Neurogenic Bowel Dysfunction

Constipation: It is a condition characterized by difficulty in passing stools or infrequent bowel movements, which might occur due to nerve-related issues, insufficient water intake, inadequate physical activity, or side effects of certain medications.

Bowel Incontinence: Also known as loss of bowel control, this condition is characterized by the inability to hold a bowel movement until reaching a bathroom. It may occur due to nerve damage that interferes with signals to the brain, resulting in the involuntary release of stool.

Diarrhea: Refers to frequently passing loose, watery stools, causing a sense of urgency to use the toilet. It might occur alternately with constipation in superficial siderosis patients, indicating a serious gut motility problem that requires medical attention.

Alternating Constipation/Diarrhea: In some cases, constipation may block bowel movement, resulting in the buildup of loose, watery stools behind the blockage. Additionally, persistent constipation can stretch and weaken rectum muscles, impeding their ability to hold stool until reaching a toilet.

Management of Bowel Problems:

  • Hydration and Diet: Consuming at least 48 ounces (6 to 8 glasses) of water daily and adding fiber-rich foods to the diet can alleviate constipation.
  • Physical Activity: Regular physical exercise can help enhance bowel movements.
  • Medications: Discuss suitable over-the-counter options with your healthcare provider, such as stool softeners or bulk-forming supplements.
  • Manual Interventions: A healthcare provider may suggest enemas, suppositories, or manual stimulation to promote bowel movements.
  • Protective Wear: Absorbent protective wear might be helpful for light or occasional leakage.

Non-invasive Treatment Options:

  • Sacral Nerve Stimulation: Electrical impulses stimulate sacral nerves, enhancing their function in controlling bowel movements.
  • SECCA®: This involves delivering controlled radiofrequency energy to the anal canal to thicken tissues and improve sphincter muscle function.
  • Fenix®: It involves using a flexible band of titanium beads with magnetic cores to create a barrier to involuntary bowel leakage. The magnetic bond is temporarily broken to allow voluntary passage of stool and restored immediately thereafter.

Vacuum Bowel Evacuation

Also known as transanal irrigation or rectal irrigation, is a procedure used to assist with bowel evacuation in individuals who experience chronic constipation or fecal incontinence. It’s often used for individuals with conditions, such as spinal cord injuries or neurogenic bowel dysfunction, that naturally affect the body’s ability to eliminate waste.

The procedure works by introducing a specific amount of water (often warmed) into the bowel via the anus. The water helps to soften and break up fecal matter, making it easier to pass. The device then uses a gentle suction (the “vacuum” part of vacuum bowel evacuation) to remove the loosened fecal matter from the rectum. The procedure can be done at home, typically every 1-3 days, depending on the individual’s bowel program and needs.

Vacuum bowel evacuation can be very beneficial for certain individuals, helping to maintain regular bowel function, reduce episodes of constipation or incontinence, and improve the overall quality of life. However, as with any medical procedure, it’s important to receive proper instruction on how to perform it correctly, and it may not be suitable or necessary for everyone with bowel management issues. Therefore, discussing this and other potential options with a healthcare provider is always important.

Surgical Treatment:

  • Colostomy: This surgical procedure involves creating an opening (stoma) in the abdominal wall and attaching the colon to it. A disposable bag is fitted to collect stool, which can significantly alleviate symptoms in severe cases.

In comparison to spinal cord injury patients, individuals with superficial siderosis might have similar symptoms, but the underlying cause (i.e., deposition of iron in the brain and spinal cord tissues) is different. Treatment options are often similar but must be customized based on individual symptoms and overall health conditions. It’s important for patients to discuss all treatment options with their healthcare providers to find the most appropriate course of action.

Updated: June 14, 2023

Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairmentnystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthriahyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245
Living With SuperficialSiderosis Website PubMed Reference Library 
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