Aging With SCI: Dr. Kim Anderson-Erisman on Bladder and Bowel Health

katia9597
Sep 12
3 min read

At the 3rd Annual Sara Mulroy Symposium, Dr. Kim Anderson-Erisman, PhD, delivered a powerful presentation titled “Aging with Spinal Cord Injury: Navigating Bladder and Bowel Challenges for Successful Aging”on one of the most significant yet under-discussed aspects of life after spinal cord injury (SCI): bladder and bowel health. Her talk, rooted in more than two decades of research and personal experience, underscored how these issues remain top priorities for people living with SCI, especially as they age.

Why Bladder and Bowel Function Matters

More than 20 years ago, Dr. Anderson-Erisman surveyed people with SCI about their most important recovery priorities. Across injury levels, bladder and bowel function (along with eliminating autonomic dysreflexia) emerged as the top-ranked needs, even above regaining walking ability. A recent review of more than 3,500 people with SCI confirmed these priorities have not shifted. Despite decades of research, bowel and bladder complications remain a major quality-of-life concern.

What Changes With Age

Dr. Anderson-Erisman shared data showing how bladder and bowel function evolves over time:

Bowel: As people age with SCI, constipation becomes more severe and bowel programs take longer. While incontinence rates remain relatively stable, the unpredictability of bowel accidents significantly affects daily life, travel, and social relationships. Autonomic dysreflexia during bowel care is common, and many people express a strong desire for interventions that improve continence, predictability, and independence.
Bladder: Management styles shift over time, often moving from clean intermittent catheterization toward indwelling catheters or surgical interventions. Aging also brings higher rates of urinary tract infections (UTIs), renal decline, and increased risk of bladder stones, catheter-related injuries, and even bladder cancer. Preserving kidney function while maintaining independence and quality of life becomes a delicate balance.

The Lived Experience Gap

While medical complications are well-documented, Dr. Anderson-Erisman stressed how little is known about the experience of aging with SCI, especially around bladder and bowel changes. She emphasized the need for more qualitative research to capture how people adapt, what interventions they try, and how health care access changes over time.

She also highlighted persistent barriers:

Difficulty finding providers knowledgeable about SCI, particularly outside of specialized centers.
Lack of accessible facilities for colonoscopies and other preventive screenings.
Confusing or unreliable information online, making peer networks essential for trustworthy advice.

Keys to Success From People With SCI

Drawing from existing studies and lived experiences, Dr. Anderson-Erisman shared factors people identify as helping them age well with SCI:

Establishing and sticking to a consistent bladder and bowel routine early.
Networking with peers to share strategies and information.
Staying proactive about preventive care and advocating for necessary tests with health providers.

Where Research and Practice Must Go Next

Dr. Anderson-Erisman called for a stronger partnership between researchers, clinicians, and people with SCI:

Include individuals with lived experience at every stage of research design.
Develop more intermediate (non-surgical) options for bowel and bladder management.
Create and disseminate clear, evidence-based guidelines for aging with SCI.
Improve education for both patients and providers about screening needs and age-related changes.

The Bottom Line

Bladder and bowel management is not just a medical issue—it’s central to independence, dignity, and quality of life for people aging with SCI. Dr. Anderson-Erisman’s message was clear: to improve outcomes, we need more research rooted in real-world experience, better clinical guidance, and stronger support networks to help people navigate changes over time.