People with disabilities often experience a change in bowel patterns. Some individuals have problems moving their bowels, while others have accidental bowel movements. Understanding how the digestive system works can help with adjusting to bowel changes.

When eating, the food that is swallowed goes first into the esophagus and then into the stomach. Enzymes (digestive chemicals in the stomach) break down the food. Next, food travels from the stomach into the small intestine, then on to the large intestine, or bowel. During this time, the body absorbs nutrients and fluids and uses them for energy. Food that is not needed for energy becomes solid waste, called stool. Stool passes through the bowel into the rectum, resulting in a feeling that it is time to have a bowel movement (BM).

Gastrointestinal Terms

Bowel: Intestinal area which processes solid waste

Bowel program: Habit that has been created to empty bowels at a certain time, prevent accidents and promote regular bowel movements

Defecation: Passage of solid waste (stool) out of the body.

Peristalsis: Wave-like action in the bowel which helps stool move out of the body

Rectal check: Inserting a gloved, lubricated finger into the rectum to check for stool. (Not appropriate for stroke patients. Please consult health care provider.)

Rectum: Lowest part of the bowel

Sphincter: Muscle surrounding and closing the rectum

Stool: Waste that has passed through the bowel

Bowel Changes after a Disability
Bowel changes occur after a disability for several reasons:

• Decreased activity and immobility slow the movement of stool through the body.
• Nerve damage can interfere with the ability to feel when a bowel movement is about to happen, and with the ability to stop and start a bowel movement.
• Muscle weakness or paralysis of certain parts of the body can make it hard to manage clothing.
• Cognitive (thinking) problems can keep the brain from knowing that it is time for a bowel movement.
• Speech problems make it hard for a person to ask others for help to go to the bathroom.
• Prescription drugs (such as pain medications), over the counter medicines, supplements, and diet affect bowel patterns.