• The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

Bladder & Bowel

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Bladder paralysis
Normal bladder function If the bladder is empty, the bladder muscle (detrusor) relaxes and the sphincter contracts – the bladder is shut. The nerves connected to the bladder wall register the bladder stretching, and as it fills, they carry a message to the brain. During urination, the sphincter muscle relaxes deliberately to allow the opening of the urethra. What is the difference with a spastic bladder? Any information concerning the filling of the bladder is registered by the stretch...
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The condom catheter
Passing urine with a condom catheter The urine is drained into the bag using reflexes – this means rhythmical tapping (triggering) on the lower abdominal region above the pubic bone triggers the drainage of the bladder. This drainage technique only works in the case of spastic cystoparalysis. How does triggering work? Triggering enables a stimulation of the reflex arc1 – thus the emptying of the bladder can be controlled manually. This drainage technique stimulates the stretch...
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Catheterisation
Urination through catheterisation Catheterisation is mostly applied in people with spinal cord injury with a flaccid bladder. A local medical sedation can sometimes enable catheterisation in patients with a spastic bladder. In order to live as independently as possible, it is important to learn self-catheterisation – this is also feasible for tetraplegics with a low level of spinal cord injury. How often do I have to catheterise? At the beginning, self-catheterisation is required every 3 –...
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Indwelling catheter
What types of indwelling catheter are there, and what are the differences between them? A suprapubic urinary catheter is an indwelling catheter that is inserted into the bladder through the abdominal wall. This allows the urine to permanently flow out of the bladder without having to pass the urethra. There are different types of catheters and options to attach them. Often a small balloon is used to hold the catheter in the bladder. The catheter is covered with a dressing at the point of...
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Bladder stimulator
What is a bladder stimulator? A bladder stimulator is an implant with which the nerves of the bladder and bowel can be stimulated directly, enabling the bladder and bowel to be emptied. It can only be used on people with a complete spinal cord injury and spastic cystoparalysis. How does a bladder stimulator work? Signals are sent externally to an implanted receiver (D) using a controller (A), stimulating the nerves of the bladder and bowel (F). The signals cause the bladder muscle to...
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Urinary tract infections
A urinary tract infection (UTI) is an infectious disease of the efferent urinary tracts caused by pathogens. People with spinal cord injuries are at increased risk of suffering from a urinary tract infection. Urinary tract infections are identifiable through specific symptoms (symptomatic). The infection can spread into the kidneys and blood stream, leading to threatening clinical pictures. A distinction is made between acute (sudden, often with symptoms of the disease) and chronic...
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Bowel paralysis
Normal bowel function The emptying of the bowel (defecation) is a reflex-type process, but one which you can consciously influence. If the rectum1 is sufficiently full and therefore stretched, an impulse is sent through the nerves to the defecation centre in the spinal cord. This triggers the sensation “urge to defecate” in the cerebrum. The defecation centre controls the rectum muscles and triggers the relaxation of the anal sphincter and at the same time the contraction of the outer muscles...
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Techniques of defecation
Emptying the bowel should occur periodically (every one or two days) possibly around the same time. Doing so trains the bowel and therefore allows you to maintain or regain control over defecation. Habits You can help to regulate your bowel movements by paying careful attention to your habits and activities. Do you normally always empty your bowel in the morning? Or do you prefer to go to the toilet in the evening if there is sufficient time? What types of food aid your digestion? How do...
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Medical measures to promote defecation
Medical stimulation and the regulation of stool consistency are often necessary in order to control defecation in people with spinal cord injury (SCI). Laxatives1 can be hazardous to health, although many of them are herbal. The principle is: as little as possible – as much as necessary. Taking laxatives can induce a habituation effect – they are therefore not suitable for long-term use. Laxatives are chosen depending on how they work. A normal stool consistency (formed stools) supports...
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Meteorism (flatulence)
Flatulence is a common problem. Is it a problem for you too? People with spinal cord injuries are frequently affected due to a disorder in bowel functions. Flatulence caused by nutrition Flatulence can occur right after eating and be caused by the following foods, among others: Cabbage Herbs Onions and other bulbous plants High-fibre foods High-sugar foods Flatulence problems as a reaction to various foods differ from person to person. Also the way they are prepared may play an...
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Constipation
What is constipation? Constipation refers to bowel movements that are infrequent, hard to pass, small in quantity or hard and dry in consistency. There are different forms of constipation: chronic constipation, acute constipation and traveller’s constipation. Different forms of constipation Chronic constipation Due to reduced bowel peristalsis and a decreased level of physical activity, people with spinal cord injury are particularly likely to be affected by chronic...
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Bowel incontinence
Bowel incontinence is the involuntary loss of bowel contents, including flatus and faeces. The causes may be of neurogenic, muscular or textural nature. However, an individually-developed bowel management makes it possible to maintain continence and to mostly avoid incontinence issues. Specific forms of diarrhoea Diarrhoea is the technical term for loose stool. Diarrhoea is frequent defecation, often in liquid form. Diarrhoea often causes incontinence. Paradoxical diarrhoea In this form of...
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Changes at the anal opening
What are haemorrhoids? The haemorrhoid veins are part of the locking mechanism of the rectum and responsible for sealing the anus. The sealing works through different levels of filling of the blood vessels. If these vessels do not inflate and deflate properly and cause problems, it is called haemorrhoids. What are the symptoms of haemorrhoids? Anal bleeding Mild faecal soiling In case of existing sensitivity: anal itching anal burning What is an anal fissure? An...

Recommendations

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Changes at the anal opening
What are haemorrhoids? The haemorrhoid veins are part of the locking mechanism of the rectum and responsible for sealing the anus. The sealing...
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The condom catheter
Passing urine with a condom catheter The urine is drained into the bag using reflexes – this means rhythmical tapping (triggering) on the...
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Bladder stimulator
What is a bladder stimulator? A bladder stimulator is an implant with which the nerves of the bladder and bowel can be stimulated directly,...
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Breathing is the most normal thing in the world for us. We hardly think about it, even though we breathe in and out about 20,000 times per day. We breathe more when we are active and exerting ourselves, and we breathe less when we are...
Contractures
What are contractures and how do they develop? Contractures are shortenings of muscles, tendons or ligaments that have a limiting effect on the movements of the joints. The normal ability to move a joint is lost. Contractures are frequently...
Suctioning
In some cases, support is needed for cleaning the nasopharyngeal space and keeping it free from secretion. For this purpose, suctioning is performed through the nose and, if necessary, the mouth. This is particularly necessary if the nose cannot be...

About the Community
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2019-07-03 In Latest
UK’s “New” Disability Measures?
With 14 million people living with a disability in the country, the UK Prime Minister announced new measures last week to address the inequalities these people face. These measures include higher...
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2019-03-27 In Latest
Our new Community
Glad to have you back! We have done a lot to make sure that you find your way around quickly and feel at home – including this new section, where we regularly post latest tips, information, links,...
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Swiss Paraplegic Research
Guido A. Zäch Strasse 4
6207 Nottwil
Switzerland

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