Sarah Arnold, Associate in the Higgs LLP Personal Injury team, takes a candid look at an often-overlooked problem following spinal cord injury: bowel care.
A spinal cord injury (SCI) can affect many aspects of daily life, including bowel movements.
If this is the case, it’s imperative a Bowel Care Programme is put in place by your healthcare professional to help make life as comfortable as possible.
At Higgs LLP, as part of our holistic approach to our clients, we are committed to supporting and signposting people to the right rehabilitation after a SCI – as well as progressing any compensation claim as a result of negligence.
Background
The bowel is part of your digestive system and its role is to break down what you eat and drink. As the bowel fills with stools it stretches, triggering messages to bowel muscles to move the stool down to the end of the large bowel, and the rectum. When it’s socially convenient we will control our abdominal and pelvic muscles to allow us to empty the rectum to pass a stool, known as a bowel movement.
The colon is controlled mainly by nerves leaving the spinal cord at level of T6-T12 (lower thoracic vertebrae). These nerves control the movement of abdominal muscles. The lower end of the colon is controlled by nerves leaving the spinal cord lower down at level S3-S5 (sacral vertebrae).
After a SCI, the messages sent by the nerves located in your bowel are not able to reach your brain as they did before. This means you will not get the message that tells you the bowel is full and it’s time to go to the toilet. You may also be unable to move the muscle at the opening from your back passage that controls when you have a bowel movement.
The extent of loss will depend upon your level of injury and the degree of your spinal damage. Being independent in bowel care is very much dependant on the level of your SCI, your general health and how strong you are.
Bowel care following SCI is crucial for assisting with the passing of stools. Bowel care includes all techniques, manoeuvres and medications used to achieve efficient and satisfactory stool passing.
It is therefore crucial to have in place a bowel care programme and personalised plan to help you regain control of your bowel after your SCI so as to improve your quality of life.
Your Bowel Care Programme
Your healthcare professional will assess your disability and identify your bowel function. This can be done by way of colon transit studies to provide information to confirm the speed of gut transit. The use of radiopaque capsule markers as well as an abdominal X-ray will be used.
Most importantly you will need to keep a bowel diary to record your daily bowel function. Every time you do your bowel care you will be asked to record important details such as the exact timing of your bowel habit, stool amount, consistency and colour as well as to record any problems with your bowel, such as unplanned bowel movements, abdominal cramps, pain, muscle spasms and rectal bleeding. You will also record your diet (fibre amount), your daily fluid intake, your activity level, and all the current medication you are on. All this information will help to precisely assess your bowel programme.
Factors to take into account when planning your bowel care plan:
Toilet aids:
Whichever method you chose needs to be approved by a healthcare professional and if you’re having problems with your bowel programme you should advise your healthcare professional immediately.
Complications can include but are not limited to:
If you or your loved ones have been unfortunate to suffer a spinal cord injury as a result of an accident then our specialist team at Higgs can assist you in bringing a compensation claim and securing the best rehabilitation and care plan needed.
Higgs works in partnership with the Spinal Injuries Association to ensure everyone receives the very best support.
Higgs LLP is authorised and regulated by the Solicitors Regulation Authority number 819589.