The Impact of Spinal Pathology on Bowel Control in Children

Authors

  • Joy Edwards-Beckett PhD, DNSc, RN,

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    • At the time this article was written, Joy Edwards-Beckett was a nurse researcher in the department of nursing research at Children's Hospital in Columbus, OH; she is currently an independent research consultant in Westerville, OH. Heather King is a clinical nurse III at Children's Hospital in Columbus, OH.

  • Heather King RN, CRRN

    Search for more papers by this author
    • At the time this article was written, Joy Edwards-Beckett was a nurse researcher in the department of nursing research at Children's Hospital in Columbus, OH; she is currently an independent research consultant in Westerville, OH. Heather King is a clinical nurse III at Children's Hospital in Columbus, OH.


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Abstract

There are two basic mechanisms of bowel control: anatomic and neurologic. The structures involved in bowel control include the colon, rectum, internal and external anal sphincters, and pelvic musculature. Also involved is the process of neural innervation. A pediatric patient's bowel function and control are altered as a result of spinal pathology. Upper motor neuron lesions leave the reflex arc intact but with a lack of voluntary control. Stimulation and timing are important in the development of a successful bowel program for pediatric patients with these lesions. In contrast, lower motor neuron lesions impair the reflex arc and result in a flaccid bowel. The pediatric patient's rectum may be extremely compliant and store copious amounts of hard stool. In such cases, bowel control is much more difficult to attain. This article presents implications for rehabilitation nursing practice for each type of lesion in pediatric rehabilitation patients.

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