1. Gastrocolic Reflex
2. Colocolic Reflex
3. Rectocolic Reflex
4. Anorectal Reflex
5. Frequently Asked Questions
6. References

The digestive and excretory processes working together

The process of digestion and excretion will begin as soon as you take that first bite of your favourite dish. When food first enters your mouth, your teeth immediately begin to grind it up into smaller bits, which makes it much simpler for you to swallow. In addition, the enzymes in your saliva, such as amylase, which are responsible for the digestion of carbohydrates, begin to break down the food as it passes through your mouth.

The digestive process will continue once the food has been swallowed and has reached the stomach. Proteins are broken down even further by the stomach’s production of gastric acids and enzymes like pepsin, among others. Additionally, gastric acids aid in the killing of any potentially dangerous bacteria that may be present in the food. After this, the food is ground up into a semi-liquid paste known as chyme, which is subsequently transported into the small intestine.

The process of digestion continues in the small intestine, where additional enzymes from the pancreas and bile from the liver and gallbladder are added to the chyme. This helps break down the food that has been consumed. The nutrients in the meal are absorbed through the wall of the intestinal tract and into the bloodstream. From there, they are carried to various regions of the body, where they are used for energy and growth.

After the nutrients have been absorbed, what is left is waste, which must then be eliminated, and this process takes place in the large intestine or colon. 

Gastrocolic Reflex

When food goes into the stomach, a reflex known as the gastrocolic reflex kicks in. This response is automatic. It causes the colon to contract, which in turn moves the faeces towards the rectum so that it can be eliminated later. This reaction is essential for controlling activities such as bowel motions and ensuring that food may flow through the digestive system as quickly and effectively as possible. 

It is vital to eat at the same time every day in order to stimulate the gastrocolic reflex. This will allow your body to better adjust and regulate your digestion, which will improve your overall health. The response will take place when food enters the stomach, creating a contraction in the colon, which in turn makes passing stool a more natural process. Consuming foods that are high in fibre can, on the other hand, cause the reflex to be triggered even more, which makes it simpler and less painful to defecate. When the gastrocolic reflex is not operating as it should, constipation can sometimes be an indication of the problem

Colocolic Reflex

Another response that takes place in the colon is known as the colocolic reflex. The colocolic reflex, in contrast to the gastrocolic reflex, is associated with the transverse colon, and more particularly, movements in the transverse region of the colon. The reflex takes place if there is either faeces or gas present in the transverse colon. This sends a signal to the descending colon, instructing it to transport the faeces towards the rectum. 

This reaction is essential to keep from becoming constipated. If the faeces are allowed to remain in the transverse colon or the descending colon, respectively, they dry out and become difficult to pass because of their consistency. If you experience the urge to defecate but are unable to do so, you may try applying pressure to the lower abdomen in an effort to manually activate the colocolic reflex. In addition, you can try getting up and moving around, practising squatting, or doing other activities that stimulate the bowels in order to assist in moving your colon.

Rectocolic Reflex

An alternative name for the rectocolic reflex is the enterogastric reflex. This reflex involves the passage of faecal matter into the rectum, which sends a message to the brain that it is time to initiate the process of defecation. The reflex works by relaxing the internal anal sphincter, which is an automatic muscle that opens up when faeces presses against it. This allows the stool to pass through the body more easily. While this is happening, the muscles in the pelvis tighten, which helps move the stool through the anal canal. 

You can stimulate the rectocolic reflex by sticking to a regimen when it comes to your bowel movements, creating an untense setting in which to defaecate, and keeping track of your bowel motions. In addition, maintaining healthy bowel habits, such as eating a diet that is high in fibre, being hydrated, and avoiding constipation are all things that can help this reflex function appropriately.

Anorectal Reflex

The anorectal reflex is the last reflex that is activated during the process of digestion and excretion. It entails the passage of faeces down the anal canal in order to complete the process. When faeces pass through the anal sphincter and into the anal canal, sensory nerves in the anal sphincter send impulses to the brain. These impulses tell the brain to move stool via the pelvic floor muscles and out the anus so that it can be eliminated. 

If you hold your bowel movements for an extended period of time, the anorectal reflex may lead you to become constipated. When you push too hard or for too long, you risk putting strain on the anal sphincter, which can result in pain as well as haemorrhoids. Maintaining healthy bowel habits such as drinking enough water, consuming foods high in fibre, relaxing during bowel movements, practising exercises that stimulate the bowels, and creating a regular pattern for defecation will assist optimise this reflex. Other healthy bowel habits include: relaxing during bowel movements, practising colon-stimulating exercises, and drinking enough water. 

