Bladder and Bowel Changes

Bowel and bladder functions are controlled by the brain and nervous system. For many people with TBI, bowel and bladder functions are impaired in the early days to weeks following injury. Healthcare providers expect this and are prepared to help. A urinary catheter (a tube placed in the body to collect and drain urine from the bladder) and use of diapers or pads may be needed. Bowel and bladder retraining are part of the rehabilitation process. Fortunately, with time and practice, most people with TBI regain control of these body functions.

What might you see?

• Loss of bladder or bowel control (inability to control normal bowel or bladder function)
• Increased urgency to urinate
• Incomplete bladder or bowel emptying
• Increased bladder infections
• Constipation
• Memory and cognitive problems that can cause the person to not recognize the need to urinate/defecate or recall when they last did so
• Skin problems due to incontinence, including lower skin tissue resistance to pressure caused by nutritional deficiencies and loss of vasomotor control (blood flow to/from the skin), skin softening and thinning from exposure to moisture (such as urine), and poor general skin condition

How can you help?

• The rehabilitation nurse will teach "bladder training," which often includes a specific fluid schedule, limiting fluids in the evening, and timed attempts to empty the bladder. Help your family member to adhere to the recommended schedule and interventions.
• "Bowel training" often includes scheduled attempts, a high-fiber diet, adequate fluids, physical activity, eating meals at regular times, and possible use of medications, including suppositories. Help your family member to adhere to the recommended schedule and interventions for improving bowel and bladder function.
• Monitor the skin for any areas of breakdown and report it to the healthcare provider.