Dysfunction of the bowel and bladder systems are common after neurological injuries such as traumatic brain, and spinal cord injury, and stroke. Incontinence and issues in this area can be a major barrier to making progress for people recovering from neurological injuries. The Tejas Program assesses these issues to determine a plan to improve continence and increase independence with toileting. 

Bowel and Bladder issues treated at Tejas: 

• Inability to control bowel or bladder function 
• Urinary retention 
• Increased urgency to urinate 
• Decreased sensation/inability to tell when the bladder or bowel is full 
• Increased bladder infections 
• Incomplete bladder or bowel emptying 
• Constipation 
• Incontinence due to cognitive and/or memory impairments 
• Skin problems due to incontinence

Assessment and Diagnosis of Bowel & Bladder Dysfunction: 

Physicians and the interdisciplinary team will assess all areas related to independence in toileting and continence to create an individualized plan for each resident.

Assessments will include determining if neurogenic bowel and bladder issues are present such as urinary retention, one of the most common problems after a neurological injury. 

Using our on-site bladder scanner, our team can assess the amount of retention and determine the need for catheterization. Tejas also works with other physicians in the community and can refer the resident to a urologist if needed.

Treatments offered at Tejas: 

Bladder Programs: 

A consistent toileting schedule is used to retrain the bladder and nervous system and decrease episodes of incontinence. This may be used in combination with the bladder scanner to determine if urine is retained. 

If excessive urine is retained, intermittent catheterization may be used temporarily until bladder function improves. 

Residents will be educated on the importance of hydration and the relation to urinary continence. 

Bowel Programs: 

Bowel training includes creating a bowel program that is individualized to the resident’s specific needs. 

Interventions may include something simple such as a consistent toileting schedule or may have to be more intensive, using medications, suppositories, and/or a technique called digital stimulation to stimulate the bowels to move. 

Residents will be educated on the importance of a healthy diet, fiber intake, and hydration and the relation to bowel training. 

Medications: Medications can be used in adjunct to scheduled programs to help retrain the bowel and bladder programs. 

Catheterization: In this treatment, residents are taught how to self-insert a small catheter tube in order to empty the bladder at regular intervals. 

Intermittent catheterization: If it is determined too much urine remained in the bladder after attempting to urinate, catheterization can be performed to remove the remaining urine. The team will educate the resident to perform intermittent catheterization if this is required.

Continuous catheterization: A catheter and Foley bag can be placed to remain in the bladder and be able to continuously drain the bladder, decreasing the frequency of catheterization required.

To make a referral or for more information please call 1-800-252-5151

CARF Accredited-Adult Residential Rehabilitation Program