282 KB0 KB200820252023Saksida, Analetnik:22str. 70-76številka:supl. 1COBISSID_HOST:153262083ISSN:2232-545XURN:URN:NBN:SI:doc-NCUBUNADslUniverzitetni rehabilitacijski inštitut Republike Slovenije - SočaRehabilitacija (Ljubljana)bowel regimeconstipationfaecal incontinenceFecal Incontinenceflaccid bowelhiperrefleksno črevohyperreflexic bowelnehotno uhajanje blataohlapno črevorehabilitationrežim odvajanja blatazaprtjeNevrogena motnja delovanja črevesa| Neurogenic bowel dysfunction|The term neurogenic bowel dysfunction (NBD) refers to bowel dysfunction due to the damage to the nervous system that regulates bowel function. It affects a large portion of patients with neurological disorders, along with their family members and caregivers. Consequently, it is also often encountered during the rehabilitation of individuals with central neurological conditions (e.g., spinal cord injury, multiple sclerosis, Parkinson's disease, stroke), as well as in some disorders of the peripheral nervous system (e.g., cauda equina syndrome). The main symptoms of NBD include constipation, diarrhoea, faecal incontinence, bloating and abdominal pain. Due to the changes in bowel control, NBD has a significant negative impact on the quality of life, resulting in poor self-esteem, avoidance of social contacts and consequent social isolation. The clinical presentation of NBD depends on the location and extent of neurological impairment. Broadly speaking, NBD presents in two distinct clinical patterns: injuries above the conus medullaris result in the upper motor neurone syndrome (hyper-reflexic bowel), while injuries at the conus medullaris or cauda equina result in the lower motor neurone syndrome (flaccid bowel). Currently available literature strongly supports an individualised stepwise, multidisciplinary approach to the management of NDC, which should be tailored to the individual’s situation based on their symptoms and lifestyle preferences. Management of NBD includes modifications in diet, lifestyle, optimisation of medical therapy, and also surgeryThe term neurogenic bowel dysfunction (NBD) refers to bowel dysfunction due to the damage to the nervous system that regulates bowel function. It affects a large portion of patients with neurological disorders, along with their family members and caregivers. Consequently, it is also often encountered during the rehabilitation of individuals with central neurological conditions (e.g., spinal cord injury, multiple sclerosis, Parkinson's disease, stroke), as well as in some disorders of the peripheral nervous system (e.g., cauda equina syndrome). The main symptoms of NBD include constipation, diarrhoea, faecal incontinence, bloating and abdominal pain. Due to the changes in bowel control, NBD has a significant negative impact on the quality of life, resulting in poor self-esteem, avoidance of social contacts and consequent social isolation. The clinical presentation of NBD depends on the location and extent of neurological impairment. Broadly speaking, NBD presents in two distinct clinical patterns: injuries above the conus medullaris result in the upper motor neurone syndrome (hyper-reflexic bowel), while injuries at the conus medullaris or cauda equina result in the lower motor neurone syndrome (flaccid bowel). Currently available literature strongly supports an individualised stepwise, multidisciplinary approach to the management of NDC, which should be tailored to the individual’s situation based on their symptoms and lifestyle preferences. Management of NBD includes modifications in diet, lifestyle, optimisation of medical therapy, and also surgeryNevrogena motnja delovanja črevesa oz. nevrogena disfunkcija črevesa (NDČ) je posledica okvare živčevja, ki uravna delovanje črevesa. Prizadene velik del bolnikov z nevrološkimi okvarami, posredno tudi njihove svojce in negovalce, z njo pa se pogosto srečamo tudi med rehabilitacijo oseb tako z okvaro osrednjega živčevja (npr. okvara hrbtenjače, multipla skleroza, Parkinsonova bolezen, možganska kap) kot tudi pri nekaterih okvarah perifernega živčevja (npr. sindrom kavde ekvine). Glavni simptomi vključujejo zaprtje, drisko, nehotno uhajanje blata, napihnjenost in bolečine v trebuhu. Zaradi pomanjkljive kontrole nad nadzorom izločanja blata ima NDČ precejšen negativen vpliv na kakovost življenja; vpliva na znižano samopodobo, izogibanje socialnim stikom in posledično socialno izolacijo. Klinična slika NDČ je odvisna od ravni in obsega nevrološke okvare. V grobem ločimo dve obliki nevrogene motnje: nevrološka okvara nad ravnijo križnične hrbtenjače povzroči NDČ s sindromom zgornjega motoričnega nevrona ali hiperrefleksno oz. spastično črevo; okvara v ravni konusa hrbtenjače ali kavde ekvine pa povzroči NDČ s sindromom spodnjega motoričnega nevrona ali ohlapno črevo. Trenutno dostopna literatura močno podpira individualiziran, stopenjski, multidisciplinaren pristop k načrtovanju ukrepov za obvladovanje NDČ, ki naj bodo prilagojeni klinični sliki in življenjskemu slogu posameznega bolnika. Ukrepi lahko vključujejo spremembo prehrane, življenjskega sloga, zdravila in tudi kirurške posegeTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča