Functional Problems in the Patient with a Neurological Disorder

  • Jeanette Gaw
  • Walter E. Longo


Bowel dysfunction in patients with neurologic disorders is common. The symptoms of constipation and fecal incontinence have a tremendous impact on the quality of life of these patients. In order to successfully manage patients with neurogenic bowel dysfunction, one should take into account the unique needs and condition of each patient, along with the patient’s lifestyle, level of activity, and social goals. Dietary modification and increased activity may be supplemented by pharmacologic agents. A scheduled and individualized bowel regimen is also important, and there are new treatment modalities that can improve the bowel function of these patients, as have been outlined in this chapter. Because of the complexity of the problems and the variability of symptoms, there is no hard data in terms of recommendations for managing these patients. The ideal bowel program for each individual often is achieved by trial and error. It is clear that meticulous attention to diet, hydration, use of bulk forming agents, exercise, and the selective use of stimulants remains a crucial part of bowel management in these cases. In refractory cases, the coloproctologist may give strong consideration to an intestinal stoma after appropriate patient and family counseling—a procedure that can be met with very satisfactory results and a normal quality of life in many cases.


Spinal Cord Injury Colonic Motility Bowel Dysfunction Colonic Transit Time Anorectal Function 
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Copyright information

© Springer-Verlag London Limited 2005

Authors and Affiliations

  • Jeanette Gaw
    • 1
  • Walter E. Longo
    • 2
  1. 1.Department of SurgeryYale University School of MedicineNew HavenUSA
  2. 2.Department of Surgery, Section of Gastrointestinal SurgeryYale University School of MedicineNew HavenUSA

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