Manual for bowel management in persons with spinal cord injury


ii. Position for easy defecation



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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.


Manual for bowel management in persons
M. akai editor
Chapter 1.purpose of bowel management in persons with spinal cord injury
Chapter 3. defecation procedures for persons with spinal cord injury
Special types of toilets for persons with spinal cord injury
Chapter 5. defecation in bed
Chapter 6.tools and devices for defecation
Chapter 7. diet and defecation
Chapter 9.going out and staying out



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