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Review
. 2019 Oct 28:8:F1000 Faculty Rev-1800.
doi: 10.12688/f1000research.20529.1. eCollection 2019.

Neurogenic bowel dysfunction

Anton Emmanuel  1
Affiliations
Review

Neurogenic bowel dysfunction

Anton Emmanuel. F1000Res. .

Abstract

The symptoms of neurogenic bowel dysfunction (NBD) comprise constipation and fecal incontinence. These have a major impact on quality of life and dignity. Bowel symptoms occur in the majority of patients with chronic neurological diseases like multiple sclerosis, spinal cord injury, and Parkinson's disease. Management relies on obtaining a careful bowel history, including assessment of bowel function prior to the onset of neurological symptoms. Objective measures of NBD are available and important in terms of monitoring response for what are often intensely personal and difficult-to-elicit symptoms. Conservative management begins by establishing an effective and regular bowel regime by optimizing diet and laxative use. If this is insufficient, as seen in about half of patients, transanal irrigation has been shown to reduce NBD symptoms and improve quality of life. Failing that, there are more invasive surgical options available. This review aims to provide practical guidance for the clinician who encounters these patients, focusing on a stepwise approach to assessment, interventions, and monitoring.

Keywords: Bowel Dysfunction; Constipation; Faecal incontinence; Neurogenic Bladder.

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Conflict of interest statement

Competing interests: The author has served on advisory boards for Coloplast, McGregor Healthcare, Wellspect. No competing interests were disclosed.No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Care options for the management of neurogenic bowel dysfunction.
Font size reflects the frequency of the options being used. Color gradation: green = conservative, orange = minimally invasive, red = invasive .
See this image and copyright information in PMC

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