Acute management of bowel dysfunction in SCI

1. What bowel dysfunction is a patient at risk for development in the acute period?
2. What is the usual time course of ileus in an SCI patient?
3. How is gastric atony usually managed?

Answer:
1. Gastric atony and ileus, resulting from spinal shock and reflex depression.
2. Ileus starts at 24-48 hrs and lasts from 3-7 days.
3. NG suction, IV fluids, abdominal massage to stimulate peristalsis, neostigmine injections, clear liquid diet when bowel sounds appear, Reglan.