Bowels respond to what is happening in your body and your world. If you have a change in diet or fluids due to illness or some other factor, the bowels will respond. Diet and fluids are just two parts of a whole scheme of things that make your bowels work efficiently. External and internal factors also play a part.
Your Diet
Eating a healthy diet is key to your general health as well as to your bowel function.
The bowels work by digested food from your stomach entering the bowel, first in the small intestine. At the top of the bowel, the chyme (food that is being digested) is very watery. Nutrients and fluid are withdrawn from the chyme throughout the entire length of the bowel.
As the nutrients and fluid are taken into the body, the chyme becomes thicker and thicker, eventually forming into a stool. When the chyme enters the large intestine, the stool becomes even thicker and is stored in the rectum for evacuation when desired.
A person with spinal cord injury (SCI) often does not feel hungry because the bowel is full. After a SCI, the bowel may become sluggish making the chyme slow to pass which creates a full sensation.
Fiber is very important to keep chyme moving through your system. Occasionally, extra fiber needs to be incorporated into the diet. The bowel wall is lined with minuscule fibers called cilia. These fibers sort of ‘grab on’ to the chyme to propel it along. If there is not enough roughage in the diet, the cilia cannot ‘grab on’ to watery chyme.
Maintaining a healthy diet helps your body to perform at its best which creates health. Too much sugar and oils can lead to diabetes and high cholesterol. Other nutrients should be eaten in moderation and in balance. A poor diet leads to a thinner chyme. Adding dietary fiber to your foods will help thicken chyme.
Fiber
Adding fiber is very helpful in making the chyme move through the bowel. There are a variety of psyllium products on the market that can add fiber. You can buy plain psyllium, or manufactured products.
It comes in powder, wafers, and cookies. Be sure to use the fiber products that do not contain sugar which can lead to insulin resistance and eventually diabetes or pre-diabetes. Follow the instructions of the product to ensure you take in enough water to moisten the psyllium, avoiding blockage.
Do not be surprised at the amount of stool in the bowel program with the use of psyllium. It greatly enlarges the stool volume with bulk which makes passage easier but also with larger results.
People can be surprised by the amount.
Fluid
Additional fluid helps to moisten the bowel for better function. You will have to maintain your fluid amount for your bladder program if using intermittent catheterization. Otherwise, check with your healthcare professional to see if you can increase your fluid intake.
In particular, the bladder program, heart conditions, and some instances of edema can restrict your fluid intake. As always start slowly. Taking in large amounts of water too quickly can overload your entire body system and even lead to incontinence.
Small sips throughout the day are the best way to increase your intake of water. You do not need to increase by cups of fluid quickly, increase slowly, just a sip or two at a time. A sip or two every hour when you are awake can add enough fluid to help your bowel.
Stool consistency
The stool should be a solid, firm consistency. Not too moist and not too dry. The unusual thing about hard or soft stool is that either way, adding fiber helps bulk up stool and makes for easier passing within the bowel. The stool can be softened using stool softener medication.
Hard stools are difficult to pass. They can over stretch the bowel as well as become so hard that an impaction develops. An impaction is stool that is blocking the bowel. Typically, no stool will pass but sometimes, liquid stool will pass around the impaction which can be confused with diarrhea. An examination can determine if there is an impaction in the lower bowel, but an x-ray is needed to establish if an impaction is higher in the bowel. Manual removal is the method for lower bowel impaction removal. Impactions higher in the bowel might require an enema or oral laxatives.
Vomiting can be the result of indigestion or illness. But it can also be due to an impacted bowel. If stool cannot move downward, it will back up through the digestive tract. Vomiting might be an indication of an impaction. You will need to look at vomit to see if there are any flakes of brown if you suspect an impaction. The flakes or flecks in vomit can be the first sign of the bowel working in reverse. Later, the flakes will be more abundant. Your vomit or breath may smell like stool.
Diarrhea is liquid stool. It occurs when the chyme moves too quickly through the bowel without time for the water and nutrients to be removed. This can occur for a variety of reasons. Illness is the primary cause. Plus, gastric distress, stress, and anxiety can create an environment in your bowel for diarrhea.
If you develop diarrhea, you will need to eat bland foods so as not to aggravate the bowel further. An example of a bland diet is the BRAT diet which stands for Bananas, Rice, Apple sauce, and Toast. Drink electrolyte balanced fluids. Diarrhea can dehydrate you quickly. You may even need medical attention.
Bowel Nerve Function
Individuals with spinal cord injury have difficulty with their bowels because of a slowing of the bowel function by the nerves of the Autonomic Nervous System (ANS) called neurogenic bowel. This nerve system slowing combined with decreased body movement affects bowel function. There is a redundant nerve system within the bowel that is also controlled by the ANS.
Many people think that because the bowels are slow, the problem is constipation. This is not the source of the problem. Treatment for constipation will not assist a neurogenic bowel to work more efficiently.
A bowel program will result in controlled bowel movements with a neurogenic bowel. Individuals with or without a spinal cord injury can become constipated. You can have a neurogenic bowel and constipation. Fiber can help with both.