Paralysis Resource Guide - (Page 67) HEALTH MANAGEMENT BOWEL MANAGEMENT The digestive tract in its entirety is a hollow tube beginning at the mouth and ending at the anus. The bowel, the final portion of the tract, is where waste products, digested food, are stored until they are emptied from the body in the form of stool, or feces. After food is swallowed, it moves through the esophagus to the stomach, which is basically a storage bag, and then on to the intestines or bowels. The absorption of nutrients occurs in the small intestines, the duodenum, the jejunum and the ileum. Next is the colon, which encircles the abdomen, starting on the right with the ascending colon, passing across the top with the transverse colon, and down the “s”-shaped sigmoid colon to the rectum, which opens at the anus. “Bowel accidents happen. The best way to prevent them is to follow a regular schedule, to teach the bowel to have a movement when it is most appropriate.” Feces move through the bowel by coordinated muscular contractions of the colon walls called peristalsis. This motion is managed by a network of nerve cells at several different levels. The myenteric plexus nerves direct local intestinal movement, seemingly without input from the brain or spinal cord. More than 100 years ago it was discovered that the intestines, even when removed from the body, have an inherent tendency to produce peristalsis. If the intestine wall is stretched, the myenteric plexus triggers the muscles above the stretch to constrict and those below to relax, propelling material down the tube. The next level of organization comes from autonomic nerves from the brain and spinal cord to the colon, which receives messages through the vagus nerve. The highest level of control comes from the brain. Conscious perception of a full rectum permits discrimination between solid material and gas, and the 67
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