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Thread: Bowel "Program Question

  1. #1

    Bowel "Program Question

    Switched from Dulcolax Suppositories to Majic Bullets. Dulcolax was too harsh for me. I started cutting them in half. My problem is I do my program every day around 6:30 or 7:00 PM. After an hour I'm finished evacuating because Majic Bullets moves my bowels out in 10 to 15 minutes. However, the next day at work if I have my coffee I'm ok. But later a bag of chips or a few bites of a sandwich I will have to rush out to take care of a bowel movement. Sometimes I make it and sometimes I'm in a position where the accident will come. I did my program Thursday evening. Friday at work I ate a bag of Cheetos and my bowels started to move. I had to rush out and take care of it. That was a large bowel movement. Since I had a big movement earlier I didn' t do the program at the evening hour. Today, I had scheduled a local alternative transit van to pick me up for breakfast at 11:00 AM. I ate but wouldn't over eat. While waiting on my ride my stomach felt queezy and I passed gas, my bowels started to move. I thought I would make it home since my ride came early. I got home but the accident happened anyway inside the alternative transit van and this was embarrassing. This time it was not formed but diarrhea. I'd started using 3/4 of the Majic Bullet Suppository. Wonder if I should use half. At times I do digital stimulation before I go to work in the morning - there is nothing but later that day my bowels may start to move. (I belief the digital stimulation is what started my bowels to move later) Sometimes the next morning there is something there to move out and with digital stimulation I can get it taken care of.

    I am at a lost for solutions to solve my problem.

  2. #2
    Ducolax suppositories and Magic Bullet suppositories have the same active ingredient, 10 mg Bisacodyl. The difference between the two is the base. Ducolax is a vegetable oil base and Magic Bullet is a water soluble base. That means that the Magic Bullet usually takes less time to melt in the rectal vault.

    Some people experience "after burn" which is usually described as a runny mucous, that occurs either during the night or the next day after a bowel program. The cause of "after burn" is that the bisacodyl hasn't been completely cleared out.

    But, it sounds like you are having stool accidents not "after burn." That suggests to me that maybe you aren't getting fully cleaned out when you do your bowel programs. Your bowels may start to move in 10-15 minutes, but unless you do digital stimulation after that first movement, you may have more stool high up that needs peristalsis to move the stool down. Peristalsis can be stimulated by certain foods and drinks or if there is a lot of stool in the intestine. I've read on this forum that some people do use a 1/2 Magic Bullet and that works for them.

    Before you insert the Magic Bullet, you need to remove stool from the rectal vault, don't insert the Magic Bullet into stool. After you have inserted the suppository and have an initial evacuation, gently stimulate the walls of the rectal vault by using a slow circular motion. This should stimulate more evacuation in 5-15 minutes. You may need to do this several times before you are completely cleaned out. Digital stimulation in the morning can definitely start the peristaltic action and cause accidents later in the day, if you aren't adequately empty. I think most of us spend about 45-60 minutes on a bowel program.

    You may want to look up a product called Enemeez. Some people find it less irritating and have good results with it.

  3. #3
    Thanks gjnl: I just read today that you should remove the stool before you insert the suppository. I'll try those. I have two boxes with samples of Eniemeez in them...I will try them.

  4. #4
    If you are having a lot of problems with accidents, would recommend going to daily bowel care. Best to do bowel care within 30-45 min. after a meal too, as you will get more complete and rapid emptying. Do you do bowel care up on a commode/toilet, or in bed? The former is preferred, again, you will usually have faster and more complete emptying. While many people do bowel care in the evening, sometimes your body just "wants" to go in the morning (or reverse), so if possible try doing your bowel care in the morning before going to work (complete with both suppository or Enemeez and dig stim).

    Would also recommend keeping a food diary and keep track of everything you eat. Since transit time in people with SCI can be 72 hours or more, it can be sometimes very difficult to remember what you ate 3 days ago. Use the diary to check back on the food you have had over the previous 3 days whenever you have an accident. This may help you identify foods that are problematic for you, individually. Often these are foods high in fat, or very spicy foods, but it varies a lot with the individual.

    It is also recommended that you continue with your regular bowel care regimen, at your usual bowel care time, even if you have a bowel accident. Don't skip.

    As above, bisacodyl is the active ingredient in both Magic Bullet and Dulcolax brand suppositories. You can also get a generic that is equal to the Dulcolax and much cheaper.

    Diarrhea is defined at 3 or more loose stools in a 24 hour period. One loose stool is not diarrhea...it is just a loose stool.

    Ideally, make only one change in your bowel program at a time, and don't make another change for 7 days. This allows you to better determine if the one change was effective.

    You may want to download this booklet on "Bowel Management: What you need to Know" from the Consortium of Spinal Cord Medicine. It has good guidelines for all aspects of bowel program management:

    http://www.pva.org/CMSPages/GetFile....f-d1d2469eec0e

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  5. #5
    I do my Bowel Care on the commode. I insert the suppository on the commode and wait for the results.

  6. #6
    Get rid of the suppositories and just dig the shit out in the a.m. every morning... Tried suppositories in rehab, always had after "effect" !!! I dig every morning and use baby wipes to whipe ass. Then toilet paper to really clean. Sometimes after I wipe with baby wipes and "think" im done I'll shit more. Put on another glove and dig again, your asshole will close up when done and you'll never use a dumb suppository again... Good luck. P.s. can't remeber last time I've had an accident and eat whatever whenever i want too

  7. #7
    AJ, that may work for you, but it does not work for everyone. If stool does not move into the rectum (which is what a suppository is needed for) you cannot manually remove it (and manual removal and digital stimulation are not the same thing).

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  8. #8
    Sometimes the stool is high up, therefore, a suppository is needed. When the stool is already in the rectum I pull it out. What I should do is insert a suppository after I've pulled the stool out to bring down the rest of what is left that is high up. I think what is what my problem was last week. A few days my stool was very hard and I inserted the suppository in on top of the hard stool only to pull out a little bit. I wasn't cleaned out. After a couple of days when the stool softened I didn't spend enough time doing digital stim or sit on the commode long enough to take care of getting the rest of what was left to move out... In addition to this, I'm going to change my diet.

  9. #9
    Let us know how you are doing and if you need any more advice. The booklet that kld recommended is very helpful, but there is nothing like experience to temper what "should" work and what "does" work.

    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  10. #10
    Made changes, went back to using a whole Magic Bullet Suppository everyday -- No accidents: Another Question in order to save money. I see on Ebay that they sell the generic brand for Magic Bullet Suppositories. Has anybody used those and will they work?

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