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Thread: Bowel Management in Aging Paraplegic

  1. #1

    Bowel Management in Aging Paraplegic

    Over the course of my 38+ year history as a T11 para (age 61) with a neurogenic bowel, my bowel program has gone through several variations. I had been able to arrive at workable solutions by changing things up. For the last 3 or 4 years though, I?ve had an ongoing problem with bowel incontinence that has me at wits end. I've tried several things but I can?t find a consistent solution. I eat very well and manage everything I can think of.


    I think I?m dealing with a gut motility and incomplete bowel evacuation issue but I?m not entirely sure. Is this normal and expected with aging paraplegia?


    After initiating my bowel program, my stools start out well, with some good volume and soft bulk but they get progressively softer with the end being very soft, almost runny, stool that has bits of insoluble fiber in it and does not pass down into the rectum without manual techniques. If I can't get that residual stool to come out at that time, I'll often have leakage or an unexpected bowel accident 3 or 4 hours later, usually after eating lunch. This happens at least once a week now and some times more often than that.


    I'm seeking professional/experiential guidance, peer?s suggestions, and/or the name of a doc or nurse with significant expertise in bowel management in aging paraplegia that can help me wrestle this down.


    I?d appreciate any insights or recommendations.


    Thanks in advance.

  2. #2
    Do you have a flaccid or spastic anal sphincter?

    What meds, if any, do you take as part of your bowel program, including suppositories?

    When you say manual techniques, do you mean manual removal of stool, or digital stimulation, or both?

    Are the accidents you are having stool, or more mucous?

    (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.

  3. #3

  4. #4
    Would colonoscopy help rule out any issues?

  5. #5
    Thank you.

    My anal sphincter is mostly flaccid. There is some spasticity but not much.

    Other than the 1/4 magic bullet, I don’t take any bowel meds.

    I use manual removal of stool primarily. I can get a response from digital stimulation but it’s generally inadequate.

    The accidents are most usually very soft stool. Occasionally a mucus discharge but that is rare.

  6. #6
    Thank you. I’ll read these threads ASAP!

  7. #7
    Thanks you. I had a colonoscopy a year and a half ago. It was all clean. My GI Doc didn’t have any solutions for me. She suggested trying Imodium the night before my BP to slow the gut down. This hasn’t produced any consistent improvement.

  8. #8
    Imodium will help but it is generally not recommended for long term chronic use.

    Digital stimulation should be used only for those with a spastic anal sphincter.

    When I am trying to firm up stool for those who have a flaccid sphincter (lower motor neuron, LMN bowel), I like Fibercon (generic available as calcium polycarbophyl). It is available over-the-counter. You can take from 1-6 tablets daily, and adjust it gradually to the point that your stools are well formed. Don't go all the way to rocks or rabbit pellets; cut back if you are having those results.

    (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.

  9. #9
    Thank you very much! I hope the solution is this simple. I’ll start the Fibercon just as soon as I can get some and will report back.

  10. #10
    Senior Member lynnifer's Avatar
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    What helped for me was a protein shake. I think I had a rectal prolapse (internal) when this happened to me too .. never had it fixed - the protein helped to firm again making it easier to remove.

    Same level, same method. 33yrs post.
    Make America Sane Again. lol

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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