Transverse Myelitis and Incontinence

Transverse Myelitis and Incontinence

9th June 2022 is Transverse Myelitis (TM) Awareness day.

What is Transverse Myelitis (TM) ?

Transverse Myelitis (TM) is a rare neurological condition caused by inflammation of the spinal cord. It often results in sudden symptoms, such as muscle weakness, pain and bladder dysfunction.  

Transverse Myelitis and Incontinence

The last two nerves on the spinal cord control bladder and bowel. Any swelling above this can affect the bowel, causing the loss of sensation in the rectum and/or control of the anal sphincter resulting in constipation and/or incontinence.

The bowel has 2 major functions:

  • Digesting food and absorbing nutrients into the blood steam
  • Eliminating waste products at a convenient and appropriate time

Starting at the mouth and ending at the anus, the digestive system includes the mouth, oesophagus, stomach, small and large intestines (known as the bowel). The end of the large bowel is the section known as the rectum. This pouch is where faeces are temporarily stored prior to emptying. Sensors in the rectum send messages to the brain making you feel the urge to go to the toilet.

These sensory nerve endings are sensitive enough to distinguish between wind, solids and liquids. Bowel habits vary from person to person from once every 3-4 days to several times a day.

Sensory loss in the rectal area can also contribute to constipation as the person is unaware of the need to void and the faeces dries and hardens in the rectum. Weakness of the anal sphincter and pelvic floor can contribute to this issue. Occasionally, the faeces becomes so hard that watery diarrhoea bypasses it however the hard faeces stays.

How can I help myself?

  • Eating regularly helps the bowel as it keeps it stimulated and ensure that you drink plenty of fluids. It is recommended to drink 6-8 glasses of water per day but juice, cordial, skimmed milk and decaffeinated tea coffee are fine. Eating enough fibre in your diet helps push contents of the bowel along.
  • Establish a good routine by going to the toilet about 30 minutes after breakfast as this is when the urge to empty the bowels is the strongest.
  • Doing regular exercise can help strength the muscles and contractions within the bowels like walking for 15 minutes a day.
  • How you sit on the toilet can affect how easily you are able to empty your bowels. The correct position is that your knees should be higher than your hips and this can easily be done by resting your feet on a step or small stool.

Management:

  • It is always encouraged and advise that one must discuss their symptoms with their GP. You GP will be able to advise you the right course of action for you. This could include medications (called Antimuscarinics) may be given where suitable to calm the bladder and give you more time to reach the toilet.
  • Continence products are available to manage bowel incontinence which could include urinary sheaths for men, continence pads are commonly used method to control anal leaking and are widely available via pharmacies, super markets and online marketplaces.

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