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Thread: problems w/bowel routine....SCI nurse help :)

  1. #1
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    problems w/bowel routine....SCI nurse help :)

    I?m a C5/6, 17 years out.

    For about 15 of these I?ve had a saline (fleet?s type) enema every other day for my bowel routine, and that has worked pretty well so far.

    For about the past year, though, I?ve had some pretty loud gas the day after the enema, which sounds (TMI!) like I?m also passing some liquid-w/solids rarely present.

    I?m curious about why I?m seeing these changes (and it?s also embarrassing!) Any theories about why it is happening and if I should do a different method?
    "courage is fear that has said its prayers"

  2. #2
    Two preparations that are commonly used for a bowel program are Magic Bullets suppositories (10mg Bisacodyl in a water soluble base) https://conceptsinconfidence.com/ind...:faqs&Itemid=4 and Enemeez, mini enema (283 mg Docusate Sodium) http://enemeez.com/.

  3. #3
    Other than the farting, have you been having good results with the Fleets (sodium phosphates) enemas? Accidents between bowel programs? How long does it take for your entire bowel care regimen? Have you also changed your diet recently?

    One concern for the routine long-term use of enemas (and strong oral laxatives) in people with SCI is that these may increase your risks for obstructive megacolon after many years. Generally though you would see it taking increasing periods of time to evacuate your bowels with your bowel care regimen, and increased problems with impactions.

    (KLD)

  4. #4
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    I too am having bowel program issues. I'm 14years out with an incomplete C5-7 injury. I use a Magic Bullet every other day. I've been hospitalized twice, once 3/21-3/26 and 5/4-5/11 with a small bowel obstruction. I've had multiple ct scans and X-rays that showed large amounts of fluid, feces, and gas. My gi doctor is stumped. I still haven't got results for my last ct with contrast. I see my doctor on Wednesday. Now I'm eating small meals, less fiber but I'm still having problems.

    I'm sorry that you're having issues. Please keep us posted and I will too.

  5. #5
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    Quote Originally Posted by gjnl View Post
    Two preparations that are commonly used for a bowel program are Magic Bullets suppositories (10mg Bisacodyl in a water soluble base) https://conceptsinconfidence.com/ind...:faqs&Itemid=4 and Enemeez, mini enema (283 mg Docusate Sodium) http://enemeez.com/.
    thanks for the tip! I'm getting some samples. are these (and the bullets) supposed to be more effective than what I'm using?

  6. #6
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    Quote Originally Posted by SCI-Nurse View Post
    Other than the farting, have you been having good results with the Fleets (sodium phosphates) enemas? Accidents between bowel programs? How long does it take for your entire bowel care regimen? Have you also changed your diet recently?

    One concern for the routine long-term use of enemas (and strong oral laxatives) in people with SCI is that these may increase your risks for obstructive megacolon after many years. Generally though you would see it taking increasing periods of time to evacuate your bowels with your bowel care regimen, and increased problems with impactions.

    (KLD)
    I've been getting similar results over the years of both volume and time spent on the process,, w/very few accidents and a few times where the stool was rather hard, but the person doing the bowel routine could always remove it. my understanding is that an impaction needs to be removed manually, which would indicate that if my stool was always removable I wasn't impacted...is this correct thinking?

    no diet changes, and process takes less than 1/2 hour usually.

    and, what is it about the fleets-type enema and strong oral laxatives that can cause megacolon? I'm trying to learn about these things
    "courage is fear that has said its prayers"

  7. #7
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    Quote Originally Posted by ima2003 View Post
    I too am having bowel program issues. I'm 14years out with an incomplete C5-7 injury. I use a Magic Bullet every other day. I've been hospitalized twice, once 3/21-3/26 and 5/4-5/11 with a small bowel obstruction. I've had multiple ct scans and X-rays that showed large amounts of fluid, feces, and gas. My gi doctor is stumped. I still haven't got results for my last ct with contrast. I see my doctor on Wednesday. Now I'm eating small meals, less fiber but I'm still having problems.

    I'm sorry that you're having issues. Please keep us posted and I will too.
    maybe you should do a colonoscopy prep (easier said than done, I know!)
    "courage is fear that has said its prayers"

  8. #8
    Quote Originally Posted by jennypenny View Post
    I've been getting similar results over the years of both volume and time spent on the process,, w/very few accidents and a few times where the stool was rather hard, but the person doing the bowel routine could always remove it. my understanding is that an impaction needs to be removed manually, which would indicate that if my stool was always removable I wasn't impacted...is this correct thinking?

    and, what is it about the fleets-type enema and strong oral laxatives that can cause megacolon? I'm trying to learn about these things
    No, impaction means stool that is "stuck" in the colon and does not move with normal peristalsis. It is the extreme end of constipation, and the stool is usually very hard little balls. It can be removed usually by the use of a combination of osmotic laxatives and stimulants, although it may take pretty large amounts. Rarely does an impaction make it to the rectum, so it rarely can be manually removed.

    We are not sure why long term heavy use of enemas and strong stimulants or laxatives can sometimes cause obstructive megacolon in persons with SCI, but there is an association with such use. It may be that these strong laxatives/stimulants increase peristalsis so much that the muscle eventually "burns out" causing little or no peristalsis to be possible (which is the definition of megacolon) similar to the decompensation of the bladder with long term high-pressure voiding, or left sided heart failure (all of these are weak, floppy smooth muscle).

    (KLD)

  9. #9
    I use Lexicarbon suppositories and they seem to work really well.

  10. #10
    Quote Originally Posted by Ironside View Post
    I use Lexicarbon suppositories and they seem to work really well.
    Not sure what the equivalent of Lexicarbon is in the United States. An internet search wasn't helpful. Anyone?

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