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Thread: SCI Nurse, Colonoscopy

  1. #1
    Senior Member Quadcessible's Avatar
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    SCI Nurse, Colonoscopy

    I am 22yrs+ post C-7 SCI. I had a colonoscopy done 12-01-06. Dr. reported all internals looked very well. Found minor external hemorrhoids and partial prolapsed colon. I am recovering from a pressure sore 1.5 cm from the anus that may be slow healing due to some clear leakage from my anus. Dr. felt that as long as the wound was healing to proceed with the following. Prolapsed colon possible due to pushing to hard during BP. Dr. suggested to increase my fiber, Fiber-Con was recommended, he felt the prolapsed may correct itself with fiber increase and ease up on pushing during BP, also attempt to decrease the amount and number of times I sit on the toilet. Option 2 is surgery to correct the prolapsed colon, which will require temporary colostomy. I would like to avoid any surgery at all. What suggestions may you have?

    Thanks

  2. #2
    I would agree with his plan. Fibercon can backfire and make stool firmer though, so I would recommend increasing stool softeners and trying to increase dietary fiber to 30 gm. daily if possible, or use Metamucil instead. Be sure you are drinking enough fluids.

    How long are you sitting on the toilet/commode at a time?

    Do you do dig stim or manual removal of stool, or only straining?

    (KLD)

  3. #3
    Senior Member Quadcessible's Avatar
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    SCI Nurse

    Quote Originally Posted by SCI-Nurse
    I would agree with his plan. Fibercon can backfire and make stool firmer though, so I would recommend increasing stool softeners and trying to increase dietary fiber to 30 gm. daily if possible, or use Metamucil instead. Be sure you are drinking enough fluids.

    How long are you sitting on the toilet/commode at a time?

    Do you do dig stim or manual removal of stool, or only straining?

    (KLD)
    I didn’t realize Fiber Con could make the stool harder. My program is as follows,

    1 BP every other day (evening), when I was on the wound vac (8 months) went every 3rd day, noticed much firmer stool during program, increased water intake 28-32 oz daily, still on the firm side.

    2 No digital stim, just sit on toilet apply pressure pushing slightly on anus with toilet paper and push with stomach, about 10-15 minutes at a time, usually, wipe with baby wipes to keep clean in between, usually 3 times.

    3 Since colonoscopy prep, I realized I really don’t have to push so hard, and even have worked at sucking my stomach back in. Past 48 hours I noticed a significant improvement in the redness and protrusion amount at my anus.

    4 Haven’t started Fiber Con yet, plan on Monday morning with next BP Tuesday evening.

    5 Plan to ease up on the pushing, and let things go more as they want to on their own.

    6 Also noticed that when I push my wheelchair for exercise, about 45 min. 3 miles, 3 times a week things are better over all, when I don’t exercise things aren’t as good. I have to watch how long I sit on the sore, which is about grade 2-3 now, from a grade 5 post surgery. I still lay down 18-20 hours daily to keep pressure off.

    7 My body as been through a lot in past 2 1/2 years, much stress both physical and mental, I am just looking to do what I can and let the stress roll off my back now. I think my body is telling me so, and as I do it will respond. I’m independent as far as life goes C-7 active some sensation in butt area, working full time from home. I just get help with the dressing change; nurse 3 times a week and my son other times.

  4. #4
    Fiber supplementation should be a routine part of your meds (unless you can get sufficient fiber reliably in your diet). It should not be taken just prn or only the night before bowel care. It does not work that way.

    Straining (valsalva) is the primary risk factor for rectal prolapse. Other measures for bowel emptying (manual removal or dig stim) will also reduce the risks.

    (KLD)

  5. #5
    Senior Member Quadcessible's Avatar
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    Quote Originally Posted by SCI-Nurse
    Fiber supplementation should be a routine part of your meds (unless you can get sufficient fiber reliably in your diet). It should not be taken just prn or only the night before bowel care. It does not work that way.

    Straining (valsalva) is the primary risk factor for rectal prolapse. Other measures for bowel emptying (manual removal or dig stim) will also reduce the risks.

    (KLD)
    My prolapsed doesn't seem all that bad. With Dr. suggesting that I increase my fiber diet and ease up on pushing may relieve the symptoms. Any idea how long before I notice progress? I am not in favor of surgery because of the colostomy procedure, even though it’s temporary, I need to ask the Dr. just how long temporary is? And what chances it solves the problem.

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