Traumatic Brain Injury A to Z - Bladder/Bowel Changes

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Headache

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The group members share information about their loved ones’ injuries and progress. Learn about managing the effects of headaches resulting from TBI.
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Headache

Tracy
Okay, now that we have all introduced ourselves let’s begin by talking about how to manage some of the effects of TBI. Michelle tell us a little bit more about how Tom is doing.

Michelle
Well, he is talking more, and beginning to recognize people. He waved at his doctor, and he seemed to remember his physical therapist that he had seen just only a few times before. Some people may think these are just little things, but after what we’ve been through, it’s definitely progress.

Julie
That’s great! And all of those small steps will add up. With Sam, we just didn’t know what to expect. We weren’t given a very positive prognosis, so when he said his first word, we were amazed. We know how significant those first steps are. That is great Michelle.

Tracy
Travis, how do you feel about the progress your dad is making?

Travis
I don’t know…It…it scares me. I mean sure he’s making this progress, he’s talking more and he recognizing a few more people…but to me he's still confused a lot. And he’s still in pain a lot of the time…I know that his head hurts and I just want the pain to stop…

Carl
Yeah. It’s tough to see someone you love in pain. When Sam was first waking up, his head hurt all the time. We just felt so helpless because we didn’t know what to do…

Tracy
Sure. Well as you all have experienced, a TBI can affect so many aspects of a person’s life. What we’re going to cover next are some of the things that you, as a caregiver, can do to help that loved one when it comes to specific symptoms. Now this information will be particularly helpful when your family member comes home from the hospital. Since Sam has recently come home, Carl and Julie, we’d appreciate your input on this, if you wouldn’t mind sharing some of the things that you’ve learned.

Julie
Sure.

Tracy
Now keep in mind that your family member is likely to experience some, but not all, of these effects. I mean many effects are common right after the injury; you may have already noticed them. And many are likely to improve over time. But though we know more now about TBI than ever before, no one can say with certainty just what effects each injured person will have.

So we do know that most people with TBI can and will make improvements. I mean of course, with the proper diagnosis, the treatment, the follow-up care... they’re so important, but so are the supportive family and the community.

Michelle
You said many effects are common. What kind of effects are you talking about, Tracy?

Tracy
Well, since we’ve been talking about headaches, let’s start there. Some people have headaches most of the time, others headaches just come and go. There’s fatigue, there’s stress... a history of migraines make those headaches worse. But now the doctor will of course will prescribe medications for your loved one and possibly some other options for later in the recovery.

Michelle
What other options are there?

Julie
Since Sam had so many severe headaches early on we tried several things. What worked for him were acupuncture and exercise.

Carl
Yeah, but we didn’t start out with those treatments. First, we tried medication. That didn’t completely get rid of them, so we talked to Sam’s doctor. He suggested stress management, like deep breathing and lying down in a dark and quiet place during a headache. So Sam tried that, along with the acupuncture and exercise.

Tracy
Well Carl and Julie just mentioned several strategies for headaches.  Depending on where your loved one is in the recovery process, those strategies can change. Another thing to consider is to give your family member some guidance in terms of behavior. For example, encourage him to avoid bright sunlight, wear dark sunglasses. Also, obviously avoiding alcohol, foods that trigger headaches like cold foods, some cheeses, chocolate... things like that.

When a headache does occur, keep track of it in your journal. Note the time of the day, the activity that he was doing, also the intensity of the pain. And if the headaches don’t improve or if they get worse, let a member of the health care team know right away.

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. Health care 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 health care providers.
Related Information:
Headaches
Other Physical Effects
Glossary
Frequently Asked Questions
"He really won’t tell me the whole story because I think he doesn’t want to scare me. But, he brought me a piece of metal back home that was embedded in the wall right behind him. He said it missed his head by a few inches. He said that he thanks God every day that he’s still alive, and that’s why he brought the piece of metal home, to show me that that’s how close he had come to dying." -  Lynn C-S.

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