To make bowel management feel less mysterious and complicated, let’s take a quick look at how the digestive system works. When we eat, our saliva, teeth and tongue start the process of breaking down our food and pushing it down the throat, through the esophagus and into the stomach, where it is further broken down into a liquidy mixture. That mixture then travels to the small intestine, where all the vitamins, minerals, carbohydrates, proteins and fats are absorbed (with help from the pancreas, liver, and gallbladder).

Now everything that is left over that our bodies can’t use goes in to the large intestine, also called the colon. The colon’s job is to absorb the liquid out of this watery mixture to create a solid stool that is pushed down to the rectum. Typically, at this point someone stores the stool until they can get to the restroom, and then they can pass it through the anus when they are ready.

For people with Spina Bifida, the digestive track runs pretty smoothly until the waste reaches the colon. Even those with the lowest of lesions often have a neurogenic bowel, which simply means the nerves to the colon are damaged and do not work to full capacity. A neurogenic colon does not move waste through as quickly, which gives that colon much more time to do its job of absorbing liquid. This creates large, hard stools, which in turn stretch out the colon. The bowel can’t tell the brain that it is full, so the brain can’t tell the bowel to empty at the right time. Once the bowel is chock full of poop, it usually starts pushing through the anus involuntarily, causing incontinence.

Next: Bowel Management by Age