Spinal cord injury patients bowel function rehabilitation related knowledge 1, understand the normal defecation mechanism: Under normal circumstances, feces is stored in the sigmoid colon, rectum without feces. Defecation is caused by peristaltic movement of the colon and feces moving down into the rectum, causing the lower end of the rectum to swell and cause the urge to defecate, while the external sphincter relaxes due to reflex inhibition and the anal levator muscle relaxes to cause fecal discharge. 2.What is spinal cord injury? Spinal cord injury is an injury to the structure and function of the spinal cord caused by spinal fracture, dislocation or other factors, resulting in impairment of spinal cord function (movement, sensation, reflexes, etc.) below the level of injury. 3.Why is there defecation disorder after spinal cord injury? When feces fills the rectum, the rectum is filled and swollen, which stimulates and excites the pressure receptors on the rectal wall and generates effective neural afferent impulses, which are transmitted from the pelvic nerve and the inferior ventral nerve to the “primary defecation center” in the lumbosacral segment of the spinal cord and to the “higher defecation reflex center” in the cerebral cortex. This center sends a signal of bowel movement, which causes bowel movement (awareness of the desire to defecate) and a reflex to defecate. The effect of spinal cord injury on defecation: after spinal cord injury, colonic motility decreases and bowel movement slows down; the brain’s influence on anal sphincter function: anal reflex, rectal sensation, and bowel coordination are altered. Resulting in neurogenic bowel dysfunction, common care problems for constipation. 4.What is the goal of bowel training? Through training, patients can achieve regular bowel movement or restore the function of voluntary bowel movement. 5.How to carry out regular defecation training? (1) Diet: It must be started only after the spinal shock period is over and normal diet is resumed. Encourage the patient to have a normal diet, eat more vegetable and fruit juices, eat fiber-rich foods such as plantains, dragon fruit, kiwi, yogurt, prunes, sweet potatoes, vegetables, corn, etc. Maintain adequate water intake, 2000-2500ml per day including food water content. (2) Training procedures: Before training, remove stool from the patient’s intestine by enema, oral laxative or manual stool retrieval method, and start the intestinal bowel function rehabilitation training program after clearing: ① Constipation patients should take 5mg or other laxative that night; ② After half an hour of breakfast the next day, instruct the patient to massage the lower abdomen in clockwise direction for 20 minutes, that is, according to the direction of the colon, from ascending colon → transverse colon → sigmoid colon →Æ descending colon → sigmoid colon to do circular massage, the technique first from light to heavy, and then from heavy to light, while the patient then cooperate with the collection and lifting of anal muscles, in order to enhance anal nerve sensitivity, stimulate the contraction of the sphincter muscle, enhance intestinal peristalsis, produce bowel movement; ③ finger rectal stimulation: regularly assist the patient to lie on the left side, the operator’s right hand wearing latex gloves, paraffin oil lubricated index finger, inserted into the rectum 3-4 cm, in order to protect the rectum Under the premise of protecting the rectal mucosa, the finger gently turns 5 circles along the rectal wall and is completed within 1 minute. After assisting in environmental and postural preparation, the patient was instructed to defecate on his own.