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Thread: Bowel Management in Aging Paraplegic

  1. #11
    My husband has a lower motor neuron sci with flaccid paralysis.
    KLD is correct. Fibercon is a bulking laxative and may be appropriate in your condition as it was with his. Try it as your only laxative for a few weeks and see if you notice a change for the better.

  2. #12
    Quote Originally Posted by 2drwhofans View Post
    My husband has a lower motor neuron sci with flaccid paralysis.
    KLD is correct. Fibercon is a bulking laxative and may be appropriate in your condition as it was with his. Try it as your only laxative for a few weeks and see if you notice a change for the better.
    Thank you! What’s the best time to take Fibercon?

  3. #13
    My Dad also is an aging paraplegic with a lower motor neuron injury. When he went through a period with looser stools, his gastroenterologist also recommended Metamucil/fiber and starting a probiotic. For my Dad, it caused a rapid improvement within a couple days. I don't think the time of day he took it was critical, as nothing works too fast for him.

    Check the instructions for whatever you take. Often you need to separate it from any pills/medicines you are taking by a few hours, or it will affect their absorption.

    Let us know how it works for you.

  4. #14
    Thanks for the advice. I started the Fibercon yesterday.

    I don’t have a completely flaccid bowel. I do have some reflex, albeit very little. In researching this, I’ve found some people with SCI in the T11/12 area, like myself, don’t always fit nicely into one type of bowel or the other.

    It does make sense to me that adding consistent bulk might be the solution. I hope the Fibercon helps me develop a consistent stool from start to finish... not just the start with the end turning very soft and runny. I have tried to do this via my diet and eat a lot of fiber, especially insoluble fiber, but it really hasn’t made any difference.

  5. #15
    How do you tell if you have a flaccid or spastic anal sphincter?

  6. #16
    Senior Member lynnifer's Avatar
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    Ahem ... my friend has a spastic one and is prone to accidents. The only time I've had a bowel accident with my flaccid bowel is after the prolapse (could not reach all like the OP).
    Make America Sane Again. lol

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

  7. #17
    Quote Originally Posted by CGray255 View Post
    Thank you! What’s the best time to take Fibercon?
    My husband takes most of his medications, including Fibercon, in the early morning. Bowel program is in the early evening
    Can't say if it's the best time, it just worked out for him.

  8. #18
    Quote Originally Posted by wheelman21 View Post
    How do you tell if you have a flaccid or spastic anal sphincter?

    The "index-fingertip handshake".
    Flaccid sphincter won't squeeze tight.

  9. #19
    Quote Originally Posted by wheelman21 View Post
    How do you tell if you have a flaccid or spastic anal sphincter?
    The following definitions are based on level of spinal cord injury. It is possible to be a little bit of both, spastic and flaccid.

    A spastic neurogenic bowel is caused when messages between the brain and the colon are interrupted (stopped) when a SCI is at the neck (cervical) or chest (thoracic) level.

    A flaccid, or “limp” neurogenic bowel is caused by a spinal cord injury at the lumbar (lower back) or sacral (tail bone) area of the spinal cord. The nerves that go out from this area to the bowel also may have been damaged, decreasing the reflex (automatic) control of the anal sphincter.


    A SCI may result in a loss of ability to feel when the rectum is full. Bowel movements occur reflexively when the rectum is full. This type of bowel problem is called an upper motor neuron or "reflexic bowel." It can be managed by causing the defecation reflex to occur at a socially appropriate time and place.

    A spinal cord injury level may damage the defecation reflex and relax the anal sphincter muscle. This is known as a lower motor neuron, “flaccid” or “areflexic” bowel. Management of this type of bowel problem may require more frequent attempts to empty the bowel and bearing down or manual removal of stool.

    http://www.uwmedicine.org/health-library/pages/neurogenic-bowel.aspx


    The following article is a bit more comprehensive: https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/bowel-management
    How paralysis impacts the digestive and bowel systems
    Christopher and Dana Reeve Foundation



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