Constipation is not uncommon but patients are usually competent in managing their bowel function. Patients can present with profuse rectal bleeding due to piles and/or rectal mucosal prolapse. Localising signs normally seen in conditions such as appendicitis, cholecystitis, pancreatitis or twisted ovarian cysts are often difficult to identify due to loss of sensation and paralysis. Appropriate investigations followed by informed assessment by a Senior Medical/Surgical Practitioner is often necessary.
Most surgical procedures including a laparotomy result in prolonged paralytic ileus in these patients. Contrast examination of the large bowel in paraplegic/tetraplegic patients is often fraught with difficulties because of the tendency for reflex bowel evacuation during the procedure. To achieve good bowel clearance patients usually need 2 full days of hospital stay with appropriate medications.