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Thread: long bowel routine needing a lot of stim. help!

  1. #1

    long bowel routine needing a lot of stim. help!

    I am a c6 ish quadriplegic 10 years in my injury and I've been having A tremendous amount of trouble with my bowel routine. I'm pretty much bedridden which I know that does not help the situation but I take 4 Senokot and 4 ducolux the morning of my routine which I do that night. I use the magic bullet by doing the digital stimulation first putting the suppository and then I have to wait about an hour to get results. but what I'm finding is theres some that comes out initially but then I have to do the stim more for quite sometime. I usually keep doing it until there is no more results which has been as long as 50min! I know way too long right but if not I have accidents. I take narcotics because of all the pain I am in from my back which always is in excruciating pain along with my legs as well as the usual baclofen and gabapentin and other medications as well.. I tried enemzz and other suppository called co2 (that was worthless). I have oatmeal every day and a normal supper such as chicken veggies whatever. and I take seven prunes the night before. i drink TONS at least 2 quarts or more of water all the time so i know I'm not lacking there,
    Help please so I don't have to do the stimulation as much it's very painful. Any advice is welcome.

  2. #2
    I use "Manevac" http://www.netdoctor.co.uk/digestive...s/manevac.html stool softener. I take a spoonful most evenings. I also "try" and eat plenty of veg. I find Cabbage is brilliant for a nice smoothie the day after, u just need to find something nice to go with the veg if your not much of a veg person. x2 Glycerine supps every day + a bit of stimulation seems to do the job for me.
    Also twice a week I have a good ol' shower (wheel in commode/wet floor) and placing the jet at a gentle setting in the appropriate area, seems to stimulate a lot of stubborn goods. I found that after years of doing this too often, you can aggrivate the area, so twice a week is my limit doing this.
    Not foolproof, but it's how I manage. Best of luck

  3. #3
    Senior Member
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    I use a Enemeez mini enema, and if no results, try a bit of stim, and then use about half of a fleet bottle with warm water in it, and the other half if a couple of gentle stims don't produce results.
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  4. #4
    Bowel programs are difficult because you have to find the right combination of food, liquids and medications to get the right results
    I always ask my patients two questions...Is your stool hard or soft? and Does it move (through your system) ? If you can figure out these out then you will figure out what combination works for you.

    Senokot is a natural stimulant - for some people it works well some it doesn't. It can cause a lot of gas (flatus). Have you needed to increase your dose over time?
    Dulcolax - many different types in that brand- can you tell us what the ingredients are? is it a stool softener? or a combination of two types of medications? Again have you needed to increase your dose over time?

    Opiates cause constipation. What was your bowel program prior to using opiates on a regular basis? What worked well?

    pbr
    Last edited by SCI-Nurse; 07-05-2014 at 11:59 PM. Reason: Spell check

  5. #5
    Because you take opiates which are constipating, suggest you take 1 capsule of magnesium citrate per day 100mg capsule. If stool is too soft, take one capsule every other day, the day before bowel pgm.

  6. #6
    SCI-Nurse-- I do use dulcolax and Senokot I take 4 and 4 the morning of around 6 AM. I am on a lot of narcotics which does make my stool A little harder in the beginning and then it is softer towards the end. I take 60 mg morphine er in the morning and 60 at night every day. I also have to take six Percocet A day. As of Monday I've stopped taking Percocets because I believe I've developed tinittus. I have Constant ringing in my ears and I read that morphine and Percocet's both can cause this :-( I'm in the process of working this out with the doctors.
    my bowel prep medications Monday Wednesday and Friday morning along with a few other medications baclofon neurontin and I take Colace every day a couple times every day.
    My bowel program worked pretty good about A year ago but I still was taking the same amount of medication. I'm 10 years in my injury June 28 so I know overtime this can be expected right? I really haven't changed much except for having to up to docolax and Senokot. I'm trying to make sure I eat proper Foods which I'm trying to get back on the better diet it's just hard to eat because I'm always nauseous from the pain I am in. I have oatmeal every day and I'm trying to eat fruit the day before like Tuesday Thursday Saturday Sunday(grapes especially) and I take 7 prunes Sunday Tuesday and Thursday night around 11 PM

    I think I answered all your questions. any other ideas?

  7. #7
    You are on some hefty doses of morphine. I would recommend getting a plain xray of your abdomen (a kidney-ureter-bladder = KUB film) to get a good view of the intestines. See if you have an enlarged part of your intestine such as an ileus or megacolon. An ileus is decreased propulsive ability of the intestine caused by bowl obstruction or intestinal paralysis. It is worth finding out.

    pbr

  8. #8
    Senior Member marvin_cr's Avatar
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    Personally, I found using too many stool softeners, laxatives, and supositories really screwed up my system. About 15 yrs ago, I completely stopped using these. What has worked for me is using Flaxseed flour or meal and putting it in my oatmeal in the morning. It takes some time and a lot of trial and error to get the right amount. My case I started out with too much flaxseed and had many accidents early on. Currently I use about a 1/2 teaspoon in my oatmeal. Also, I went to a daily bowel routine in the evening after dinner. I use digital stimulation and I am usually done in 15 mins. I may have one accident a year now and about one bout with constipation a year.

  9. #9
    yeah i know i'm in an immense amount of pain. That's what pain management put me on. I tried other narcotics but nothing seems to help as good as the morphine. Even that doesn't help much but at least it takes the edge off slightly. Any ideas for different pain management? I will have to look into getting there is test.

    Marvin I've heard of people using flaxseed and I guess it's worth a try. As far as consistency the first part little hard in the rest is okay. I hope it doesn't make a soupy mess. LOL

  10. #10
    Pain medication management deserves a thorough review type, description, location, history of meds tried - effect and side effects.

    Your question is regarding your bowel program - have you had an xray of your intestines to see their condition?

    pbr

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