Bowel dysfunction after cauda equina syndrome
Recent research in the US suggests that 20% of patients who experience cauda equina syndrome will require on-going medical/surgical intervention including the possible need for a colostomy bag. Why does this happen?
Why does cauda equina syndrome cause bowel dysfunction?
Cauda equina syndrome occurs as a result of the compression of the cauda equina nerves at the base of the spinal cord. These are the nerves which control the functioning of and awareness of sensation in the bowel and bladder, as well as the legs. As the nerves become increasingly compressed, their ability to function reduces and the patient's control of their bowel and bladder decreases.
What kind of bowel problems?
Depending on the severity of the compression, a patient with cauda equina syndrome might experience the following bowel problems:
- Loss of sensation around the anus
- Loss of control of the anus (faecal incontinence)
- Loss of feeling when passing stools
- Poor anal tone
- Constipation, which may be exacerbated by pain relief medication
Why is a colostomy necessary?
Faecal incontinence can be distressing to the patient. Faecal incontinence can also cause on-going infections due to the leakage of bacteria from the bowel in the faeces.
It may be preferable to have a colostomy bag fitted in order to manage the way in which faeces leave the body.
In a colostomy operation, a part of the large intestine is diverted through the abdominal wall so that faeces can be collected hygienically rather than allowed to leak through the anus.
Could it have been prevented?
The presence of long-term symptoms with cauda equina syndrome depends on the point at which the condition is diagnosed and the speed with which it is treated with surgical decompression.
If cauda equina syndrome is diagnosed and treated within 48 hours of the onset of symptoms, and before the patient begins to experience urinary incontinence, it is generally agreed that the patient has a high chance of a good recovery, including recovery of bowel function.
If diagnosis is delayed beyond the point where urinary function is lost, a poorer outcome is likely and on-going symptoms will probably be present, including bowel dysfunction.
It can, therefore, be seen how important it is that cauda equina syndrome is treated as an emergency in order to avoid the patient reaching the point where their outcome is likely to be significantly worse.
Medical Negligence
If the patient attended the medical practitioner too late for early decompression to take place, it may be that bowel incontinence and the need for a colostomy could not have been avoided.
If, however, the patient visited the GP or A&E before they were experiencing urinary incontinence and their treatment or diagnosis was delayed, then it is arguable that long-term bowel incontinence might have been avoided.
Speak to a solicitor
If you have experienced long-term problems due to undiagnosed or poorly treated cauda equina syndrome, contact Glynns Solicitors to discuss your situation with a solicitor experienced in dealing with cauda equina cases.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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