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Thread: Newbie Bowel Care Program

  1. #1

    Newbie Bowel Care Program

    Hello, I'm still in Rehab and seaching for a bowel program that works. So far I've received caster oil, laxatives, suppositories, stool softners, etc. No luck with any of them so far.

    According to the Rehab nurses, I can only receive products stocked in the hospital pharmacy.

    Has anyone out there found products that really work for stubborn bowels? All I'm getting is a massive stomach ache.

    I'm a T6 Complete.

    Thank you,

  2. #2
    A good bowel program is a combination of 5 components:

    -Diet: should be high in fiber (at least 30 gm. daily) and fluids (at least 2.5 quarts of water daily). Keep a food diary as you may not see the effects of specific problematic or helpful foods for 3-5 days.

    -Medications: never use oils such as castor oil or mineral oil. They can cause fat soluable vitamin deficits. Stool softeners such as DSS (Colace) can be taken routinely at as much as 1000 mg. daily or more. Avoid strong stimulants and laxatives which tend to cause accidents and long term can cause problems such as megacolon. Suppositories should be used to get stool into the rectum to prepare for evacuation.

    -Timing: Bowel care should be done within 30-45 minutes after a meal to take advantage of the gastrocolic reflex. Most people start on a daily program, but many can eventually go to every other day if stool is not hard and results occur within 45 minutes and there are no accidents. Stick to the same time of day whenever you do bowel care. Don't skip bowel care if you have an accident.

    Techniques: Use an upright posture (avoid bowel care in bed) on a toilet or commode. Use abdominal massage before starting bowel care. Use digital stimulation (UMN bowel) or manual removal (LMN bowel) as needed.

    Equipment: Have the right type of raised toilet seat or commode to allow access to do your bowel care, and be sure it is well padded. Suppository inserters, digital stimulators, and toilet aids (for clean up) can make you more independent if you can't reach or have limited hand function.

    How many other SCI patients are at this rehab center? Many places that don't care for many SCI patients are not very expert in SCI bowel management. I would encourage you to download and read the consumer version of the clinical practice guideline on bowel management that is published by the Consortium for Spinal Cord Medicine, and the nurses and your physicians should be familiar with and consulting the professional version. Both are available for free downloads here:

    http://www.pva.org/site/PageServer?p...eneralpubs#cpg

    (KLD)

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