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Thread: Lazy bowel!!

  1. #1

    Lazy bowel!!

    I've been having problems adjusting to a good bowel program. The thing is I'm trying not to depend too much on sennaside (hope it's the correct spelling). If I use it on the night b4 my bowel program which is digital stimulation, stool "will be all ready near the doorway" the next morning. So it takes only 4 digital stimulations to clear.

    But lately I've read this article suggesting not to rely on senna as with time my bowel will depend too much on them. So without it even after 3 digital stims i dun see anything. I have a history of hard stool. People suggest drinking more water to aid this but I have a spastic bladder and I'm on oxybutinin. I know oxybutinin may cause hard stool (am I right?). But I can't drink lots of water or i'll have to cath once every 2 hrs..or so. Please help me on what shall i do to increase my bowel action without senna.?

    T-2 Incomplete Paraplegia
    2 yrs post

  2. #2
    I would first make sure you are doing the right non-medicine things to promote bowel health, namely: diet, fiber, stool softener, timing, positioning, fluid intake.

    Ditropan in some (me included) just literally turns off the bowel contractions. I need to be on it now and have been instilling it in my bladder after cath 2-3x/day, thus putting it exactly where it's needed and avoiding the GI complications. There's many posts on instillation, just search for it. Basically the tablet(s) get crushed up, mixed with 30 cc sterile water and injected up the cath after emptying the bladder. Pull cath out and leave solution inside. It's worth a try.

  3. #3

    Slow bowels

    A couple other things to consider:

    How much fluid do you actually drink daily (not counting alcohol)? Even on intermittent cath it should be 2-2 1/2 liters daily at minimum, more if you are very physically active.

    How much fiber do you eat daily? Often people think they are eating a lot, yet are taking significantly less than the 30 gm. daily recommended for people with SCI. You really have to sit down with a fiber content chart to figure if you are eating enough.

    How much exercise do you get? Do you stand daily? Both of these will increase bowel motility and decrease problems with constipation.

    I assume you are doing your bowel program within 1/2 hour after a meal or hot liquid, and that you do it up on a toilet or commode instead of in bed.

    Stool softeners can be taken without any problem for long term use. DSS (Colace) 250 mg. 3-6 daily is often helpful in this area.

    You are correct that long term use of senna and cascera has been implicated in more lazy bowel long term, including possibly megacolon, so it is good if possible to find another route for maintaining your bowel program trouble free.


  4. #4
    I think I drink around 1.5 litres of water daily.
    And I do my bowel care once i get up in the morning along with my shower. I did not have a meal b4 my bowel program.
    On fibre wise, I'm not that calculative of fibre charts and stuff..
    Yesterday, at 9 pm i took senna and this morning the bowel program is good. That is the dependance i don't want to have on senna.
    Any suggestions sci nurse?

    By the way i take 15ml of lactulose twice daily and do stand for 10 mins a day(izzit enough)?
    How long is the recommended standing time?

    T-2 Incomplete Paraplegia
    2 yrs post

    [This message was edited by Dizzy on Aug 12, 2002 at 09:37 AM.]

  5. #5
    Senior Member TD's Avatar
    Join Date
    Aug 2001
    Phoenix, AZ, USA

    How much do you really drink?

    I have copied this link from a previous posting to give you an idea of how much to drink each day. Apparently it is common not to include all that you drink each day (I didn't!!). Remember, you drink milk, coffee, juice, etc. each day and this should be included in your daily total of input.

    SCI Nurse!! Any comments on this posting?

    "And so it begins."

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