Frequently Asked Questions

All right, without further ado, here are some questions and answers that are frequently asked regarding the several reflexes that are involved in the process of digestion and elimination:

After a meal, a typical question people ask is how long it takes for the gastrocolic reflex to kick in.

After a meal, it may take anything from half an hour to many hours for the gastrocolic response to manifest itself. A. In most cases, it is determined by the kinds of foods you consume and how your digestive system processes those foods.

Is it possible for stress to have an effect on the gastrocolic reflex?

A: The gastrocolic reflex can indeed be affected by stress, which can then lead to irregular bowel motions. The digestive system can be disrupted by stress, resulting in cramping and bloating, which can impact other reflexes in addition to the gastrocolic reflex.

How can I make the colocolic reflex work more effectively?

A: The colocolic reflex can be stimulated by being active and drinking plenty of water. This is the most effective method. Consuming a diet that is high in fibre can assist in the maintenance of regular bowel motions that are healthful. In addition, specific workouts like as squatting, walking, and stretches can assist in the activation of the colocolic reflex.

To what extent are drugs able to influence the rectocolic reflex?

Yes, the rectocolic reflex can be affected by some drugs, which can lead to gastrointestinal issues such as constipation or diarrhoea. If you are having these issues, you need to make an appointment with your physician so that he or she can increase the dosage of your medicine or suggest other possible solutions.

What are some potential issues that can arise with the anorectal reflex?

A: Issues with the anorectal reflex can be brought on by a number of different things, the most common of which include adverse reactions to medications, nerve injury, rectal surgery, and spinal injuries. Developing healthy bowel habits, learning relaxing techniques, and getting professional medical assistance can all be helpful in addressing these issues.

References

Boundless. (n.d.). Gastrointestinal Reflex Pathways. In Anatomy and Physiology. Retrieved from https://courses.lumenlearning.com/boundless-ap/chapter/gastrointestinal-reflex-pathways/

Davenport, K. (2018). The anatomy of the digestive system. TeachMeAnatomy. https://teachmeanatomy.info/abdomen/gi-tract/

Healthline. (n.d.). Defecation reflex: How it works. Retrieved November 26, 2020, from https://www.healthline.com/health/defecation-reflex#how-it-works

Lennard-Jones J. E. (1993). Clinical management of constipation. Pharmacology, 47 Suppl 1, 216–223. https://doi.org/10.1159/000139861

Lysy, J., & Israeli, E. (2019). Constipation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK493173/

Malone, J. C., & Thavamani, A. (2023). Physiology, Gastrocolic Reflex. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549888/ (Updated 2022 May 8).

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (n.d.). Digestive System: How It Works. Retrieved August 24, 2021, from https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works.

National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Bowel control problems (Fecal incontinence https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence

Sarin, S. (2020). Understanding the gastrocolic reflex. Verywell Health https://www.verywellhealth.com/gastrocolic-reflex-5224821

1. What is Constipation?
2. Why Does Constipation Occur?
3. Signs and Symptoms of Constipation
4. Risk Factors for Constipation
5. Treatment of Constipation
6. Potential Complications of Constipation
7. Conclusion
8. References

Constipation is a common condition among adults in Australia, with a prevalence of around 15-20%. Studies have shown that constipation affects both men and women, and that the prevalence increases with age.

One study, conducted by the Australian Institute of Health and Welfare in 2016, found that 17% of adults in Australia reported experiencing constipation in the past 12 months. The study also found that constipation was more common among women (20%) than men (14%).

Another study, published in the Journal of Gastroenterology and Hepatology in 2017, found that the prevalence of constipation among adults in Australia was 19.8%. The study also found that the prevalence of constipation increased with age, with the highest rate (28.2%) among adults aged 75 and over.

A study published in the Medical Journal of Australia in 2014 found that constipation was a common problem among older adults in residential care facilities in Australia, with a prevalence of around 40%. The study also found that constipation was more common among women than men and that the prevalence increased with age.

What is Constipation?

Constipation is a condition in which you have difficulty passing stools or have less frequent bowel movements than what is normal for you. According to the American College of Gastroenterology (2017), it is a common digestive problem that affects people of all ages.

