Injury above T-12
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 defaecation 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
NOTE: Soft formed stool is advisable – this can be influenced by what you eat and drink
Outline of a bowel routine
Reflex bowel can be managed by triggering the defaecation 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
- Insert suppositories
- Transfer to toilet / shower chair OR lie on left side
- Abdominal massage, digital stimulation and/or digital evacuation may be used to help trigger the bowel movement
- Note: These methods are covered in more detail under Interventions
