Table 4.

Overview of Basic Bowel Management (BBM) According to NBD Classification

Reflexic Neurogenic Bowel Dysfunction	Areflexic Neurogenic Bowel Dysfunction
Lifestyle modifications: adequate fluid and fiber intake, physical exercise, and an individualized bowel care plan
Daily but can be a minimum of 3 times per week	One or more times each day
Lifestyle +/− medication regimen to achieve a Bristol Stool Form Scale score of 3 (firm) or 4 (smooth soft)	Lifestyle +/− medication regimen to achieve a Bristol Stool Form Scale score of 3 (firm) or 4 (smooth soft)
Rectal stimulants (suppository or mini enema)
Digital rectal stimulation and manual evacuation of stool	Manual removal of stool
Medication options: oral laxatives (stimulants, bulk-forming agents, and stool softeners) and prokinetics

Source: Adapted and modified from the Multidisciplinary Association of Spinal Cord Injury Professionals (MASCIP) Guidelines for Management of Neurogenic Bowel Dysfunction in Individuals with Central Neurological Conditions.⁸⁹ The order of the components in the table is not necessarily chronological, but represents only the general order in which basic bowel management components appear in the literature.^{65,67,89,90,91}