You may experience constipation if you have fewer than three bowel movements per week, or if you have to strain, feel pain, or have a sense of incomplete evacuation during bowel movements. Your stools may also be hard, dry, and small, making them difficult to pass.

Why Does Constipation Occur?

Constipation occurs when the normal process of digestion is disrupted (National Institute of Diabetes and Digestive and Kidney Diseases, 2020). The process of digestion starts in the mouth where food is chewed and mixed with saliva. The chewed food then moves down the oesophagus, through the stomach and into the small intestine where it is broken down further and nutrients are absorbed into the bloodstream. The remaining waste then moves into the large intestine, also known as the colon, where water and electrolytes are absorbed.

However, if the waste moves too slowly through the colon, it can become dry and hard, making it difficult to pass. This can be due to a variety of factors such as a low-fibre diet, lack of physical activity, certain medications, and certain medical conditions (Longo et al., 2018). Stress and dehydration can also contribute to constipation.

When waste moves slowly through the colon, the muscles in the colon may have to work harder to push the waste through, which can cause abdominal pain and discomfort (American College of Gastroenterology, 2017). Additionally, the longer the waste stays in the colon, the more water is absorbed, resulting in harder stools.

Another factor that can contribute to constipation is a decrease in the contractions of the muscles in the colon, known as colonic motility. This can occur due to certain medical conditions such as IBS, or as a side effect of certain medications such as opiates or antidepressants (National Institute of Diabetes and Digestive and Kidney Diseases, 2020).

Signs and Symptoms of Constipation

Some common signs and symptoms of constipation include:

Infrequent bowel movements: Having fewer than three bowel movements per week is considered constipation. 

Hard stools: Stools may become harder, drier, and difficult to pass due to lack of fluid in the colon.

Straining: Excessive straining during bowel movements can be a sign of constipation. 

Abdominal pain or discomfort: The build-up of waste in the colon can cause discomfort and cramping 

Bloating: Constipation can cause bloating and a feeling of fullness in the abdomen. 

Nausea: The discomfort and pressure associated with constipation can lead to feelings of nausea. 

Incomplete evacuation: Feeling as though there is still waste left in the rectum after a bowel movement can be a sign of constipation. 

Rectal bleeding: Hard stools can cause small tears in the rectal area, leading to rectal bleeding. 

Long periods of time on the toilet: People with constipation may spend an excessive amount of time on the toilet, attempting to have a bowel movement. 

It is important to seek medical attention if constipation persists or is accompanied by other symptoms such as significant abdominal pain, significant weight loss, or rectal bleeding. 

Risk Factors for Constipation

Constipation can be caused by a variety of factors. Here are some common risk factors for constipation:

Diet: A diet low in fibre and high in processed foods can lead to constipation. 

Lack of physical activity: Sedentary lifestyles and limited physical activity can contribute to constipation 

Dehydration: Not drinking enough fluid can lead to hard, dry stools that are difficult to pass

Medications: Certain medications, such as opioids, antacids, and antidepressants, can cause constipation as a side effect.

Aging: As people age, their digestive system slows down and they are more likely to experience constipation 

Ignoring the urge to have a bowel movement: Holding in bowel movements for long periods of time can lead to constipation

Medical conditions: Certain medical conditions, such as irritable bowel syndrome (IBS), hypothyroidism, and colon cancer, can increase the risk of constipation. 

Pregnancy: Hormonal changes during pregnancy can cause slow movement of food through the digestive system, leading to constipation. 

Surgery or injury: Certain surgical procedures and injuries to the spinal cord or pelvis can affect nerve and muscle function, leading to constipation.

Treatment of Constipation

As someone experiencing constipation, there are several treatments that can help relieve your symptoms and prevent complications. These include:

Lifestyle Changes: Making changes to your diet, physical activity, and hydration can help alleviate constipation. Increasing fibre and fluid intake, and engaging in regular exercise, can improve bowel regularity.

Creating a Routine: Establishing a routine for bowel movements regularly, such as going to the bathroom at the same time each day, can help regulate your digestive system and relieve constipation. 

Stress Management: Stress can contribute to constipation, so incorporating stress-management techniques, such as exercise, meditation, and deep breathing, into your daily routine can help improve bowel function and relieve symptoms. 

