Investigating neurogenic bowel in experimental spinal cord injury

Where to begin?

Amanda White, Gregory Holmes

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

The devastating losses following traumatic spinal cord injury (SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evacuation difficulties, decreased anorectal sensation, fecal incontinence or some combination thereof. Furthermore, neurogenic bowel is one of the most prevalent comorbidities of SCI and is recognized by afflicted individuals and caregivers as a lifelong physical and psychological challenge that profoundly affects quality of life. The restoration of post-injury control of movement has received considerable scientific scrutiny yet the daily necessity of voiding the bowel and bladder remains critically under-investigated. Subsequently, physicians and caregivers are rarely presented with consistent, evidence-based strategies to successfully address the consequences of dysregulated voiding reflexes. Neurogenic bowel is commonly believed to result from the interruption of the supraspinal control of the spinal autonomic circuits regulating the colon. In this mini-review, we discuss the clinical challenges presented by neurogenic bowel and emerging pre-clinical evidence that is revealing that SCI also initiates functional remodeling of the colonic wall concurrent with a decrease in local enteric neurons. Since the enteric input to the colonic smooth muscle is the final common pathway for functional contractions of the colon, changes to the neuromuscular interface must first be understood in order to maximize the efficacy of therapeutic interventions targeting colonic dysfunction following SCI.

Original languageEnglish (US)
Pages (from-to)222-226
Number of pages5
JournalNeural Regeneration Research
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2019

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Neurogenic Bowel
Spinal Cord Injuries
Caregivers
Colon
Fecal Incontinence
Autonomic Nervous System
Constipation
Smooth Muscle
Reflex
Comorbidity
Urinary Bladder
Quality of Life
Psychology
Physicians
Neurons
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Developmental Neuroscience

Cite this

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Investigating neurogenic bowel in experimental spinal cord injury : Where to begin? / White, Amanda; Holmes, Gregory.

In: Neural Regeneration Research, Vol. 14, No. 2, 01.02.2019, p. 222-226.

Research output: Contribution to journalReview article

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