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Thread: Bowel regime

  1. #1
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    Bowel regime

    For the past 35 years, I've been using the same bowel prep. I take three Senokot the night before and then a suppository followed by digital stimulation. I do this every Monday, Wednesday and Friday. I used to have good results, but lately not as much. I also find it is taking at least two hours. I've been reading where you shouldn't use suppositories that often and too much stimulation can be irritating. I thought about taking Metamucil, but was worried I would have accidents. I try to eat plenty of fiber each day. I don't know what else to try. Does anyone have any suggestions?

  2. #2
    Actually, there is little evidence that long-term use of bisacodyl suppositories causes any problems. Chronic long-term use of strong stimulants, such as senna, or laxatives, is associated with development of obstructive megacolon though.

    How much dietary fiber? It should be at least 30 gm. How much water daily?

    Do you do bowel care within 30 after a meal?

    What kind of suppository?

    Are you on any new meds that can cause constipation, such as opioids or anticholinergics?

    (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
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    Thank you very much for your response. I am desperate for suggestions to help relieve my severe stomach and groin pain that I have had for several years now. I,m not on any medications such as opiods or anticholinergics, however I do take a large dose of Baclofen each day (40 mg QID) and I have been taking Senna for many years. I honestly have no idea how much fiber I am taking although I try very hard to eat a healthy, well-balanced diet. I've though about taking Metamucil but I was concerned about incontinence. I do my bowel regimen every Monday, Wednesday, and Friday before I eat breakfast. I use the Magic Bullet suppository. I believe my water intake is sufficient. I usually drink at least 75 ounces of water daily and at least one cup of green tea. Also, I had a Colonoscopy two years ago which was normal except for a few benign polyps. If I had Obstructive Megacolon I would think it would have been diagnosed, right?

    I've never really had any follow up with Neurology since my accident. I sincerely appreciate any help or suggestions you could give me.

    Steve

  4. #4
    No, obstructive megacolon is not diagnosed with a colonoscopy.

    You should have better bowel care results doing it 30 after a meal that includes some fat or hot liquid.

    A GI specialist is best for evaluation of possible megacolon, usually starting with a bowel transit study.
    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
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    If I stop using Senokot the night before, what would you recommend? Should I try Metamucil? I'm just so worried about incontinence. And as far as the suppository goes, it's safe to keep using the magic bullet? They do the digital stimulation, but it seems to be taking much longer. It's always at least two hours.

    The problem is, I do my bowel care in the mornings at 7:00. I really don't have time to eat. But maybe I could have some hot tea during it.

  6. #6
    No more than one change per week.

    Why do you think Metamucil will cause accidents?

    It takes15-30 min. for the gastrocolic reflex to kick in after drinking a hot liquid or eating food.

    (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.

  7. #7
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    Thank you again for all your responses and information. I will try the hot liquid for a couple of weeks to see the results I get. As for the Metamucil, I just didn't know how my body would react seeing I have no control over my bowels. Is that something you're supposed to take on a daily basis? Also, do you know of any neurologist in my area (Dartmouth Massachusetts) that specialize in spinal cord injuries? Like I said, I've never really followed up with one of them since my accident all the way back in 1984. I spent a total of two months in the hospital and that was it. I've pretty much been on my own with just regular doctors since then. I have other issues I've always wondered about and can never get answers from anyone. For years, my back has been freezing cold like I'm laying on a slab of ice. But it's always to warm touch. No matter what I'm wearing or laying on, it doesn't change.
    Last edited by Handiman67; 10-18-2019 at 09:52 PM.

  8. #8
    Metamucil is not a laxatives. It should be taken daily.

    Why do you need a neurologist? A good physiatrist who specializes in SCI/D would seem more appropriate for your needs.

    (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
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    So you don't think I would run into any incontinence problems taken Metamucil on a daily basis? And if I do, should I just skip Senokot from now on? Would you know of a good physiatrist? I would love to hopefully get some answers to my problems. I appreciate you taking the time to answer all these questions.

  10. #10
    Metamucil works to hold water in the stool and keep it soft, as well as increase the bulk of the stool, stimulating more peristalsis. Combined with a good bowel care regimen, it should not cause any unusual incontinence any more than increasing dietary fiber in general will. If you can get down 30 gm. of dietary fiber daily, you probably don't need Metamucil.

    As i said, only one change per week. So either start Metamucil and continue senna for the next week-10 days, or just stop senna, but not both at the same time.

    Where in MA are you? Generally you can find physiatrists listed in the yellow pages under Physical Medicine & Rehabilitation, or you can contact your local large SCI inpatient rehabilitation center to see who works there and sees outpatients. You can also look up possible providers for you using the website for the AAPMR (American Academy of Physical Medicine & Rehabilitation):
    https://members.aapmr.org/AAPMR/AAPMR_FINDER.aspx

    In addition, you would do best to find a physiatrist who is also board certified in Spinal Cord Medicine. You can search for that for your city/state here: https://www.abpmr.org/

    (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.

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