Hi - my son Mark suffered a severe TBI in August 2010. His is still recovering and still in outpatient rehab for pt/speech/ot.

Our biggest issue right now is that he is obsessed with feeling like he needs to have a bowel movement. He constantly wants to go to the bathroom even though he doesn't have to go. We put him on a schedule but hat just causes him to ask what time it is. As soon as he leaves the bathroom he asks when he can go back.

We have had him checked for a urinary tract infection and he does not hav e one. This is all about having a bowel movement though.

This interferes with school, therapy, and at home. He is getting more and more difficult when we tell him he can't go.

I have asked his doctors and no one can tell me how to deal with this. It is getting progressively worse to the point where he hit his teacher because she would not let him go. She did let him go and he stayed in there 20 minutes and did not have to go. He gets very frustrated and starts pounding on the wall when he does not have to go.

Please help. This is so hard to deal with along with all of the other issues we are working through.

Has he been checked by a GI doctor to feel if his bowels are moving correctly?

I spent a year and a half with a paralytic ileum. Basically, the peristaltic muscles in the small and large intestine were not moving properly. This caused me to become bloated and with full but non-moving bowels. A PT found the problem and could manipulate the ileal-cecal valve to allow proper flow into the large intestine and on.

The root cause was a chronic nerve impingement in my back. Relieving the impingement resolved this but the impingement took about a year of therapy to overcome. It flares up from time to time (like the past month or so). The most common symptoms of this is a bit of weight gain and bowel movements that are like deer droppings. For those of you who do not know what deer droppings are like, they are marble sized droppings. During the year, I had to take a spasmodic laxative to keep the peristaltic muscles exercised.

Like your son, I was sitting on the toilet a half dozen times a day or more. It was very annoying.

There is also a problem where the brain is not properly receiving the bowel signals even though the bowel is empty. I do not know if there is any way to diagnose this situation.

One of the problems I had at the same time was my brain failing to understand the position of an arm or a leg. This is nerve function is called proprioception. This problem resulted in ballistic movement. I might try to move my arm just a small bit across my chest and instead it would fly across my chest to the opposite extreme.

This was common if I tried to roll over in bed from my back to my side. My arm would fly across and my leg and/or knee would do likewise. My wife took quite a few knees in the thigh before we learned to put more distance between us.

We determined that this was caused by inflammation in my neck that was effecting the nerve signals.

I was quite a mess of problems for the first two years after my injury.

Interoception is when the brain uses nerve signals to understand how internal body parts are acting or feeling such as hunger or bowel fullness. This could be the faulty system in your son.

Oddly enough, I have not felt hunger pangs for decades. I recognize my need to eat by how my mind feels. It gets lethargic when I need to eat.

As nightnurse is finding, nerve problems in the neck can cause a myriad of symptoms.

Hopefully, you can find a good neurologist or maybe a neuro-chiropractor who can help you understand this, if it is a neurological issue. A high quality image study of his cervical vertebra may be in order. Cervical vertebra are rarely looked at closely even though they are usually impacted from the concussive forces.

Hope this helps you find some help for him.

My best to you.

Thank you for your response! I am new to this group and it helped a lot. We are very frustrated and I know my son is.

Another issue he has is eating - A LOT! He is a 16 year old boy and they usually eat a lot but he doesn't remember that he ate so always wants to eat again. Could this be related to the bowel movement issue?

He has always been a big eater. He has definitely gained weight - he is 6'2 - 220 pounds. Before his accident he weighed 185 and was 6 ft. He grew when he was in the hospital.

We are going to the doc tomorrow for a follow up. I will discuss these issues with him. I really think this is a brain signal thing (I don't know the proper terms).

Has he been tested for all of the hormones? Thyroid and all of the sex hormones and such? Hormones are the signaling system in the body.

He also has appetite issues. He wants to eat all the time! Could this be related to the bowel issue?

No he has not been tested for that. How would this relate to his TBI? are they related?

Hormones are regulated in the brain by the pituitary gland and the hypothalamus. They can easily be injured in a concussion.

If the pituitary gland is injured - is there anything that can be done to correct it? Is this something that would require a MRI to determine?

You treat the symptom rather than try to treat an injured pituitary. Besides, the injuries are usually microscopic.

There are some situations where there becomes a simple chemical imbalance that, once corrected, will begin to work correctly again. Sort of a Catch-22. Get the chemicals back in balance and they can regain self regulation.

There are many of us who take hormone supplements. I take DHEA because my DHEA was low. I supplemented Testosterone while my DHEA was getting balanced.

Low thyroid is easy to treat, too.

Some of his issues can be due to his age. Once he finishes maturing, some of these symptoms may spontaneously resolve. His body and brain can continue to mature until he is about 25 years old.

Get a full hormone panel including all thyroid (4 tests), cortisol, testosterone, DHEA, and the rest.

Check out https://www.womensinternational.com/..._referral.html for a hormone specialist in your area who understands male hormone levels. Their focus is women's hormones but also work with men's hormones. They also have the best prices for the hormone supplements that my wife and I have found.

Many doctors use a very broad range of acceptable hormone levels. Some of us need closer analysis.

Mark had a physical medicine follow up on Wednesday. I asked him about some of the things you mentioned. He believes Mark's issues are because of perseveration. He is "stuck" on wanting to go to the bathroom. His bowel movements are normal but he thinks he needs to go even though he doesn't.

Thoughts?