Peristalsis is the involuntary muscular contraction that moves digested food through the intestines. Spinal cord injury (SCI) changes your peristalsis. Instead of food passing through the body every 18-24 hours after eating a meal, for those with spinal cord injury it can be up to twice as long.
Regular bowel movements are essential to remove toxins from your body. If waste is sitting in your colon for too long, it can lead to a greater risk of constipation, gas, hemorrhoids, colon distension, and a buildup of toxins in the colon.
Standard bowel management for individuals with SCI often includes a combination of pharmacological and non-pharmacological approaches, including stool softeners, laxatives, rectal suppositories, enemas, and/or digital stimulation. Some of these approaches, however, may become ineffective over time as they can deplete minerals from your body, lead to dehydration, and cause the bowel to become dependent on these medications.
The goal of managing neurogenic bowel is to keep your stool soft, well-formed, and moving through the intestine as efficiently as possible while avoiding bowel incontinence (accidents). Neurogenic bowel is the loss of normal bowel function and is common in those living with SCI.
Something that might not be used in standard treatment is the use of nutrition. What and when you eat and how much you drink have a major impact on your digestive tract and can be the difference between a good routine and a disastrous one.
Constipation is the biggest gastrointestinal complaint after SCI. Some common causes include low fiber intake, low water intake, eating too many refined and processed foods, high protein intake, or side effects of medications. Common symptoms of constipation include pebble-like stool, pain in the abdomen, loss of appetite, headaches, nausea, sweating, autonomic dysreflexia, and bowel accidents.
Increasing fiber intake helps able-bodied individuals increase the weight of the stool, propel the stool through the intestine, and increase the frequency of bowel movements. Recommended daily fiber intake for able-bodied individuals is 35-50 grams a day. However, studies have shown that increasing fiber in diets of individuals living with SCI does not have the same effect on bowel function, and the recommendation is 19-30 grams of fiber a day for those living with SCI.
There are two main types of fiber, and you need both to prevent constipation. Soluble fiber forms a gel-like substance that helps prevent and alleviate constipation by making the stool softer, moister, and more pliable. Good sources of soluble fiber include barley, beans, peas, oats, apples, apricots, bananas, berries, figs, grapes, prunes, peaches, and pears. Insoluble fiber passes through the intestine relatively unchaged and adds bulk to stools which help push matter through your colon and relieve constipation. Good sources of insoluble fiber include seeds, whole grains, and the skins of many fruits and vegetables such as sweet potatoes.
Your large intestine is responsible for reabsorbing excess water out of digested matter and putting it back into your body. When you are dehydrated, your body will suck out more water from your colon, resulting in more solid stools which are harder to pass.
Drinking 8-10 cups of healthy fluids such as water, herbal teas, diluted juices, and broths is an important part of preventing constipation and maintaining a good bowel program. It’s also important to limit alcohol, coffee, and soda, which are diuretics and can contribute to dehydration.
Eating good, healthy fats and magnesium-rich foods contribute to maintaining a healthy bowel program. Healthy fats, such as omega-3 can help lubricate your bowel and soften hardened stool. Good sources include flax seed oil and fish oil. Then, magnesium-rich foods can be used as a natural laxative as they help relax intestinal muscles to help move stool through your colon. Magnesium-rich foods include bran, sunflower seeds, sesame seeds, black beans, and quinoa.
