Many patients with spinal cord injury suffer from chronic constipation, diarrhea, or alternating constipation and diarrhea. It cannot be examined at the hospital for any reason, not an infection or an obstruction. We call this condition neurogenic bowel dysfunction (NBD). Many people are at their wits’ end with this condition, and most patients rely solely on enemas to solve the problem due to poor care practices. The long-term use of these medications causes considerable physical damage to the patient with little success in resolving constipation. So, what are some ways to improve this situation? First of all: for patients with constipation (most of them show constipation), we recommend patients to eat more foods with high fiber. For example, green leafy vegetables, fruits, etc. Patients with severe cases should have a daily fiber intake of 15 grams or more. Our department has made a special health education form on the fiber content of food at a glance. It is available free of charge at the time of consultation, and there are also some fiber content calculations on the Internet that you can check. It is also important to make sure you drink a certain amount of water, preferably regularly and not in large amounts at one time. Some patients have urinary incontinence, so they try to reduce their water intake, which is not advisable. There are also specific training methods for urinary incontinence, which we will mention later when we have the opportunity. Secondly, we recommend that patients keep their own records of how long each bowel movement takes. It is terrible for some patients to go several days without having a bowel movement without dealing with it. Retaining stool in the body for too long is self-evidently harmful to the body – the equivalent of drug use. It is also important to keep track of the shape and amount of each time, and to adjust the diet in a timely manner. In the case of inpatients, these tasks are done by nurses. Next comes the most important aspect: establishing a new bowel reflex. After a spinal cord injury, the bowel is deprived of innervation, just like a soldier in a battle without a commander, so it becomes a mess. Therefore, it is important to try to restore bowel movements as soon as possible. It is recommended that patients have a bowel movement half an hour after breakfast every day or every other day, which is the peak of peristaltic movement of the intestines after receiving food stimulation, and it is best to establish a bowel reflex. Even if there is no bowel movement, try to complete the series of bowel movements. In addition, the patient needs to be in a relatively quiet and relaxed environment with less external stimulation during each care session. Maintain a comfortable position. Patients who can sit must try to maintain a sitting position. Patients who cannot sit up are advised to lie on their side with a clean tissue and other cleaning items. You can massage your abdomen clockwise to increase the stimulation of the rectum and facilitate bowel movements. We recommend finger rectal stimulation (DSR) for all patients, especially for those who have not passed stool after waiting for more than 5 minutes. Finger rectal stimulation is simple to perform, but requires specialized care, although family members can perform it after several training sessions. The prerequisite is that the training must be done by a professional. Finger bowel stimulation not only assists in defecation, but also has a secondary stimulating effect on the urethral sphincter, reducing sphincter spasm and increasing the volume of urine per pat, all in one fell swoop. When none of the above methods can make the patient defecate, medications may still be used, including laxatives and drugs that promote gastrointestinal motility. In general, after 3 to 5 such exercises, the patient is likely to have established new bowel habits, the time required for defecation will be reduced, and the quality of life will naturally improve. Some physical therapy measures are also useful as adjuncts to the treatment of neurogenic bowel. For example: abdominal interferential electricity, biofeedback point stimulation, magnetic therapy and vibration therapy. Of course, patients with a particularly severe condition (failure to establish reflexes after most training sessions, or severe incontinence/diarrhea may be considered for surgical treatment) when economic conditions allow.