Bowel & Bladder

Moving toward control and independence

The two-way communication system between brain and body is often affected or cut off with an SCI, as a result, bladder and bowel control is likely to change. Facing this reality can be tough and is often emotional. But in time, you will acquire the knowledge and training you need to regain control and independence.

The Bladder: The urinary system

A person with an injury to their spinal cord may have problems with bladder function, including:

  • damage to the nerves in the spinal cord can prevent messages from going between the brain, bladder and muscles
  • trouble holding or emptying their bladder
  • frequent urinary tract infections or kidney damage
  • urinary or kidney stones


Additional complications could include: 

Overactive or spastic bladder: This occurs when the muscles in the wall of the bladder are constantly pushing, and you cannot control when you urinate.

Flaccid or non-reflex bladder: This refers to not being able to urinate when your bladder is full. It is likely that the muscles of the bladder are not strong enough or the ring that holds the bladder shut won’t relax.

Urinary tract infections (UTI): A UTI happens when bacteria enter your bladder and multiplies, often caused by the use of catheters. If not treated, the infection can spread to your kidneys and further.

Bladder or kidney stones: These are caused when waste does not get removed properly from the bladder or kidneys. Indwelling catheters can increase your risk, as the catheter itself can form a build-up that leads to stones.

The Bowel: the digestive system

After a spinal cord injury, the digestive system works differently. The changes depend on the level of the injury and its severity. Here are some things that can happen:

  • Movement of food through the large intestine may be slower.
  • The person with SCI may not feel the need to have a bowel movement.
  • They may be unable to control the voluntary muscles that contract or relax the anal sphincter.
  • They may not be able to bear down with the abdominal muscles to help evacuate the stool.


The result is that bowel movements require more time and planning. The risk of accidents is increased.

Terms you may here:

Reflex bowel: This refers to a bowel movement being triggered any time the rectum is full, without a sensation of fullness and not knowing when it might occur. This could happen frequently throughout the day.

Flaccid bowel: The nerves involved with a bowel function are damaged, which means that you are not able to have a bowel movement even when the bowel is full. This often results in constipation.

You will need an individualized protocol to address and overcome the particular bladder and bowel issues you face. Work with your health team to understand your situation and determine what’s right for you. They will provide you with detailed information and guidance.

We’re here to help when you need it. Our Peer Support Program is a great resource.

Looking for support in this area? Connect with the SCIO Service Navigation coordinator in your area.

Not sure how we can help? Looking for answers? Complete the form below of email us at [email protected]

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