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Thread: AD during bowel program question

  1. #1

    AD during bowel program question

    Here's my problem: During my bowel program my autonomic dysreflexia builds and builds as I'm about to pass stool, and then once I evacuate it subsides. For the first three years of my accident it was never like this, and now for the past year and a half this is the routine. My program causes intense dysreflexia and extreme pain. Any idea what I could get checked out? I use a magic bullet and some digital simulation (not much anymore, the pain is too intense).

    Any advice is appreciated!

  2. #2
    Do you use the Lidocaine gel before beginning bowel program?
    Also Enemeez Plus (has Benzocaine in it) and replaces the use of the suppository.
    Its contents are Docusate Sodium- not a chemical irritant and works well for most.
    You can read more at www.enemeez.com if you are interested.
    CWO

  3. #3
    Quote Originally Posted by SCI-Nurse View Post
    Do you use the Lidocaine gel before beginning bowel program?
    Also Enemeez Plus (has Benzocaine in it) and replaces the use of the suppository.
    Its contents are Docusate Sodium- not a chemical irritant and works well for most.
    You can read more at www.enemeez.com if you are interested.
    CWO
    Call or email Enemeez and they will set you up with samples and support.

    All the best,
    GJ

  4. #4
    I have the same problem too. I am C-5 five years post but I've had the AD during bowel routine since the beginning of my accident. I use magic bullets and it takes about an hour while the whole time I am sweating along with high blood pressure. I'm tried enemies they don't work well for me. I also drink prune juice every day but that seems to not work as well either because I still get AD but not as much. I wish we could find an answer to this AD problem because lately I feel like it's causing damage to my body. I almost feel like any bowel program could be my last.

    What I've heard this is a pretty common problem what I would like to know how many people this effects and what are some things to alleviate it, If anything.

  5. #5
    Quote Originally Posted by Padred123 View Post
    I have the same problem too. I am C-5 five years post but I've had the AD during bowel routine since the beginning of my accident. I use magic bullets and it takes about an hour while the whole time I am sweating along with high blood pressure. I'm tried enemies they don't work well for me. I also drink prune juice every day but that seems to not work as well either because I still get AD but not as much. I wish we could find an answer to this AD problem because lately I feel like it's causing damage to my body. I almost feel like any bowel program could be my last.

    What I've heard this is a pretty common problem what I would like to know how many people this effects and what are some things to alleviate it, If anything.
    Have you tried using lidocaine gel 2% or 4% both before you start bowel care and as the lubricant for any digital stimulation? We find this helps with a lot of bowel care related AD. Do you have hemorrhoids? AD from irritated hemorrhoids is a possible reason to have the hemorrhoids treated. Stimulants like prune juice do little or nothing to reduce AD during bowel care, which is generally related to stimulation of the anal sphincter.

    (KLD)

  6. #6
    Quote Originally Posted by SCI-Nurse View Post
    Have you tried using lidocaine gel 2% or 4% both before you start bowel care and as the lubricant for any digital stimulation? We find this helps with a lot of bowel care related AD. Do you have hemorrhoids? AD from irritated hemorrhoids is a possible reason to have the hemorrhoids treated. Stimulants like prune juice do little or nothing to reduce AD during bowel care, which is generally related to stimulation of the anal sphincter.

    (KLD)
    I've used Lidocane but its doesn't help.. I just went to a Hemorrhoid doc n he said my Hemorrhoid is too small to do anything to. I've been to tons of docs n they cant figure out whats going on. Its all getting worse.. Stomach cramps, indigestion, anxiety, spasms, chest preasure, shortness of breath. I feel like I am running outta options.. I am thinking about getting a colostomy.

    heres my other related post:
    http://sci.rutgers.edu/forum/showthread.php?p=1568155#post1568155

  7. #7
    Have you seen your SCI doc? He might recommend putting you on nitropaste for a few minutes before your bowel program to keep your ad in check.
    Just a thought.
    CKF

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    Have you seen your SCI doc? He might recommend putting you on nitropaste for a few minutes before your bowel program to keep your ad in check.
    Just a thought.
    CKF
    Ya thats what he does recommend but i'd rather find an answer to whats causing the AD than just making it a little better. Plus I'm always nervous about using the nitrobid and dropping my bp too low since normally my bp is low to begin with.

