Bowel Problems - Symptoms & Causes

Neurogenic bowel can be described as slow movement of stools, constipation, bowel leakage, and difficulty emptying the bowel. Control of the external anal sphincter muscles may also be disrupted, increasing the risk of bowel accidents. 

There are two main types of neurogenic bowel dysfunction:

• Reflex bowel  
• Flaccid bowel

Reflex bowel

Reflex bowel causes loss of the ability to feel when the bowel is full. Although the anal sphincter muscle (the muscle that keeps the anus closed) remains tight, it will open on a reflex basis when the rectum becomes full and, therefore, the bowel can empty at any time. Reflex bowel can occur when the spinal cord is damaged above the T12 level.

Flaccid bowel

Flaccid bowel is when the anal sphincter muscle (that normally keeps the anus closed) becomes relaxed and stays open, often leading to accidental emptying of the bowel. Flaccid bowel is generally caused by damage below the T12 level.

One cause of neurogenic bowel is spinal cord injury (SCI). The impact on bowel function depends on the level of spinal cord injury and where the damage occurs (as mentioned above).

Other possible causes of neurogenic bowel include multiple sclerosis, spina bifida and Parkinson’s disease. 

Find out more

If you have neurogenic bowel it can be properly managed. Learn more about symptoms and how to take care of your bowel.

Bowel symptoms can vary depending on the underlying cause. The most common bowel problems people experience are:

Bowel leakage

Bowel leakage is the involuntary passage of stool e.g. you cannot control when stool is released, often resulting in bowel accidents.

Constipation

There is no exact science to what constitutes constipation as the symptoms vary from person to person. It is often characterized by decreased bowel movements (less than 3 times a week) and straining at defecation.

Overflow incontinence

This is a combination of bowel leakage and constipation. You can be constipated, but still experience loose stool that leaks past the hard stool.

Typical symptoms of bowel leakage

• Feeling the urge to have a bowel movement but not being able to control when your bowels release stool, resulting in a bowel accident (urge incontinence)
• Leaking stools (passive incontinence)
• Soiling of underwear
• Being unable to control loss of stool when you pass air (flatus)

Typical symptoms of constipation

• Inability to have a bowel movement
• Bloating
• Discomfort
• Severe stomach ache
• Spending long amounts of time trying to pass stool

When to get in contact with your healthcare provider

A lot of people who experience bowel problems may be reluctant to go and talk to their healthcare provider, as bowel problems are very private, personal, l and potentially an embarrassing subject. It is important to go and seek help, otherwise you may find that your bowel problems start to impact your daily life. 

Test your bowel symptoms

If you are experiencing episodes of fecal incontinence and/or chronic constipation, we recommend you to consult your health care provider To prepare yourself for the consultation, you can take a simple self assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment option.
Test your bowel symptoms now.

Find out more

Read more about causes of bowel problems and how to manage of your bowel.

It is important to understand that having bowel problems are not disease. There is usually an underlying cause as to why your bowels may not be functioning properly. Common causes of bowel problems can be related to either neurogenic or non-neurogenic disorders.

Neurogenic disorders

If you have a neurogenic disorder, you may have neurogenic bowel as it is likely the nerves in your spinal cord, controlling bowel function, are damaged. Some neurogenic conditions causing bowel problems include:

• Spinal cord injury
• Multiple sclerosis
• Spina bifida  
• Parkinson's disease

Non-neurogenic disorders

Bowel problems can also be caused by a number of non-neurogenic conditions including:

• Obstetric trauma - complications after childbirth, where the sphincter muscles have been damaged leading to the inability to control when you go to the toilet. 
• Cancer of the colon or rectum: Cancer of the colon or rectum describes the uncontrolled growth of cells that may cause bowel dysfunction. Some people have an inherited condition called familial polyposis, where large numbers of projecting, swollen and thickened areas of membrane called polyps, which develop on the inner lining of the colon. These polyps can eventually become cancerous.
• Anorectal malformation from birth - even with surgical correction, you can still experience bowel leakage episodes. 
• Inflammatory bowel disease: Inflammatory bowel disease (IBD) is a collection of conditions characterized by inflammation of the large and/or small intestine. 

Test your bowel symptoms

If you are experiencing episodes of fecal incontinence and/or chronic constipation, we recommend you to consult your healthcare provider. To prepare yourself for the consultation, you can take a simple self-assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment option.

Test your bowel symptoms now.

Find out more

Read more about neurogenic bowel and how you take care of your bowel.

This FAQ is intended as a guide to commonly asked questions. You should always consult your healthcare provider regarding bowel problems and bowel management routines.

How does the bowel work?

The bowel is the last section of the digestive system and is divided into the small intestines and the large intestines (the colon, rectum and anus). The main function of the small intestine is to absorb nutrients from food digested in the stomach. The main function of the large intestine is to absorb water and to form stools from any waste products that cannot be used by the body. Stools are discharged from the body via the rectum and anus. View a video animation of how the bowel works.

