Injury above T-12

Bowel Management

Injury above T-12

spinal_cord1a (1)If the injury is above the T-12 level, the ability to sense a full rectum may be lost. The anal sphincter remains tight, however, so bowel movements will occur on a reflex basis. This means that when the rectum is full, the defecation reflex will occur. This is called an upper motor neuron or reflex bowel.

  • Injuries to T12 and above result in a reflex bowel and spastic sphincter
  • Management is based on stimulation of reflexes
  • Soft formed stool advisable – this can be influenced by what you eat and drink

Outline of a bowel routine

Reflex bowel can be managed by triggering the defecation reflex at socially appropriate times and places:

  • Set up a daily or alternate day routine
  • Take oral medication approx 12 hours before evacuation
  • Make sure you have breakfast – and a hot drink

The procedure

  1. Insert suppositories
  2. Transfer to toilet / shower chair OR lie on left side
  3. Abdominal massage, digital stimulation and/or digital evacuation may be used to help trigger the bowel movement (these are covered in more detail under Interventions)