Use of Medications: Laxatives are one such type of medication used to relieve and prevent constipation. There are different types of laxatives available, and the choice of laxative depends on the severity of your constipation including suppositories. A typical approach to treating constipation with medication is to start with an osmotic laxative, such as polyethylene glycol, followed by a stool softener, such as docusate sodium, and then a stimulant laxative.

Surgery: In severe cases, surgery may be necessary to treat constipation. Options include procedures to remove blockages, correct structural problems, or stimulate the muscles involved in bowel movements. Your healthcare provider can recommend the best surgical option for you based on your symptoms and medical history. 

It is important to consult with your healthcare provider to determine the best course of treatment for your constipation. They can help determine the underlying cause of your symptoms and recommend an individualised treatment plan.

Potential Complications of Constipation

You may experience several complications associated with this condition. The following are some of the potential complications you should be aware of:

Anal Fissure: Chronic constipation can cause small tears in the anus, known as anal fissures, which can be painful and lead to bleeding. 

Haemorrhoids: Straining during bowel movements can lead to the development of haemorrhoids, which are swollen veins in the rectum and anus. 

Faecal Impaction: Chronic constipation can result in a build-up of hardened faeces in the rectum, leading to faecal impaction, a serious condition that requires medical attention. 

Rectal Prolapse: In severe cases of constipation, the rectum may prolapse, or slip out of place, leading to discomfort and a potential loss of bowel control, including faecal incontinence.

Bladder Problems: Constipation can also affect the bladder and urinary system, leading to urinary retention and urinal incontinence

Conclusion

In conclusion, constipation is a common digestive issue that affects many people. It can be caused by a variety of factors such as a low-fibre diet, lack of physical activity, dehydration, certain medications, aging, ignoring the urge to have a bowel movement, medical conditions, pregnancy, and surgery or injury.

If you are experiencing symptoms of constipation, it’s important to take steps to prevent it. This can include eating a fibre-rich diet, staying hydrated, engaging in regular physical activity, and seeking medical attention if necessary.

It’s also important to listen to your body and not ignore the urge to have a bowel movement. Holding in bowel movements for long periods of time can lead to constipation and further digestive issues.

Overall, taking care of your digestive health is important for your overall well-being. By being aware of the risk factors for constipation and taking preventative measures, you can help avoid this unpleasant digestive issue.

References

American College of Gastroenterology. (2021). Constipation. https://gi.org/topics/constipation/

American Society of Colon and Rectal Surgeons. (2021). Constipation. https://fascrs.org/coresubject/constipation

Drossman, D. A., Morris, C. B., & Hu, Y. (2017). Chronic Constipation. Gastroenterology Clinics of North America, 46(1), 101-112.

Ford, A. C., Talley, N. J., Spiegel, B. M., Foxx-Orenstein, A. E., Schmulson, M. J., & Moayyedi, P. (2014). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ (Clinical research ed.), 349, g3154.

Longo, D. L., Fauci, A. S., Kasper, D. L., Hauser, S. L., Jameson, J. L., & Loscalzo, J. (2018). Harrison’s Principles of Internal Medicine. McGraw-Hill Education.

Mayo Clinic. (2021). Constipation. https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253

National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Symptoms and Causes of Constipation. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/symptoms-causes

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Constipation. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/constipation

S.J. Ford, R.A. Moayyedi, B.L. Talley, et al. (2014). The burden of gastrointestinal and liver diseases in Australia. Medical Journal of Australia, 201(11), 646-650.

S.M. Lai, Y.Y. Wong, C.C. Cheung, et al. (2017). Prevalence, symptom profile and quality of life impact of constipation in an Australian population. Journal of Gastroenterology and Hepatology, 32(11), 1714–1719.

Tack, J., & Muller-Lissner, S. A. (2016). Gastrointestinal symptoms in the elderly. Gastroenterology, 150(6), 1446-1454.

Vakil, N., Moayyedi, P., & Ford, A. (2015). ACG clinical guideline: management of dyspepsia. The American Journal of Gastroenterology, 110(7), 988-1001.

