Neurogenic Bowel Dysfunction Review by Anton Emmanuel 2019 (PDF)

Abstract
The symptoms of neurogenic bowel dysfunction (NBD) compriseconstipation and fecal incontinence. These have a major impact on qualityof life and dignity. Bowel symptoms occur in the majority of patients withchronic neurological diseases like multiple sclerosis, spinal cord injury, andParkinson’s disease. Management relies on obtaining a careful bowelhistory, including assessment of bowel function prior to the onset ofneurological symptoms. Objective measures of NBD are available andimportant in terms of monitoring response for what are often intenselypersonal and difficult-to-elicit symptoms. Conservative management beginsby establishing an effective and regular bowel regime by optimizing diet andlaxative use. If this is insufficient, as seen in about half of patients, transanal
irrigation has been shown to reduce NBD symptoms and improve quality oflife. Failing that, there are more invasive surgical options available. Thisreview aims to provide practical guidance for the clinician who encountersthese patients, focusing on a stepwise approach to assessment,interventions, and monitoring.

Emmanuel A. Neurogenic bowel dysfunction [version 1; peer review: 2 approved] F1000Research 2019, 8(F1000Faculty Rev):1800 (https://doi.org/10.12688/f1000research.20529.1)