Medical and surgical administration of neurogenic bowel.
Curr Opin Urol. 2016 Jul;26(four):369-75
Authors: Gor RA, Katorski JR, Elliott SP
PURPOSE OF REVIEW: Neurogenic bowel dysfunction (NBoD) generally impacts sufferers with spina bifida, cerebral palsy, and spinal wire harm amongst different neurologic insults. NBoD is a big supply of bodily and psychosocial morbidity. Treating NBoD requires a diligent relationship between affected person, caretaker, and supplier in establishing and sustaining a profitable bowel program. A nicely designed bowel program permits for normal, predictable bowel actions and prevents episodes of fecal incontinence.
RECENT FINDINGS: Remedy choices for NBoD span conservative way of life adjustments to fecal diversion relying on the character of the dysfunction. Way of life adjustments and oral laxatives are efficient for a lot of sufferers. Sufferers requiring extra superior remedy progress to transanal irrigation gadgets and retrograde enemas. These receiving enemas could go for antegrade enema administration by way of a Malone antegrade continence enema or Chait cecostomy button, that are more and more carried out in a minimally invasive style. Choose sufferers profit from fecal diversion, which simplifies care in additional extreme instances.
SUMMARY: Many medical and surgical choices can be found for sufferers with NBoD. Deciding on the suitable medical or surgical therapy entails a cautious analysis of every affected person’s bodily, psychosocial, monetary, and geographic variables in an effort to optimize bowel perform.
PMID: 27152922 [PubMed – indexed for MEDLINE]