What is bowel leakage?

Bowel leakage occurs when you cannot control when your bowels open, resulting in a bowel accident. The condition can range from minor leakage and soiling of underclothes to complete and uncontrolled emptying of the rectum. 

What is constipation?

The symptoms vary from person to person but are often characterized by decreased bowel movements, bloating, discomfort, straining and spending long amounts of time try to pass stool. 

What are the causes of bowel problems?

Bowel problems can be caused by a number of different conditions – some relatively minor and some potentially life threatening. Neurogenic causes include spinal cord injury, spina bifida and multiple sclerosis. Non-neurogenic causes include obstetric trauma (sphincter muscle damage after childbirth), cancer of the bowel or colon, Inflammatory bowel disease. This list is by no means exhaustive.

What is neurogenic bowel?

Neurogenic bowel is a condition where there is damage to the nerves that control bowel function. The effect on bowel function depends on where the spinal cord is damaged.

How can bowel problems affect my lifestyle?

Bowel leakage and constipation can be very uncomfortable, and they also have a significant impact on our quality of life. Apart from the frequent physical discomfort and bloating, you may worry about having an accident in public. It makes it important to find a way to manage your bowel.

What can I do to manage my bowel problems?

Bowel problems can often be improved by changing diet; there are also several types of medication that can help. Transanal irrigation can be used to help prevent constipation and bowel leakage.

How can I prepare for my conversation with my doctor?

To prepare yourself for the consultation with your health care provider, you can take a simple self-assessment test that both indicates the severity of your symptoms and gives your doctor relevant insights to decide on a proper treatment option.

Test your bowel symptoms now.

Find out more

Read more about Peristeen® Plus,* a bowel irrigation system, for predictable bowel management.

Important Safety Information:  Peristeen® Plus empties the bowel by introducing water into the bowel using a rectal catheter. The anal irrigation procedure should always be carried out with care. Bowel perforation is an extremely rare, but serious and potentially lethal complication to anal irrigation and will require immediate admission to hospital, often requiring surgery. The risk information provided here is not comprehensive. To learn more, talk to your healthcare provided to understand the risks and benefits to determine if Peristeen is right for you. This treatment is prescribed by your physician. Although many patients benefit from the use of this device, results may vary.

This FAQ is intended as a general guide meant to help you with typical questions. You should always follow the specific instructions provided by your healthcare provider.

What is bowel irrigation?

Bowel irrigation is where water is introduced into the bowel using a rectal catheter. The water stimulates the bowel and flushes out the stool, leaving the lower half of the bowel empty. It is important to do it regularly to prevent constipation and the risk of bowel accidents. Read more about Coloplast’s bowel irrigation system, Peristeen® Plus.*

Where can I get Peristeen® Plus?

In order to use Peristeen® Plus, you need to get a prescription from your physician or nurse. You must also always consult an experienced healthcare professional before starting up the irrigation procedure and you must receive thorough instruction from a healthcare provider before using this product.

How often should I irrigate?

Most people start with irrigating every day. It can take approximately 3 months to establish a regular routine. Once you have an established routine, irrigating every other day may work well. With time and practice, you will find out what works best for you. What is important, is to remember to irrigate regularly to prevent constipation and minimize the risk of bowel accidents. You should always follow the advice and instructions of your healthcare provider.

What time of the day is best for irrigating?

Try to get into a routine where you irrigate around the same time of the day. Eating and drinking helps the bowel’s natural movement, so about 30 minutes after a meal is a good time. But do not be afraid to change the routine slightly to suit your day-to-day routine. Remember, users performing anal irrigation should always follow the advice of their healthcare provider.

Can I travel with the irrigation equipment?

Yes – remember to bring your irrigation system along with lots of disposable catheters as you may not be able to buy them everywhere. If you are going to use the system abroad or in another country use bottled or cooled boiled water in places where the tap water is not safe to drink. Remember in different time zones your body may take a while to get used to a new routine. You may also be eating different types of food, which can affect the bowels.

What should I do if I leak between irrigations?

If you experience bowel leakage between irrigations, it may be due to insufficient emptying of your bowel due to constipation or hard stool. Alternatively, you may be using too much water during irrigation. Contact your doctor or nurse to help you adapt to your bowel plan and optimize your new bowel management program.

* Important Safety Information:  Peristeen® Plus empties the bowel by introducing water into the bowel using a rectal catheter. The anal irrigation procedure should always be carried out with care. Bowel perforation is an extremely rare, but serious and potentially lethal complication to anal irrigation and will require immediate admission to hospital, often requiring surgery. The risk information provided here is not comprehensive. To learn more, talk to your healthcare provided to understand the risks and benefits to determine if Peristeen® Plus is right for you. This treatment is prescribed by your physician. Although many patients benefit from the use of this device, results may vary.