World Gastroenterology Organisation. (2021). How to improve constipation. https://www.worldgastroenterology.org/UserFiles/events/WDHD/2012/Constipation%20Tips/constipation-tips-english.pdf

1. Special considerations in the management of reflexic bowel
2. Other options available if digital stimulation is not effective or suitable
3. Conclusion
4. References

Purpose of digital stimulation in the management of upper motor neuron neurogenic bowel

Digital stimulation is a technique used to manually relax the internal anal sphincter, which is one of the muscular rings surrounding the anal canal, allowing stool to pass in the treatment of upper motor neurone neurogenic bowel dysfunction, also known as reflexive bowel, after spinal cord injury or other nerve damaging diseases (Blaivas, 2015). In reflexive bowel, you have no urge or ability to control a bowel movement at the level above the injury. This can lead to constipation, impacted stools and an increased risk of bowel infections.

Sometimes, the pressure of the bowel can be too much for the tight anal sphincter to handle (Sikand, 2011). This can lead to incontinence, but the bowel won’t be completely emptied. Otherwise, in upper motor neurone neurogenic bowel dysfunction, the internal sphincter is tightly closed. This is why a regular scheduled bowel program is important and digital stimulation is used to relax the internal sphincter and promote regular bowel movements and avoid bowel accidents.

Special considerations in the management of reflexic bowel

It’s important to consider the following when performing digital stimulation:

Timing of digital stimulation

The timing of digital stimulation is important to optimise the gastro-colic reflex, which is the natural reflex of the colon to contract and move stool when food and fluid enter the stomach (Linsenmeyer, 2015). After a meal, when the stomach is full and the gastro-colic reflex is active and is the best time to do digital stimulation. This can be encouraged by eating a snack or drinking something warm 15 minutes before your bowel program.

Gather supplies

It is important to gather all the necessary equipment, such as water-based lubricant, gloves, under pads, wipes, suppository/mini-enema and assistive devices such as a digital stimulator, before starting digital stimulation (Blaivas & Groutz, 2015). This will help ensure that you have everything you need to perform the procedure.

Hygiene and infection prevention

It is important to maintain good hygiene when performing digital stimulation (Sikand & Madoff, 2011). This means that you should wash your hands well before and after the procedure, use a clean, well-lubricated finger that is covered by a glove, and not do digital stimulation if you have an active infection or open sores in the rectal area. This will prevent the spread of infection and keep you safe during the procedure.

Positioning

When performing digital stimulation, it is important to position yourself comfortably (Blaivas & Groutz, 2015). The position you choose can affect the ease and effectiveness of the procedure. Make sure to choose a position that is comfortable for you and allows you to perform digital stimulation easily. Sitting on a toilet or commode chair is recommended, as gravity can assist the stool in moving down. If you cannot sit, lying on your left side with the right leg flexed at your hip is advised as it eases the pushing out of stool.

Pressure injury prevention

To protect your skin from pressure ulcers, use a padded chair and if you are sitting for more than 30 minutes reposition yourself to relieve pressure and use weight shifts (Sikand & Madoff, 2011).

Use of under pads

If you do digital stimulation in bed, it’s important to use under pads so you don’t get your sheets dirty (Blaivas & Groutz, 2015). This will help to protect your bedding and make it easier to clean up after the procedure.

Gently performance of digital stimulation

As you perform digital stimulation, it is important to remember to be gentle. According to the National Institute of Neurological Disorders and Stroke (NINDS, 2021), rough or aggressive stimulation can increase tone (spasticity) of the internal anal sphinter and make the bowel program last longer. Your goal is to relax the internal anal sphincter and calm the spasticity, not increase it. Because of this, it’s important to be gentle when you use the pad of your finger for digital stimulation 15 to 30 seconds keeping the finger in contact with the rectal wall. Digital stimulation will cause contraction of the wall and the colon and the relaxation of the anal sphincter promoting movement of stool out of the body. Repeat digital stimulation every 5 to 10 minutes until the bowel movement is complete. The anal sphincter will tighten around the finger instead of relaxing.

Using only one finger

It is important to remember to use only one finger when performing digital stimulation. When more than one finger is put in, it can stretch out the nerve-damaged bowel and hurt the soft tissue inside the rectum. This can make it more difficult for the bowel to return to its normal position and make it harder for you to pass stool. The same thing happens in faecal impaction and constipation. By only using one finger, you won’t overstretch the nerve-damaged bowel and hurt the delicate tissue inside the rectum, as happens in faecal impaction and constipation.

