Does Cauda Equina Syndrome Cause Constipation?

Cauda equina syndrome is often associated with constipation. Conversely, it is also associated with incontinence and reduced anal tone.

Can cauda equina syndrome cause constipation?

Cauda equina syndrome has a constellation of symptoms which together indicate the presence of spinal nerve compression. There a certain ‘red flag’ symptoms which together act as a warning sign, highlighting the presence of cauda equina syndrome.

The red flag symptoms of cauda equina syndrome are:

• Loss of sensation in the perineum, buttocks and genitalia
• Urinary dysfunction, such as the inability to empty the bladder
• Bladder dysfunction, including constipation and incontinence

Therefore cauda equina syndrome can cause constipation. This happens because the cauda equina nerves enable function in the pelvic organs and rectum. When they are compressed this function will be lost, affecting bowel function.

Additionally, many cauda equina patients will initially seek help from their GP for chronic lower back pain. This may extend into one or both legs, imitating sciatica. A patient may be prescribed strong analgesics for this pain, something which can cause constipation.

Can cauda equina syndrome cause incontinence?

Some cauda equina patients may instead (or additionally) experience incontinence of faeces. This happens because cauda equina syndrome leads to reduced anal tone. Due to the laxity of the anal sphincter, the individual in question may not have the ability to defer defecation for very long, meaning he/she does not have time to reach a toilet.

Bowel disturbance and cauda equina syndrome

If a patient presents to a GP or other healthcare organisation complaining of bowel disturbances, the clinician must take a detailed history, noting whether there are any additional symptoms.

If a patient confirms that he/she also has symptoms including lower back pain, problems urinating and a loss of sensation, a suspected diagnosis of cauda equina syndrome should be made. This diagnosis must be verified as a matter of urgency, with a patient being sent for an emergency MRI scan.

Once diagnosed, cauda equina syndrome should be treated with emergency decompression surgery.

Failure to recognise symptoms

A diagnosis of cauda equina syndrome is dependent upon a clinician recognising the signs of cauda equina compression and sending a patient for an emergency MRI scan. If medical practitioners fail to accurately assess a patient’s symptoms, resulting in a delayed diagnosis of cauda equina syndrome, there may be a case of medical negligence.

To talk to a solicitor about a delayed diagnosis of cauda equina syndrome, please get in touch with us today.

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