Aim: To increase the understanding of bladder and bowel dysfunction following Acquired Brain Injury.
A
dult Continence Protocols Manual [NHS Lothian]
Continence is both a physical and cognitive skill. The subtle signs that a person needs to use the toilet must be recognised by the brain while the person needs to be able to act on the signs to remain continent of both urine and faeces. Following a brain injury, a number of these basic skills may need to be relearned.
Other factors related to brain injury may affect bladder and bowel function and the person’s adjustment to these difficulties e.g. cognitive, communicative, physical, psychological and psychiatric problems. Pre-existing medical problems and medication regime may also have an impact.
Patients with bladder and bowel dysfunction may experience substantial levels of embarrassment, distress, depression, anxiety, and social isolation.
Following exclusion of a physical cause for bladder and bowel dysfunction, all of the above mentioned factors need to be included in a comprehensive multidisciplinary bladder and/or bowel dysfunction assessment. In most areas, a bladder and bowel specialist nurse is available to provide additional advice if bladder and/or bowel dysfunction persists. They can help by advising on treatment, specialist products/equipment, onward referral etc that may be able to help. Expert advice from other professionals may be required in some cases. Please refer to the following document for further details:
Referrals to Healthcare Professionals
Products to Support the Management of Bladder and Bowel Problems
References: National Guidelines for Management of Bladder and Bowel Dysfunction
Additional References:
NICE (2012) Urinary Incontinence in Neurological Disease: Assessment and Management
SIGN Guideline (2013) 130 Brain Injury Rehabilitation In Adults