A herniated disc is typically a relatively minor issue, as most patients experience relief after a few weeks. The compression of nearby nerves is often limited to the lower back area in a way that is noticeable but not life-threatening or serious enough to require immediate medical attention. However, in rare instances, a herniated spinal disc can affect the bowels. This article explains how this can happen and why it can be a serious issue.
Compressed Nerves
There are nerves that connect to the bowels and control the actions required for proper bowel function. If some of these nerves get compressed by a herniated disc (also commonly known as a "slipped disc" or “ruptured disc”) and the irritation or compression is severe, bowel function may be disrupted. Digestive system nerves can become compressed in a way that contributes to neurogenic bowel dysfunction. Even a single nerve that is compressed can have a noticeable impact on bowel or bladder function, especially if the affected nerve is severely compressed.
Cauda Equina Syndrome
The cauda equina is a bundle of nerves located at the base of the spine that affects the bladder. In rare instances, a herniated spinal disc can irritate or compress these nerves. When this happens, it is called cauda equina syndrome. These nerves affect the bladder and some areas in the legs. Possible issues associated with cauda equina syndrome include:
• Bladder and bowel dysfunction
• Permanent paralysis of leg muscles
• Lost or reduced reflexes
• A loss of sensation in the saddle area—referred to as saddle anesthesia
• Severe pain in the lower back area
Making a Diagnosis
Since it is rare for a herniated spinal disc to be the reason for bowel-related issues, it is common for patients to have MRIs or similar image tests to determine the source of the nerve compression. This is necessary because there are several possible sources of nerve irritation in the bowel/bladder area.
A myelogram may be ordered as well. This test is performed with a dye injection followed by an X-ray or CT scan. The purpose is to trace the path of the dye to determine with better certainty which nerve is affected. This is also an effective way to positively link the compression of the affected nerve to a specific spinal disc if herniation is affecting the nerve.
If you are experiencing any issues with bowel or bladder function, seek prompt treatment from your doctor or go to an emergency room right away.
Treatment
Due to the severe nature of nerve compression affecting bowel function, treatment often involves decompression surgery such as a laminectomy. If a herniated spinal disc is a factor, treatment may involve either a traditional discectomy or a microdiscectomy, which is a minimally invasive version of the same procedure. Typically, only a portion of the spinal disc is removed to relieve nerve pressure.
If you have a herniated disc that is not responding to conservative treatment, a discectomy may be discussed and potentially recommended. Although this is generally a very successful procedure, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.
If you have any questions about the Barricaid treatment, ask your doctor or contact us at 844-288-7474.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.
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