TY - JOUR
T1 - Medical and surgical management of neurogenic bowel
AU - Gor, Ronak A.
AU - Katorski, Jenna R.
AU - Elliott, Sean P.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Purpose of review Neurogenic bowel dysfunction (NBoD) commonly affects patients with spina bifida, cerebral palsy, and spinal cord injury among other neurologic insults. NBoD is a significant source of physical and psychosocial morbidity. Treating NBoD requires a diligent relationship between patient, caretaker, and provider in establishing and maintaining a successful bowel program. A well designed bowel program allows for regular, predictable bowel movements and prevents episodes of fecal incontinence. Recent findings Treatment options for NBoD span conservative lifestyle changes to fecal diversion depending on the nature of the dysfunction. Lifestyle changes and oral laxatives are effective for many patients. Patients requiring more advanced therapy progress to transanal irrigation devices and retrograde enemas. Those receiving enemas may opt for antegrade enema administration via a Malone antegrade continence enema or Chait cecostomy button, which are increasingly performed in a minimally invasive fashion. Select patients benefit from fecal diversion, which simplifies care in more severe cases. Summary Many medical and surgical options are available for patients with NBoD. Selecting the appropriate medical or surgical treatment involves a careful evaluation of each patient's physical, psychosocial, financial, and geographic variables in an effort to optimize bowel function.
AB - Purpose of review Neurogenic bowel dysfunction (NBoD) commonly affects patients with spina bifida, cerebral palsy, and spinal cord injury among other neurologic insults. NBoD is a significant source of physical and psychosocial morbidity. Treating NBoD requires a diligent relationship between patient, caretaker, and provider in establishing and maintaining a successful bowel program. A well designed bowel program allows for regular, predictable bowel movements and prevents episodes of fecal incontinence. Recent findings Treatment options for NBoD span conservative lifestyle changes to fecal diversion depending on the nature of the dysfunction. Lifestyle changes and oral laxatives are effective for many patients. Patients requiring more advanced therapy progress to transanal irrigation devices and retrograde enemas. Those receiving enemas may opt for antegrade enema administration via a Malone antegrade continence enema or Chait cecostomy button, which are increasingly performed in a minimally invasive fashion. Select patients benefit from fecal diversion, which simplifies care in more severe cases. Summary Many medical and surgical options are available for patients with NBoD. Selecting the appropriate medical or surgical treatment involves a careful evaluation of each patient's physical, psychosocial, financial, and geographic variables in an effort to optimize bowel function.
KW - antegrade continence enema
KW - cerebral palsy
KW - fecal incontinence
KW - neurogenic bowel dysfunction
KW - spina bifida
UR - http://www.scopus.com/inward/record.url?scp=84965082149&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84965082149&partnerID=8YFLogxK
U2 - 10.1097/MOU.0000000000000299
DO - 10.1097/MOU.0000000000000299
M3 - Review article
C2 - 27152922
AN - SCOPUS:84965082149
SN - 0963-0643
VL - 26
SP - 369
EP - 375
JO - Current Opinion in Urology
JF - Current Opinion in Urology
IS - 4
ER -