regular schedule is called a bowel program; this can “train” your bowel to empty on a schedule and help avoid accidents. In some cases, patients may initially need to have stool removed manually by a nurse or aide.

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