After a spinal cord injury (SCI), the normal communication between the brain and the nerves that control bowel and bladder function may be disrupted. When this pathway is injured, these messages may be slowed, changed, or blocked. Because of this disruption, the body may not correctly sense when the bladder or bowels are full, and it may not be able to fully control when you empty.
These changes are often called neurogenic bowel and neurogenic bladder.
When communication between the brain and these systems is affected, the body may have difficulty:
- Recognizing when it is time to go
- Starting or controlling bowel or bladder emptying
- Fully emptying waste from the body
What you may notice:
Bladder changes (neurogenic bladder):
- Loss of bladder control (leakage or accidents)
- Difficulty knowing when the bladder is full
- Trouble fully emptying the bladder
- Needing to urinate more often or in small amounts
- Increased risk of urinary tract infections (UTIs)
Bowel changes (neurogenic bowel):
- Accidents or loss of bowel control
- Difficulty fully emptying the bowels
- Constipation (hard or infrequent bowel movements)
- Bloating, gas, or abdominal discomfort
- Changes in regular bowel routine or timing
Bowel and Bladder Programs
Even though bowel and bladder function may change after injury, there are safe and effective management programs that can help establish a routine, reduce complications, and improve independence. A bowel and bladder program is a structured routine designed to support regular elimination and reduce complications. These programs are based on your level and severity of spinal cord injury, daily routine and activity level, diet and fluid intake, and amount of physical assistance needed.
Goals of a bowel and bladder program are to:
- Promote regular bowel and bladder emptying
- Prevent accidents and leakage
- Reduce complications (infection, constipation, impaction)
- Improve comfort and quality of life
Programs are individualized, developed with your healthcare team, and adjusted over time.
Bowel and bladder changes after a spinal cord injury are common and can be managed with a consistent, individualized routine. These programs may take time to develop and adjust as your body and needs change. Your healthcare team is here to support you, answer questions, and help you find the safest and most effective approach. Please reach out to your healthcare team with any concerns or questions about your bowel or bladder program.