Brain injury may affect bowel and/or bladder function. After a brain injury, the person may need help re-establishing and maintaining regular bowel movements and/or emptying the bladder.
Managing the bowel
The goals of bowel management include creating a regular emptying pattern, not leaking stool (incontinence), and managing diarrhea or constipation.
Constipation can be caused by less physical activity, not eating or drinking enough, and confused nerve messages to and from the bowel.
Bowel problems can happen if the person with the brain injury can’t:
- recognize that his bowels are full and he needs to have a bowel movement
- plan ahead to give himself enough time to get to the bathroom
- control his bowel movements
- ask for help to get to the bathroom
- walk to the bathroom
- eat enough food with fibre and drink enough fluids
For a healthy bowel function, he should eat at regular times, eat foods high in fibre, drink the amount of fluids recommended by the dietitian or doctor, and be as active as possible.
He may be asked to follow a bowel care schedule, which includes trying to have a bowel movement at the same time every day and eating at regular times.
At certain stages of recovery, he may need to use other methods for bowel emptying (fibre supplements, stool softeners, suppositories, and/or laxatives). These methods aren’t used regularly because it makes it harder for the bowel to regulate itself. Some of these methods may also be habit-forming.
Most people with a brain injury don’t end up with a permanent problem managing their bowels.
Managing the bladder
The goal of managing the bladder is to keep the kidneys healthy. Some of the reasons for bladder problems after a brain injury are because of the damage to the parts of the brain that control behaviour and memory.
The person with a brain injury may have a problem with emptying his bladder while his brain is healing. Managing the bladder is an important way to prevent bladder infections. Damage to these areas may mean the person can’t:
- recognize that his bladder is full
- remember when he last passed urine
- control passing urine
- ask for help
- plan ahead to get to the bathroom
- walk to the bathroom in time
Early in the care of someone with brain injury, the bladder may be drained through a catheter (a tube that is inserted and left in the bladder). The urine empties through the catheter into a drainage bag, which also allows the urine output to be measured. The catheter is usually taken out as the person gets better.
Problems that were there before the injury (for example, an enlarged prostate in men) may add to bladder problems after a brain injury.
Problems with managing the bladder may include:
- not being able to pass urine
- leaking urine (incontinence)
- strong urge to pass urine
- passing urine more often
- not emptying the bladder completely
- skin problems because the urine touches the skin for too long
If the person can’t sense the need to empty his bladder, other ways to manage the bladder are:
- keeping the catheter in the bladder
- inserting and removing a catheter at set times so that the bladder is emptied regularly (intermittent catheterization)
- scheduling attempts to pass urine
- using an external condom catheter for men
- using an adult diaper
To keep the kidneys healthy, the person with a brain injury should drink fluids as recommended by the dietitian or doctor.
It may help to meet with your nurse or doctor to create a plan to manage the bladder. Most people with brain injury don’t end up with a permanent problem managing their bladder.