ii. Position for easy defecation Bending forward while in the sitting position makes it easier to defecate because this creates an obtuse angle between the rectum and the anus. In contrast, a lying-down position makes the defecation reflex less likely to occur. Therefore, defecation should be performed in the sitting position as often as possible. Source: Management Support Committee for Persons with Cervical Spinal Cord Injury, Beppu Rehabilitation Center for Physical Disabilities Handbook of Self-management Support for Persons with Cervical Spinal Cord Injury, Chuohoki Publishing Co, Ltd, 2008, P121. Rectum Puborectalis muscle Pubis Anus Standing position Sitting position It is easier to defecate because the anorectal angle becomes obtuse in this position. Figure 3: Anorectal angles in 2 positions
In the case of spinal injury above the eighth thoracic spinal cord, the hips tend to move forward in the sitting position because of the paralysis of the abdominal and back muscles. To promote bowel movement, maintain a straight-back position during defecation. For defecation while lying down in bed, turn the face to the left and bend the knees to expand the angle between the rectum and the anus. Elevate the upper body whenever possible.