    Is this a common quad problem? I don't think my body can handle 5 more years of AD. I need some answers but it seems like nobody has any.. So I'm inquiring about a colostomy tomorrow. That seems like my best bet at the moment.

    I hope there's some other quads out there that can point me in the right direction because I'm lost.

  9. #9
    Senior Member dnvrdave's Avatar
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    Quote Originally Posted by Padred123 View Post
    ... i'd rather find an answer to whats causing the AD than just making it a little better.

    ..Is this a common quad problem? I don't think my body can handle 5 more years of AD. I need some answers but it seems like nobody has any.. So I'm inquiring about a colostomy tomorrow. That seems like my best bet at the moment.

    I hope there's some other quads out there that can point me in the right direction because I'm lost.
    For me, the problem was the suppository (or enemeez; they both were hard on me). The answer was to stop using them, after 25 years of sweating and (unfelt) pain. I didn't have detectable AD (bp-wise), but it felt very similar. I had (and still have) large hemorrhoids.

    Stopping suppositories was the best decision I ever made. I don't do dig stim either, because it doesn't help. I just try 5 or 6 different tricks to go (I have posts on this somewhere). And I am C5/6 complete.

    The downside is that, instead of going every other day, I sit on the commode chair every morning and every evening (and always have results). But the total time is only about 30 minutes per day on the commode (20 minutes AM, 10 minutes PM), vs 1 hour+ with a suppository (every other day).

    The upside is that there is no more sweating or discomfort. I didn't really have a choice; the after-effects were starting to last for hours, and I was miserable with sweating and tension.

    I know we're all unique, but I think the suppositories are hard on many of us, and I think many quads still have normal peristalsis. I never thought I could give up suppositories, but life is so much better now (even with managing the help I need). Just make sure you get enough fiber along with plenty of water, and avoid foods that constipate.

    On the other hand, I've heard the colostomy is not a bad way to go either. You definitely need to stop the AD. BTW, do you take ditropan (oxybutanin)? That can slow the bowels, and it seemed to contribute to AD for me sometimes, esp. during bowel care. I gave that up too.
    Last edited by dnvrdave; 11-28-2012 at 11:39 AM.

  10. #10
    Quote Originally Posted by dnvrdave View Post
    For me, the problem was the suppository (or enemeez; they both were hard on me). The answer was to stop using them, after 25 years of sweating and (unfelt) pain. I didn't have detectable AD (bp-wise), but it felt very similar. I had (and still have) large hemorrhoids.

    Stopping suppositories was the best decision I ever made. I don't do dig stim either, because it doesn't help. I just try 5 or 6 different tricks to go (I have posts on this somewhere). And I am C5/6 complete.

    The downside is that, instead of going every other day, I sit on the commode chair every morning and every evening (and always have results). But the total time is only about 30 minutes per day on the commode (20 minutes AM, 10 minutes PM), vs 1 hour+ with a suppository (every other day).

    The upside is that there is no more sweating or discomfort. I didn't really have a choice; the after-effects were starting to last for hours, and I was miserable with sweating and tension.

    I know we're all unique, but I think the suppositories are hard on many of us, and I think many quads still have normal peristalsis. I never thought I could give up suppositories, but life is so much better now (even with managing the help I need). Just make sure you get enough fiber along with plenty of water, and avoid foods that constipate.

    On the other hand, I've heard the colostomy is not a bad way to go either. You definitely need to stop the AD. BTW, do you take ditropan (oxybutanin)? That can slow the bowels, and it seemed to contribute to AD for me sometimes, esp. during bowel care. I gave that up too.
    I just read about others stopping supp's and it looks promising. I will give it a try but it seems like the AD intensifies when the stool is dropping out, no matter what I take. I also get it during the day alot worse when I'm gassy. After taking to my dr yesterday he thinks its all related to distention of the rectum(which makes sense) and I don't see anyway to stop it if that is the cause. Especially since I cant pass gas on my own. I dont know why its gotten worse lately but I'll try no supp and see where it gets me. Thx for the advice.

    n oh ya.. I dont take anything but baclofin.

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