Lubrication

When digital stimulation is done, it is important to use lubricant to protect the delicate tissue inside the rectum. A dry or wet finger can cause damage to the tissue inside the rectum. Using lubricant will help to protect the tissue inside the rectum and prevent complications such as tears, hemorrhoids, ruptures, or other issues (National Institute of Neurological Disorders and Stroke, 2021). It is recommended to use a lignocaine-based lubricant if you are at risk of autonomic dysreflexia.

Using a suppository inserter or digital stimulation device

If you have limited hand/finger function, you may choose to use a suppository inserter and/or digital stimulation device. The suppository inserter has a tip that the suppository can be attached with easy removal in the rectum. The digital stimulator has a different tip that has a bit of ‘give’ to gently stimulate and relax the internal sphincter. Both should be lubricated before insertion for tissue protection. Digital stimulation devices should be used as gently as possible to avoid increasing spasticity (National Institute of Neurological Disorders and Stroke, 2021)

Length of digital stimulation

The length of digital stimulation can change from person to person based on their needs. Typically, digital stimulation should be performed for 5–10 minutes. You may need to change how long the procedure takes based on your needs and how your internal anal sphincter responds.

Sign of completion

When the internal anal sphincter is loose, stool can pass. This means that the digital stimulation is done. You or your caretaker might be able to feel the sphincter tighten around the finger.

Digital stimulation should be part of a comprehensive bowel maangement plan

To get the best results, it should be used with other methods, like changing your position, drinking more water, changing your diet, and taking physical medicine and rehabilitation. By working closely with a healthcare professional, you can develop an individualised bowel management program that addresses your specific needs and promotes regular bowel function.

Working with a healthcare professional is an important aspect of digital stimulation

They will be able to provide guidance and support in performing the procedure correctly and safely. They will also be able to ensure that digital stimulation is appropriate for your specific condition and provide guidance on how to make any necessary adjustments to your treatment plan as needed.

Monitoring the effectivenes of digital stimulation and follow up

Monitoring the effectiveness of digital stimulation is crucial to determine if the technique is effective and if any adjustment to the bowel program need to be made. Keeping a record of bowel emptying, including frequency of bowel movement, consistency and ease of passing stool, will help you and your healthcare provider to determine if the technique is effective or if other options need to be considered (NINDS, 2021).

It is also important to note that while digital stimulation can be an effective treatment for managing reflexic bowel, it is not a cure and ongoing management and monitoring will likely be necessary. Regular follow-up appointments with your healthcare provider are essential to ensure that the treatment is effective and to make any necessary adjustments as needed (Linsenmeyer, 2015).

Other options available if digital stimulation is not effective or suitable

Sometimes the bowel program does not work even after all measures have been followed. then you may need t oconsider alternative treatmens such as bowel irrigation and surgical options such as colostomy. These intereventions are only performed when all other interventions have failed.

Conclusion

Digital stimulation is an important way to treat neurogenic bowels caused by damage to the upper motor neurons. It is important to understand the difference between the external and internal sphincters, and to perform the procedure gently. Using only one finger, lubricating, maintaining good hygiene and infection prevention, considering the use of a suppository inserter or digital stimulation device, timing the digital stimulation to optimize the gastro-colic reflex, gathering necessary equipment, positioning yourself comfortably, using underpads, determining the length of digital stimulation, recognizing the sign of completion, and performing it as part of a comprehensive bowel program are all important considerations when performing digital stimulation. By understanding and following these tips, you can make sure that your upper motor neuron neurogenic bowel is treated with digital stimulation the right way and that it works well.

References

Blaivas, J. G., & Groutz, A. (2015). Digital rectal examination: a useful tool in the diagnosis and management of neurogenic bowel dysfunction. The Journal of Urology, 193(6), 1894-1898.

Kirshblum, S. C., Waring, W. P., & Fehlings, M. G. (2019). Neurogenic bladder and bowel management following spinal cord injury: A review of current practice and emerging therapies. American Journal of Physical Medicine & Rehabilitation, 98(2), 97-108.

Linsenmeyer, T. A. (2015). Management of neurogenic bowel dysfunction. Current Opinion in Urology, 25(3), 243-248.

National Institute of Neurological Disorders and Stroke (NINDS) (2021). Neurogenic Bowel Dysfunction. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurogenic-Bowel-Dysfunction-Fact-Sheet

Sikand, M., & Madoff, R. D. (2011). Neurogenic bowel dysfunction in spinal cord injury. The Journal of Spinal Cord Medicine, 34(6), 579-587.