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Thread: Is there anything I can do to make my bladder/bowels work better?

  1. #1

    Is there anything I can do to make my bladder/bowels work better?

    I recently had a L2 spinal cord injury (partial). I have to catheterize intermittently for my bladder and take 2-3 stool softeners plus 3 sennakot plus pills daily to help me have a bowel movement. My injury was Sept. 2005 and I still Cath and I have alot of stomach/intestinal pain/discomfort on a daily basis. I can usually have a bowel movement once per day, but it is usually low volume and I have cramps all day.
    I quess my question is, what can I do to improve ANYTHING, the pain, discomfort, etc.
    Can I see anyone to improve any function at all. The doctors didn't give me any advice other than time and pills for my bowel movements.
    Is there any chance of improvement??
    Is there any procedures to improve them? I know they are working on a bladder pacemaker, but what do they have now? Please if anyone has info let me know.
    Thank You

  2. #2
    If you are lucky, you may still get some return, but currently there is nothing we can do that will fix your neurogenic bowel and bladder.

    Did you get rehab at a major SCI Center? Did you get set up then with an appropriate bowel and bladder program, and were you educated about this?

    Intermittent cath is the best method for bladder management for maintaining your health long term. The so-called bladder pacemaker (Interstim) is not appropriate for someone with an areflexive bladder (as I assume you have at your level) and often does not help with a reflex bladder either. Several people here have had trials and all have either failed or had the device removed (that I know of). Do you leak urine at volumes under 450 cc.? Do you know what your external sphincter EMG shows (from when you had urodyanamics)? I assume that you are seeing a neurologic urologist on a regular basis.

    Most people at your level of injury need to do bowel care to prevent accidents and constipation. If you have a LMN bowel (common) you may need to do bowel care daily or even twice daily, and should keep your stool on the very firm side (not too soft). A suppository should be used to move stool into the rectal vault, and a combination of manual removal and straining (valsalva) used to evacuate. If you have a UMN bowel, then after the suppository digital stimulation should be used to help relax the sphincter and allow evacuation to occur. Both work best on a toilet or commode (not laying down). Other than a colostomy, there is nothing else currently available for bowel management.

    I suspect you are taking too many stimulants, and that this is making your cramping pain worse. Try to eat at least 30 gm. of dietary fiber daily, drink at least 2.5 quarts of water daily, and get more exercise rather than using senna. Long term use of senna can cause problems for many people with SCI, and can sometimes cause accidents, esp. for those with a LMN bowel. How much stool softener are you taking? You can take up to 1000 mg. daily of DSS, but don't let your stool get too soft if you have a LMN bowel.

    Do you walk? Vigorous exercise, esp. walking, or standing for those who cannot walk, will also help with bowel motility.

    I hope you already have a copy of this booklet (which you should have received in rehab), but if not, you can download it for free. Read it carefully and it will help you manage your bowel care:

    Neurogenic Bowel: What you should know.

    Are you seeing a physiatrist who specializes in SCI? This is ideal, as many physicians really don't know much about SCI, esp. long-term health management.

    (KLD)

  3. #3
    Miralax, even a little dosage, can help your stool move through your system.

    Magic Bullet suppositories can make your bowel program a bit quicker and more efficient if you don't like oil-based suppositories.


  4. #4

    bowel program

    Try Citrucel for fiber therapy -- less gassy.

  5. #5

    Is Miralax better than sennakot

    Hello, thanks for the replies. I am down to 3 stool softeners and 2 senna daily with lots of cramping still. I tried to back off the senna but could not go at all. Should I try Miralax in place of the 2 sennakot plus at night?? Will it even be equally effective? Also, I have Acid reflux every day and I am taking 40mg of nexium daily, can any of these drugs make it worse?
    Also with the stool softeners, can I take one 100mg pill with each meal (4-5 meals)? When is the best time to take them?
    Please help, still can't find a good schedule
    Brian Hilton

  6. #6
    My son in an L1 -- he takes two colace a day one in the morning, one at night. In addition to his regular meals, we also make sure he gets two additional servings of fruit (usually an apple and a good sized handfull of grapes -- sometimes canned pineapple). Additionally, he drinks a 10 oz. glass of water with two scoops of Citricel in it before he goes to sleep. We also make sure he drinks plenty of water during the day. Typically, he uses the bathroom each evening, but sometimes feels an urge to go sooner.
    He does standing exercises and walking short distances each day to put gravity to work for him. He also does a PT routine and stretching every day. If any one of these components is left out, he can start to have trouble. I really think the fruit and fiber are key. We also limit the amount of soda he drinks and make sure he doesn't get too much fried or greasy food.

    Hope that helps.
    Ugh, I've been kissed by a dog!
    Get some hot water, get some iodine ...
    -- Lucy VanPelt

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