Neurogenic bladder and bowel occur when nerve damage causes you to have difficulty controlling your bladder and bowel. If left untreated, they can cause serious complications. However, treatment can help and typically involves lifestyle changes and medical interventions.

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Your bladder and bowel work to remove waste from your body. A variety of nerves and muscles need to work together in order for them to function properly.

For example, the interplay between these nerves and muscles must function to maintain bowel and bladder control. However, it must also work to empty your bladder and bowel when necessary.

Sometimes, nerve damage can impact this system, affecting the control of your bladder or bowel. This is called neurogenic bladder and neurogenic bowel, respectively.

Neurogenic bladder is when your bladder doesn’t fill or empty properly due to the effects of nervous system damage. You may also see it called neurogenic lower urinary tract dysfunction.

There are two broad types of neurogenic bladder, overactive and underactive:

  • Overactive neurogenic bladder: This type happens when your bladder muscles squeeze more often, even if the bladder isn’t full. This can lead to needing to urinate more frequently or to urinary incontinence.
  • Underactive neurogenic bladder: In this type, bladder muscles don’t squeeze when the bladder is full and needs to be emptied. This can lead to trouble urinating or retention of urine in the bladder.

Neurogenic bowel is when your bowel function and control have changed because of nervous system damage. You may also see this called neurogenic bowel dysfunction.

There are also two different types of neurogenic bowel, reflex and flaccid:

  • Reflex (spastic) neurogenic bowel: In this type, damage affects the upper motor nerves of the bowel. The anal sphincter remains tight, leading to stool retention. Spasms can lead to the release of stool at unexpected times.
  • Flaccid neurogenic bowel: In this type, damage affects the lower motor nerves of the bowel. This slows the movement of stool and can lead to constipation. Because the anal sphincter is also flaccid (loose), accumulated stool can be released at unexpected times.

The symptoms of neurogenic bladder and bowel can vary by individual, depending on the type and location of nerve damage.

Potential symptoms of neurogenic bladder include:

Some of the possible symptoms of neurogenic bowel are:

Neurogenic bladder and bowel happen because of nervous system damage that affects nerve signaling in these areas of the body. Some potential causes include:

People with neurogenic bladder or bowel can experience a variety of complications, particularly if their condition remains untreated.

The potential complications of neurogenic bladder are:

Possible complications of neurogenic bowel include:

Quality of life concerns

It’s important to note that both neurogenic bladder and bowel can significantly affect your quality of life.

Not only can these conditions affect your work and social interactions, but they can also lead to feelings of anxiety or embarrassment surrounding the condition.

Treatment can also be time-consuming. For example, a 2019 review notes that 22% of people with neurogenic bowel due to SCI reported that their bowel care takes up to an hour each time.

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The diagnosis for both neurogenic bladder and neurogenic bowel will start with a doctor taking your medical history and doing a physical exam.

Some of the tests used to diagnose neurogenic bladder are:

The tests that can be used to help diagnose neurogenic bowel are:

  • bowel diary
  • stool sampling
  • abdominal imaging, such as with X-ray or CT scan
  • colonoscopy
  • colon transit studies, which measure how long it takes a marker to go through your bowel
  • anorectal manometry, which measures the strength of your anal sphincter
  • electromyography, which measures the electrical activity of the muscles around your rectum and anus

The overall goals of treatment for neurogenic bladder and bowel are to manage your symptoms, prevent complications, and improve your quality of life.

Treatments for both conditions can be divided up into lifestyle and medical interventions.

Neurogenic bladder

The lifestyle recommendations that are typically made for neurogenic bladder are:

  • aiming to urinate on a regular schedule, called scheduled voiding
  • double voiding, which is when you wait a short period of time after urinating and then try to urinate again
  • delayed voiding, which can help with overactive neurogenic bladder and involves delaying urination for progressively longer periods of time
  • avoiding foods and drinks that can irritate the bladder
  • doing pelvic floor exercises

Medical treatments for neurogenic bladder can involve:

  • medications or Botox treatments to relax overactive bladder muscles
  • placement of a urinary catheter to help your bladder empty completely
  • surgery, which is typically only used when other treatments haven’t been effective and can include:
    • urinary diversion, which involves creating a hole in your abdomen that allows urine to leave your bladder and move into a collection pouch outside of your body
    • bladder augmentation, which can increase the size of your bladder by removing part of the intestine and attaching it to the wall of your bladder

Neurogenic bowel

The lifestyle adjustments that may be made for neurogenic bowel are:

  • optimizing diet to suit symptoms, such as adjusting fiber levels and avoiding other foods or drinks that may affect stool consistency
  • drinking enough fluids
  • setting up regular eating patterns, which can promote more regular bowel movements
  • avoiding medications that may promote constipation or diarrhea, if possible
  • trying to have bowel movements on a regular schedule
  • massaging your abdomen to help promote a bowel movement
  • doing digital rectal stimulation or stool removal, which is using a finger to help stimulate the anal sphincter or to remove stool, respectively
  • using transanal irrigation, which helps with a bowel movement by introducing water into the rectum

Medical treatments for neurogenic bowel can include:

  • laxatives
  • Botox treatments to help relax the anal sphincter
  • nerve stimulation, which uses an implanted electrode to promote a bowel movement
  • colostomy (typically only used when other treatments have been ineffective), which involves making a hole in your abdomen that allows stool to exit your body into a collection bag

Both neurogenic bladder and bowel are chronic conditions that require lifelong management. Without treatment, these conditions can cause potentially serious complications.

The type of treatments used depends on many factors. These can include:

  • the cause and location of the nerve damage
  • what type of symptoms you have
  • how severe your symptoms are
  • your age and level of physical functioning
  • whether you have any other underlying health conditions
  • your personal preference

Regardless of your treatment plan, you’ll need to see your doctor regularly for health check-ins so that they can gauge whether your treatment plan is effectively managing your symptoms.

How common are neurogenic bladder and bowel?

Neurogenic bladder and bowel can be common in some types of nerve damage. For example, a 2020 article notes that neurogenic bladder and bowel affect the vast majority of people with SCIs.

Can you prevent neurogenic bowel and bladder?

There’s no surefire way to prevent neurogenic bowel and bladder.

One way that you may be able to reduce your risk is to take steps to prevent SCI or TBI. Additionally, you can ensure chronic conditions, such as MS or diabetes, are managed.

Neurogenic bladder and bowel are when you have problems with bladder control, bowel control, or both. These conditions happen due to nerve damage.

Both conditions can cause serious complications if they’re not treated and can also have a great impact on quality of life. Treatment plans vary by individual and typically include lifestyle changes and medical interventions.

Neurogenic bladder and bowel are chronic conditions that require lifelong care. You’ll check in with your doctor at regular intervals to make sure your treatment is working and to check for any complications.