Lindsey Freysinger RN, MSN: On Neurogenic Bladder and Bowel


People with SCI have trouble emptying their bladder and bowel normally.  Many people with SCI experience a hyperactive bladder that empties whenever it likes. This can cause wetness leading to other issues like skin breakdown (discussed in next week’s post!). There are treatments, medications, and surgical procedures to reduce the hyperactivity of the bladder. Medications have side effects, treatments can be painful (Botox injections), and surgeries come with a whole list of possible complications.

After treatment of a hyperactive bladder, we must empty our bladders using a small plastic tube called a catheter. Some people do this multiple times a day, while others have a catheter in place draining into a bag 24/7. These artificial devices can cause bladder infections. Often, they become chronic, requiring a need for daily antibiotics, which over time creates a resistance to them. The bladder issues put us at major risk for sepsis (infection in the blood), and kidney problems severe enough to cause even kidney failure.

People with SCI experience a slowing of their bowels. Side effects from medications can make this slowing even worse. Constipation is a common and an extremely frustrating part of SCI. Many people with SCI use stool softeners, laxatives, suppositories, and/or enemas as a way to solve these issues. Digital stimulation of the rectum is often necessary to promote emptying of the bowel. This process can be very time consuming and embarrassing (especially in the beginning).

I get Botox injections in my bladder to reduce hyperactivity. I made this decision after wetting myself on multiple occasions (even on dates!!). I now empty my bladder using a catheter about 6 times a day. I manage my bowels with medication, plenty of fluids, good diet with probiotic foods, and digital stimulation when constipated.

I want to stress to all the readers that this is NOT a “poor me, pity me” post. This is meant to bring awareness to the many other things people with SCI deal with on top of paralysis or partial paralysis. Even those of us that can stand up or walk without assistance have to deal with these somewhat invisible secondary conditions on a day-to-day basis.


Lindsey looks left and smiles.
Lindsey Freysinger

In 2013 I was in a car accident resulting in an incomplete C5/6 SCI. I recently received my Master’s degree in nursing from University of Michigan and am working on my Doctorate in nursing practice. I’m passionate about changing healthcare for people with disabilities using education and awareness. I live in Oregon with my husband and 3 dogs. We participate in activities like skiing, kayaking, biking & ATV’s! Every summer we explore the country in an adaptive RV.

Instagram: @therealquadzilla215

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