Neurogenic Bowel Management, Spina Bifida — Overview — Clinical Pathway: Outpatient Specialty Care

Neurogenic Bowel Management, Spina Bifida Clinical Pathway — Outpatient Specialty Care

Patient with Spina Bifida and Neurogenic Bowel Dysfunction

This pathway provides guidance for identifying and treating patients with Spina Bifida who have neurogenic bowel symptoms. Neurogenic bowel dysfunction is the loss of normal bowel function (i.e. impaired control of anal sphincter, decrease in functional nerve supply, prolonged transit time) affecting the body’s ability to store and eliminate waste properly.

Common neurogenic bowel symptoms
  • Lack of sensation for imminent bowel movement
  • Difficulty having a bowel movement, frequent accidents, stool leakage
  • Diarrhea
  • Constipation
  • Nausea or abdominal pain
Impact of effective bowel management on patient outcomes
  • Bowel incontinence is associated with lower quality of life in both children and parent assessment.
  • Quality of life scores improve with successful regimens.
  • Poor bowel management can be associated with medical complications such as UTIs, skin breakdown and bowel obstructions.
Exclusions Patients with the following:
  • Hirschsprung’s disease
  • Anorectal malformation (ARM/Imperforate Anus)
  • Cloacal exstrophy/OEIS Syndrome (omphalocele, exstrophy, imperforate anus, spinal defects)
  • Colostomy
  • Spinal-cord injury (SCI)
  • Sacrococcygeal teratoma (SCT)
  • Transverse myelitis
  • Colonic inertia
  • Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)