After a spinal cord injury, three primary areas of nutritional concern are: regulation of bowel habits, skin care, and weight management. Dietary habits affect how these problems are prevented and managed.
Bowel management is an everyday concern for those with a spinal cord injury. The time required for food to move through the gut is slower after a spinal cord injury. If the bowel is not emptied on a regular basis, hard stools, and impaction may occur. Sometimes diarrhea occurs with impaction. This type of diarrhea may be incorrectly treated with an anti-diarrheal medication.
Drinking water and eating high-fiber foods such as fruits, vegetables, whole grains and legumes may help to soften the stools, making it easier for them to pass through the intestines. They also make the stool bulkier, which stimulates movement of the bowel. In addition, peristalsis can be stimulated with vegetables, fruits (especially dried fruits), caffeine and warm fluids with lemon juice.
If high fiber foods are eaten only on occasion, loose stools and Incontinence can occur. Therefore, fibrous foods should be gradually increased in the diet until the stools are soft and formed. Adequate fluid in the diet is also essential to help prevent impaction. Once the Bowel program and diet are established, eating habits should not be radically altered so that the extremes of constipation and incontinence can be avoided.
Skin Care
Immobility is a major risk factor for Pressure Sore development, especially when malnutrition is present. Lack of sufficient nutrients can be the reason that a wound does not heal completely. Nutrients particularly necessary for the health of skin include protein, vitamin C, vitamin A, and zinc:
Protein is primarily found in meat, fowl, fish, eggs, milk and milk products, nuts, and in dried peas and beans.
Vitamin C is found in citrus fruits, tomatoes, peppers, greens, raw cabbage, strawberries, pineapple, and potatoes.
Vitamin A is found in dark green and dark yellow vegetables and fruits, egg yolks, liver, and dairy products.
Zinc is primarily found in meat, fish, turkey, whole grain products, sunflower seeds, and dried beans.
Adequate fluid intake is also necessary for keeping the skin healthy. In healing, the work of the vitamins and minerals depend upon the presence of water in the body. In preventing pressure sores, water strengthens the skin, making it less susceptible to breakdown.
Weight Management
After a spinal cord injury, eating habits are especially important in preventing unwanted weight gain. The goal is to get enough nutrients needed for health without consuming a lot of calories. For this reason, the diet should consist primarily of highly nutritious, low-calorie foods like fruits and vegetables, whole grains, and low-fat proteins. This type of diet is in contrast to a high-fat, high-sugar diet that offers little nutrition, but can easily cause weight gain.
Overall, a diet that contains plenty of water, fruits and vegetables, whole grains, and is low in fat and sugar supports the goals of regulated bowel habits, skin care, and weight management.
References:
Brody, Jane, Jane Brody’s Nutrition Book, Bantam Books, 1989
Phillips, Lynn, et al, Spinal cord Injury: A Guide for Patient and Family, Raven Press, 1987
Ozer, Mark N., The Management of Persons with Spinal Cord Injury, Demos Publications, 1988
Jean Stork, R.D.
