Bowel management

Bowel management

It can be one of your most distressing and embarrassing concerns if you have a spinal cord injury: how can I manage the loss of control over my bowel?

You’re likely to have lost sensation and control of when your bowels will empty, and you might also be prone to constipation. This is due to interruption of the nerve pathway between the brain and muscles in your rectum and anus.

So you need a plan and routine for how you’ll manage your bowel movements. This can help you feel more confident and ease your concerns.

People with spinal cord injuries have told us that being bowel incontinent is the biggest problem in their lives. It affects their confidence to leave the house, especially if they need more support with their routine. We can help by discussing options for bowel management

Debbie Green, our spinal cord injury nurse specialist

Bowel diary

To find a bowel management plan that works best for you, your healthcare professional may ask you to keep a record of your bowel movements for a few weeks. It should include when you emptied your bowels, what methods you used to do so and how the stool looked. Diet, drinking lots of fluids and exercise are essential for avoiding constipation.



For a non-disabled person, stools take around 31.5 hours to pass through the colon. For people with spinal cord injuries, the average time is 86.6 hours, which leads to a high risk of constipation

Regular bowel movements

With diet, mediation and correct interventions it’s possible to have a predictable bowel pattern while preventing constipation and embarrassing accidents. You can arrange to speak to one of our nurses here.

There are a few things you can do to help prevent constipation outlined below.


Eat a well-balanced high soluble fibre diet.


Drink two-three litres of fluid a day (unless told otherwise by a heathcare professional).


If you’re able remain active, pushing your wheelchair a mile or so a day can help to prevent constipation.

Gastrocolic reflex

Have a warm drink or food about 20-30 minutes before you want your bowel to open. This can help to stimulate contractions and emptying of the bowel.

If a predictable bowel pattern cannot be achieved with diet, medication and simple interventions alone there are other options to consider.

Trans-anal irrigation

This involves instilling a large volume of water into the rectum with a special kit. You or a carer can be taught to do this.


A colostomy can be life-changing. It’s when you have surgery to reroute your large intestine so that it empties on the outside of your stomach into a bag. People may choose to have a colostomy if it becomes difficult to manage their bowel care routine. It can also help you become more independent and ease worry about accidents.If you’d like to consider any of these options, talk to your GP.   You can also download our Colostomy fact sheet or speak with one of our SCI specialist nurses

More information

Go to the bladder and bowel community website for information on bowel-related problems

Get a RADAR key when you sign up to SIA Healthcare

Need support?

We understand that adapting to managing your bowel movements can be tough on your self-esteem and mental health. Whether you need practical advice and information or to speak to someone about your mental health and well-being we have services available to support you.  In the first instance contact our SCI nurses for support and information.