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Evidence to support management of neurogenic bowel dysfunction remains sparse in comparison to other areas of care; such evidence as is available arises mostly from the spinal cord injury arena. This chapter discusses the clinical and investigational assessment, management of fecal impaction, gastrocolic reflex, abdominal massage, rectal stimulation, and feces evacuation methods. Dysfunction of the bowel has considerable implications for quality of life. Assessment of an individual for neurogenic bowel management is a multidisciplinary activity. Anorectal manometry tests can quantify more precisely the functional status of the anorectum. Irregular or too infrequent management is associated with incontinence and constipation. The majority of individuals with neurogenic bowel dysfunction will use the conservative methods to manage their bowel dysfunction. Biofeedback, Transanal irrigation, surgical interventions, and antegrade continence enema (ACE) are some useful options when conservative methods are not effective.
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