Treatment
Treatment varies due to the different types of spina bifida. The mildest form spina bifida occulta does not usually need treatment and some people never know they have it. With spina bifida meningocele children often need surgery when they are born to push the meninges back into the body. Children born with the most serious form, Myelomeningocele, need to have surgery immediately to close the hole in spine. Antibiotics are also prescribed instantly to stop any infection spreading to the spinal cord.
Although there is no cure for the nerve damage caused by Spina bifida, a team of healthcare professionals are assigned to allow a better quality of life through the following treatments and medications.
Surgery 
When a child with spina bifida is born surgeons will operate within 48 hours. The surgery includes pushing the protruding meninges and spinal cord back into the body as well as closing the gap between the vertebrae. Back muscles and skin are then used to close the gap. Scoliosis (curvature of the spine) is a common condition associated with spina bifida and further surgery may be needed to correct this.
Bladder problems
Many Spina bifida sufferers suffer from bladder problems especially urinary incontinence. A cure for this drastically improves sufferer’s confidence.
- Antimuscarinics
These are most commonly used to treat urinary incontinence in adults and work by blocking the muscarinic acetylcholine receptor. This has the effect of increasing the size the bladder can stretch to therefore hold more urine and decrease the amount of times the sufferer needs to go to the toilet. However these drugs often have side effects:
· Blurred vision
· Loss of appetite
· Constipation
· Nausea
· Insomnia
- Artificial Urinary Sphincter (AUS)
This is a device inserted around the urethra that mimics the body’s urinary sphincter. It uses compression around the urethra by a fluid filled cuff to stop urine flow. When a pump, inserted in males in the scrotum and females in the labia, is pressed the cuff deflates allowing urine to flow.
- Clean intermittent catheterisation
This empties the bladder regularly. A lubricated tube is inserted into the urethra and the urine runs down this tube into the toilet. It can be used from an early age meaning children get used to it as at first it can be painful. Frequent use of a catheter however can increase the risk of urinary tract infections.
Bowel problems
Bowel problems are common with sufferers of Spina bifida and often present with urinary incontinence. Bowel incontinence can include constipation and/or diarrhoea and may be tac
ked in the following ways:
Diet
Changing diet is a simple yet effective way to control bowel movements. Increasing fibre (30 grams daily) can prevent constipation. Fibre is present in foods such as wholemeal breads and pasta, vegetables and oats. Removing caffeine and alcohol from a sufferer’s diet also can prevent diarrhoea.
Medication
Bowel incontinence caused by diarrhoea can be treated with loperamide. To reduce bowel movements and secretions atropine an anti-cholinergic medication can be prescribed. Conversely laxatives are used to treat constipation.
Bowel retraining
Regular exercises to strengthen the bowel can help to reduce incontinence. This can either be digital stimulation to trigger bowel movements for constipation or perform daily exercises to strengthen the rectal muscles and to increase muscle tone in that area to help with diarrhoea.
Enema
Enema’s can be used to combat constipation where other methods have been unsuccessful. It involves a solution through a tube inserted into the anus to clean out the bowel and can last around 3 days. Spina bifida sufferers with long term problems may be taught how to perform the enema at home.
Colostomy
If no previous method has worked surgery is the final option. A colostomy involves the formation of a stoma in the abdomen and the end of the large intestine diverted to the stoma where the stools are collected.
Article image - Surgery in the womb on a foetus with spina bifida courtesy of Flickr: www.flickr.com/photos/chant3/2923134982/
Article image - Vegetables rich in folic acid courtesy of Wiki Commons:commons.wikimedia.org/wiki/File:West_Show_Jersey_July_2010_11.jpg