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Thread: Bowel Incontinence

  1. #1

    Bowel Incontinence

    Hey all, quick question. Here in about the last 3 weeks I have been having invols quite frequently. Before that I would have one when I was sick or just randomly maybe one every other month. I have not changed meds. I don't do a good job of eating, maybe once a day, sometimes twice, but it has never affected me like it is now. Stool seems to be pretty soft during bowel program. I do take hydrocodone, zoloft, and Valium. Does anyone have any suggestions on how I could fix this. Thank u

  2. #2
    How do you manage your bowel program? Magic Bullets? Enemeez? Digital Stimulation? Some combination of these?

    Do you take any fiber supplements?

    Do you take any laxatives?

    How often do you do a bowel program?

    All the best,
    GJ

  3. #3
    I take magic bullets and then digitally stimulate myself. I do my program every morning. Everything looks voided and about 2 hrs later here comes more. I dnt take any laxatives or fiber supplements

  4. #4
    Aside from GJ's questions -
    My suggestion is regularity in everything.
    Times and quantity of eating & drinking; time of BP, etc.
    I found that quite often after it seemed like everything was out, with continued stimulation, more would appear.
    - Richard

  5. #5
    Go back to the bowel care basics in all 5 areas:

    Diet & Fluids:
    3000 ml. water daily if possible
    30 gm. dietary fiber daily
    Keep a food diary so you can see what impact foods may have in the next 48-72 hours.
    Medications:
    Avoid harsh laxatives and stimulants
    Use a suppository to move stool into the rectum to prepare for evacuation.
    Adjust stool softeners to compensate for constipating meds such as opioids and anticholenergics.
    Keep stool on the VERY firm side if you have a LMN bowel. Fibercon and Imodium may be needed (avoid softeners).
    Timing & Frequency
    Do bowel care no less often than 3X weekly. If having accidents, keep to no less often than daily. Those with a LMN bowel may need to do bowel care several times daily.
    Do bowel care within 30 minutes after a meal that includes either some fat or hot liquid.
    If you have a bowel accident, don't skip scheduled bowel care.
    Do bowel care at the same time of day every time you do it.
    Avoid making more than one change in your bowel program per 7 days.
    Techniques:
    Use digital stimulation (for a UMN bowel) or manual removal (for a LMN bowel) to empty the rectum.
    Do bowel care up on a toilet or commode (rather than in bed) unless medically contraindicated.
    Try some abdominal massage after suppository but before emptying the bowel.
    Equipment:
    Use a padded raised toilet seat or commode seat to protect your skin.
    Invest in a digital stimulator and/or suppository inserter if you lack finger function or cannot reach to do your own care.
    Consider a bidet or bidet toilet seat for clean up.
    Explore different devices for help in independent clean up.
    When you have an accident several hours later, is it actually stool, or is it mostly mucous (Butt Snott or After-burn)???

    (KLD)

  6. #6
    I agree with Richard. Using Magic Bullet and digital stimulation is a multi step process that can't be rushed and you need to be sure all the stool that will pass during a program has passed.

    I find the sitting position is best for a bowel program, commode chair or toilet. It is important to remove any stool in the rectal vault before inserting a suppository or mini enema. Don't insert these into stool. Suppositories and mini enemas can be inserted while in bed and the program completed with a transfer to a commode chair shortly after one of these preparations have been inserted. Wait for an initial evacuation of stool, then perform digital stimulation to encourage more peristalsis and movement of stool into the rectal vault. Wait for another evacuation of stool and perform digital stimulation again. Once all stool and any mucus seems to have passed, (usually after 2-4 digital stimulation periods) clean the perianal area thoroughly. Making sure all of the stool and mucus has passed and the medication has been removed from the rectal vault is important to help avoid accidents and release of mucus known as "after burn."

    You may want to try a switch from Magic Bullets to Enemeez. Many people who have used Magic Bullets for years, begin to experience accidents and mucus. Enemeez is called a mini enema. Take a look on the following website for more information and request free samples of Enemeez.
    Enemeez: http://www.enemeez.com

    Here are a couple threads from Care Cure Community that you might find helpful.

    http://sci.rutgers.edu/forum/showthr...t=magic+bullet
    http://sci.rutgers.edu/forum/showthr...emeez+catheter

    A fiber supplement (Metamucil, Citricel etc.) can help regulate your bowels, especially if you are not eating well.

