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Thread: Unusual bowel?

  1. #1

    Unusual bowel?

    O.k., I'm going to ask. I have searched through pages of old messages and looked up info on other web sites about neurogenic bowel and I just can't figure out the best way to manage my program.
    I'm not sure if I have a totally reflexive bowel. My injury is T-11,12, complete. I seem to get burning neuropathic pain in my butt when I have to have a bowel movement (sometimes there's only a small amount there)and I usually find that the sphincter is relaxed then. It is not always tight nor is it always relaxed. I'm finding after 1 1/2 yrs of trying to do a "regular bowel program, that I'm needing to check after every meal to avoid an accident. Other factors are that I'm very physically active and I eat a pretty healthy diest with lots of fiber (vegeatables, whole wheat, oats, etc.) Sometimes its soft, sometimes harder. I've tried suppositories to "get it all out" and I get a reaction within 5 mins. (if I don't hold it in it comes out)and so does 1/2 the suppository. I've tried holding 1/2 of one in, then after it comes down,dig. stim, then the other 1/2, repeat, but after the whole routine I still have more after I eat my other meals. I'm going crazy trying to figure out the best routine and am worried about too much intrusion. Any ideas/ suggestions?
    PS Its hard to talk about this stuff...

  2. #2
    I suspect you probably have an areflexive bowel. Doing bowel care 1-2X daily is common with this type of bowel. More often tends to just encourage more accidents.

    Are you using generic bisacodyl or brand name Dulcolax suppositories? If so, you will always see some of the non-melted, non-water soluable suppository come out with the stool. The suppositories job is to get stool into your rectum, not to get it out. This requires either dig stim for those with a reflex bowel, or straining and manual removal for those with an areflexive.

    With an areflexive bowel you need to keep your stool consistency on the very firm to hard side, otherwise accidents will be common, esp. with any straining such as transfers, standing, or vigorous exercise. This may require the use of medication such as Fibercon (calcium polycarbophil) or Imodium.

    If you don't have it already, I would recommend that you download this booklet from the Consortium for Spinal Cord Medicine and read it carefully:

    Neurogenic Bowel: What You Should Know

    (KLD)

  3. #3
    Senior Member MikeC's Avatar
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    darla - my sphincter is relaxed all of the time. As the nurse suggested, I use Fibercon and Immodium . . . suppositories don't help me at all and I never take a stool softener. I still sit on the toilet every time I cath (5 or 6 times a day) and see if I need to go. As long as the stool stays firm I don't have accidents but I'd rather check several times a day just to be sure. Mike

    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

  4. #4
    Thank you nurse. I've downloaded and read the booklet ($5.00 now)and it seems to me I have partly reflexive and partly areflexive. I just started trying magic bullet because the mini-enemas were too expensive and didn't work that well. Seems no matter how hard I try in the morning I still have a movement after lunch. I feel burning pain when its there and at least I've learned to check things out with that pain, although I get the same pain other times. When I have pain and I suspect and I find that my sphincter is relaxed, does it cause me to have to go more often if I do a rectal check? If I find stool, should I just quickly remove it or do I linger to see if there's more? When you say to do bowel care 2x a day does that mean a complete program both times? If I just follow my body, I usually get pain and my sphincter is relaxed after every meal, 3x a day. If I ignore it, I'm afraid to do much exercise or activity during the day or eve. (I do my routine exercise in the am before my regular bowel program.)I've been getting some thigh muscle return ( after 18 mos. t-11,12 complete!) and am anxious to work them. One more question- what about taking an iron supplement when it is too loose, is that healthier than immodium or the fibercon? (I eat plenty of fiber.) Wow, good thing you don't charge $5.00 for every question! Thanks for any help from you or anyone out there!

  5. #5
    Just to clarify, the charge for the booklets from the Consortium does not at all cover the costs of producing them. This charge was added by the PVA on the advice of their attorneys to protect their copyright. The PVA does not produce, but does print and distribute these materials, and of course I have no personal profit from their materials.

    You could experiment with using iron to firm up your stools, although you should not take more than one iron tablet daily (I recommend ferrous sulfate). Iron can sometimes make your stool sticky, so you will have to judge the result. I know of no long term disadvantages to taking Fibercon (buy generic, it is much cheaper).

    If you need to do bowel care more than 2X daily, try to keep it limited to manual removal of only what is in the vault. You should not do dig stim with a flaccid sphincter, but repeatedly doing manual removal will stimulate more peristalsis, bringing more stool into your rectum. This can become a vicious cycle.

    (KLD)

  6. #6
    Thanks, again. The booklet is 55 pages long and very complete. I think its totally worth it. My comment about you charging was just my teasing way of saying that I appreciate the answers and replies you give out of your expertise for free. This whole forum is the best resource I've found to learn more about my injury and what I can do.

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