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Thread: Help with changing my bowel program

  1. #1
    Junior Member
    Join Date
    Feb 2018
    Barre, Vermont

    Help with changing my bowel program


    I'm a T-9 paraplegic. I started my bowel program on a commode in my rehab stay after my accident and I still do it on a commode to this day. It will be 12 years in May. I do not take a suppository or enema to initiate my BP. I have always taken Senna and ended up adding Colace almost a year after my injury because I was having a problem with constipation. I use dig stim to move the stool. For the most part I have been doing my BP every other day for the last few years because I was having issues when I was going every day. My problem now is how long my BP takes, and making sure all the stool is gone. I take four 8.6mg pills of Senna and three 100mg pills of Colace the night before I do my BP. On the days I don't do my BP in the morning I take one to one and a half Senna pills just because I don't want to have constipation issues the next day.

    My job is changing and I need to be ready earlier in the morning on the days I do my BP. I normally finish at about 10:30am, but now I need to be finishing at 7:30am or earlier if I can. I really need my BP to be faster and to make sure it's complete. One of my problems of doing it earlier in the past was not getting all of the stool out, and having an accident later in the day? Any suggestions would be much appreciated as I am stressing about this change, but it needs to happen.

    Thanks for your comments/suggestions in advance!
    Last edited by TimB22; 01-10-2020 at 10:44 AM. Reason: Gramar

  2. #2
    First, I would change the way you take your Colace. It should be taken daily, routinely. It works by preventing too much water being removed from your stool, it does not soften already hard stool. Recommended dosage can be up to 1000 mg. daily, taken 2-3X daily.

    It is best to make only one change in your bowel program every 7 days; this lets you better evaluate the effect of each change.

    A suppository such as a generic bisacodyl, Magic Bullet, or Enemeez mini-enema would help to bring still down into your rectal vault for evacuation with either manual removal or digital stimulation (which are not the same). Dig stim primarily is used to relax the anal sphincter to allow stool to pass, it doesn't do much to increase peristalsis and move stool into the rectal vault; that is what a suppository can do.

    It will also be helpful to drink a hot liquid (coffee, tea, etc.) or eat some food with fat content 30 minutes before starting your bowel program. This helps to stimulate peristalsis as well.

    Ideally, your bowel care should not take more than 45-60 minutes start to finish.

    If you have not already done so, I would also recommend that you download and read the consumer version of the clinical practice guideline on bowel management in SCI:

    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
    I struggled using the commode for the first year. Now I do my bp on the bed. So much easier laying on my side. And much least for me.
    "Never turn your back on fear. It should always be in front of you, like a thing that might have to be killed." - Hunter Thompson
    T5/6 complete

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