    All the best,
    GJ

  7. #7
    Question-Magic Bullet vs. Enemeez? I live in NY and don't know who to order these from for my husband? Should I go straight to the product site for each. Lastly, which one? Magic or Eneneez. Thank you.

  8. #8
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    nurse, three letter acronyms are the worst. define lmn and umn bowels please
    "Smells like death in a bucket of chicken!"
    http://www.elportavoz.com/

  9. #9
    Quote Originally Posted by crypticgimp View Post
    nurse, three letter acronyms are the worst. define lmn and umn bowels please


    I have always believed that abbreviations and acronyms are used by the "establishment" and "experts" (in what ever field) to keep all the rest of us clueless, out of the loop, and in the dark. Buzz words and Jargon. When you are writing for a group as diverse as Care Cure Community with new spinal cord injured people finding this site every day, you need to define your terms, no matter how repetitive that is for the writer. This isn't the first time I have vented about this and I have asked that a dictionary that is easy to access be added to the site rather than the difficult to find (how many people really know it is there or how to find it, and how complete is it) "Acronyms Used On This Site" http://sci.rutgers.edu/forum/showthread.php?t=85062

    Thanks "crypticgimp" for bringing this up.

    This may help:
    Function of the Bowel Following a Spinal Cord Injury

    Following a spinal cord injury, damage to the spinal cord may result in the loss of the ability to control the bowel reflex when the rectum is full, or the reflex to empty the rectum may be lost altogether. The function of the bowel is maintained by the nerves entering the spinal cord at the sacral levels of S2 - S4. Due to the voluntary action of the bowel being communicated so low in the spinal cord, any spinal cord injury will usually have some impact on the defecation process.
    Buzz words and Jargon.

    The Reflex Bowel or Upper Motor Neuron Bowel (UMN)

    If the spinal cord injury is above T12, the sensation of a full bowel may no longer be detectable by the injured person. In such cases, the anal sphincter will remain closed, however, it will open on a reflex basis when the rectum becomes full.

    This type of bowel is referred to as an upper motor neuron bowel reflex. As the person will not be able to sense when the rectum is full, the reflex to empty the rectum can happen at any time unless the bowel is managed properly.

    The upper motor neurone bowel reflex can be managed to prevent accidental defecation, by causing the defecation reflex to occur at a socially appropriate time.

    The Flaccid Bowel or Lower Motor Neuron Bowel (LMN)

    If the spinal cord injury is below T12, then there may be damage to the defecation reflex, and the anal sphincter muscle may relax, staying open. This type of bowel is referred to as an lower motor neuron bowel or flaccid bowel.

    The lower motor neurone bowel reflex can be managed to prevent accidental defecation, by emptying the bowel more frequently at a socially appropriate time, by bearing down or the manual removal of stool.

    Both types of bowel, reflex and flaccid, can be managed to avoid the accidental opening of the bowel, and to avoid constipation and impaction.


    All the best,
    GJ
    Last edited by gjnl; 03-13-2013 at 12:48 AM.

  10. #10
    Quote Originally Posted by MichelePaula View Post
    Question-Magic Bullet vs. Enemeez? I live in NY and don't know who to order these from for my husband? Should I go straight to the product site for each. Lastly, which one? Magic or Eneneez. Thank you.
    You can buy Magic Bullets from: http://conceptsinconfidence.com

    You can buy Enemeez from: http://www.enemeez.com
    Enemeez will ship free samples to you.

    Or, you can search the internet for a better price at internet medical supply outlets.

    Each of these work differently for different people. There is really no way to know which one will work best for your husband. He may just have to try both to see which one gives him the best results, least accidents, least autonomic discomfort. It may take some long term experimentation with both of these products to decide which one is right for him.

    All the best,
    GJ
    Last edited by gjnl; 03-13-2013 at 12:27 AM.

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