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Neurogenic Bowel Dysfunction

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Neuro-Urology

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Abstract

Individuals suffering from a central neurological condition often experience neurogenic bowel dysfunction (NBD). NBD is defined as a dysfunction of the colon, rectum, and anus, resulting in constipation, fecal incontinence, and disordered defecation, due to loss of normal sensory and/or motor control as a result of central neurological disease or damage. The neurogenic function may be (hyper)reflexic, areflexic, or mixed.

NBD often has a severe impact on the quality of life (QoL) of individuals involved. Surprisingly, despite its high prevalence in neurologically affected individuals, NBD has received much less attention by the medical providers compared to bladder dysfunction.

Depending on the severity and type of the NBD, the tendency of the individual to be constipated or fecally incontinent, and the available resources surrounding the individual, an individualized bowel management program needs to be established. Possible interventions are modulation of stool consistency, promotion of colon transit time, and mechanical evacuation of stool. Transanal bowel irrigation has received increasing attention in adults. Surgical measures could be a continent catheterizable (appendico)stoma, percutaneous cecostomy, or enterostomy. Nerve stimulation techniques can be an option in well-selected patients.

Non-operative treatment of NBD appears to be successful in 60–90% of NBD patients. However, limited evidence is available evaluating interventions for NBD and its impact on QoL.

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Authors and Affiliations

  1. Department of Surgery-Pediatric Surgery, Radboudumc-Amalia Children’s Hospital, Nijmegen, The Netherlands

    Herjan van der Steeg & Ivo de Blaauw

  2. Department of Surgery, Radboudumc, Nijmegen, The Netherlands

    André J. A. Bremers

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  1. Herjan van der Steeg
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Correspondence to Herjan van der Steeg .

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  1. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA

    Roger Dmochowski

  2. Department of Urology, Radboud University, Nijmegen, The Netherlands

    John Heesakkers

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van der Steeg, H., Bremers, A.J.A., de Blaauw, I. (2018). Neurogenic Bowel Dysfunction. In: Dmochowski, R., Heesakkers, J. (eds) Neuro-Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-90997-4_18

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