Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson’s disease

Table 2 Suggested pathogenesis of gastrointestinal disorders underlying spinal cord injury, myelomeningocele and multiple sclerosis

Disease	GI pathogenesis	Disorder
Spinal cord injury	Abnormal rectosigmoid compliance	Fecal incontinence[73]
Myelomeningocele	Loss of recto-anal sensitivity
Multiple sclerosis	Loss of voluntary control of the external anal sphincter
Spinal cord injury Myelomeningocele Multiple sclerosis	Immobilization, abnormal colonic contractility, side effects of medication	Constipation[94]
Multiple sclerosis	Paradoxical puborectalis contraction	Constipation[94]
Multiple sclerosis	Bladder distension	Autonomic dysreflexia[56]
Myelomeningocele	Severe constipation	Ventriculoperitoneal shunt malfunction[87]
Myelomeningocele	Visceral hypersensitivity	Constipation and impaired rectal tone and response to food[88]
Myelomeningocele	Higher spinal level of cord lesion, completeness of cord injury and longer duration of injury	Severe neurogenic bowel dysfunction[20]
Spinal cord injury	Noxious stimulus	Autonomic dysreflexia[46]
Spinal cord injury	Manual emptying of rectal contents and gastric and bowel distension	Cardiovascular dysregulation[47]