The Caregiver's Journey

Bladder/Bowel Changes

Even bowel and bladder functions are controlled by the brain. 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. Urinary catheters 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 you might see:

  • Loss of bladder or bowel control 
  • Increased urgency to urinate 
  • Incomplete bladder or bowel emptying 
  • Increased bladder infections 
  • Constipation
  • Memory and cognitive problems, such that the person does not recognize the need to urinate/defecate or recall when he or she last did so
  • Skin problems due to incontinence

How you can help:

  • Indwelling urinary catheters followed by the use of pads or diapers are common early on. Reassure your service member/veteran that these are nearly always temporary.
  • 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 service member/veteran 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 service member/veteran to adhere to the recommended schedule and interventions.
  • Monitor for skin breakdown and report it to healthcare providers.

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