OK My Turn To Vent With Bowels (no pun intended)

tbdeaux · 10-18-2003, 05:54 PM

I'm a c5-c6 incomplete quad for 1 year 4 months. My Bowel Program has been the same for the last year. I take two pericolace every morning. No suppository and do BP by dig stim around 10:00 pm taking 1 - 1 1/2 hours. I have had very few accidents with this proceedure. I have some feeling when I need to go. Four times in the last 3 weeks I have been awakened around 5:00 am because of an accident. This is starting to get old and don't know what to do. Any advice would be gratefully appreciated.

Thanks,
Chuck

Sue Pendleton · 10-18-2003, 06:04 PM

Umm, lay off the pericolace. Colace = stool softner; pericolace = laxative. Save the laxatives for when you actually need them. Might want to ease off gently like take one peri for a few days as you add colace into your schedule.

Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

tbdeaux · 10-18-2003, 06:43 PM

Thanks Sue for the tip. Makes a lot of sense. I'm just curious why I would start having trouble after a year of using the same dosage of Pericolace.

Chuck

SCI-Nurse · 10-18-2003, 08:11 PM

What time do you eat? Bowel care should occur within 30 minutes after a meal or drinking a hot liquid. Why do you do bowel so late at night? Are you staying up after midnight? Or do you do bowel care in bed?

Doing bowel care on a commode or toilet will usually shorten the time by about 2/3. Using a suppository will also bring stool down into your rectal vault for quicker evacuation with dig stim. Ideally a good bowel program should take less than 45 min. total, and result in no more than 1-2 accidents annually.

Your bowel, and your bladder can change with time. As always, one change at a time.

As always, it is better to eat more fiber and drink plenty of fluids so you can avoid use of laxatives like Peri-Colace. Plain Colace (DSS generic) will work to prevent stools that are too hard. Laxatives should be reserved for occasional constipation when you have not been eating well or are having medication side effects.

(KLD)

tbdeaux · 10-18-2003, 08:46 PM

The reason I do my BP so late is because I try to do it right before I go to bed. (I'm a night owl) I am able to transfer to the toilet for this. While in rehab I was told to take 2 Pericolace each day. I don't like using a suppository because of the lingering mucous. Occasionally, I don't have to stim and have an almost "normal" BM. Just wondering why all of a sudden the accidents. Keeps me pAraNOiD !!

SCI-Nurse · 10-18-2003, 10:01 PM

Accidents are often caused by incomplete emptying. This is especially true if you are having early AM accidents after doing late night bowel care. Delaying many hours after a meal will result in less complete emptying.

What suppositories have you tried?

(KLD)

tbdeaux · 10-19-2003, 10:36 AM

I have tried the Magic Bullet while in rehab, almost always leaving smelly mucous excretion the next day. (Sorry for the graphic details but don't know how else to describe it) I eat around 6pm. The reason I do BP so late is so I don't have to get dressed after I finish but that's another topic. Thank y'all so much for all the tips.

SCI-Nurse · 10-19-2003, 03:23 PM

The Magic Bullet is pretty strong. I would suggest you try a generic bisacodyl suppository or a glycerine suppository to see if this would speed up your program. Doing it within 1/2 hour after a meal would also be very helpful.

(KLD)

Hopkins · 10-20-2003, 09:56 AM

I need help. I'm a T-10 para. I only have Bowel movements once a week. What kind of programs are you on? I take fibre pills, ex-lax when I need to (which is often and even still with limited results)...I'm desperate.

SCI-Nurse · 10-20-2003, 07:30 PM

Jill H - I would suggest that you review KLD's points in the various posts on this topic. How long have you been injured and what were your bowel habits prior to your injury? Your long range goal should be to try to return to habits that you had prior to your injury. Other points include drinking at least 8 - 8 oz glasses of fluids daily (this should be exclusive of caffeinated or alcoholic beverages as both tend to deplete the body's fluid balance), planning BP about 1/2 hour after a meal that includes a warm liquid, using digital stim prior to BP, using some type of suppository prior to BP, use a commode chair or be upright for program. When you are trying to get your bowel program established, it is important to make only one change at a time.

An excellent resource is available through the PVA, "Neurogenic Bowel: What You Should Know - A Guide for People with SCI". It can be downloaded (it is about 50 pages) for a $5 fee from their website: http://www.pva.org/cgi-bin/pvastore/products.cgi?id=1
or ordered for about $10 from their circulation department at 1-888-860-7244. Another good resource can be found at the University of Alabama, Spain Rehab Center: http://www.spinalcord.uab.edu/show.asp?durki=21479 Scroll down to InfoSheet #9 on Bowel Management. CRF

10-18-2003, 05:54 PM	#1
tbdeaux Senior Member Join Date: Feb 2003 Location: Greenwell Springs La. Posts: 183	OK My Turn To Vent With Bowels (no pun intended) I'm a c5-c6 incomplete quad for 1 year 4 months. My Bowel Program has been the same for the last year. I take two pericolace every morning. No suppository and do BP by dig stim around 10:00 pm taking 1 - 1 1/2 hours. I have had very few accidents with this proceedure. I have some feeling when I need to go. Four times in the last 3 weeks I have been awakened around 5:00 am because of an accident. This is starting to get old and don't know what to do. Any advice would be gratefully appreciated. Thanks, Chuck

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10-18-2003, 06:04 PM	#2
Sue Pendleton Moderator Join Date: Jul 2001 Location: Wisconsin USA Posts: 9,117	Umm, lay off the pericolace. Colace = stool softner; pericolace = laxative. Save the laxatives for when you actually need them. Might want to ease off gently like take one peri for a few days as you add colace into your schedule. Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

10-18-2003, 06:43 PM	#3
tbdeaux Senior Member Join Date: Feb 2003 Location: Greenwell Springs La. Posts: 183	Thanks Sue for the tip. Makes a lot of sense. I'm just curious why I would start having trouble after a year of using the same dosage of Pericolace. Chuck

10-18-2003, 08:11 PM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,367	What time do you eat? Bowel care should occur within 30 minutes after a meal or drinking a hot liquid. Why do you do bowel so late at night? Are you staying up after midnight? Or do you do bowel care in bed? Doing bowel care on a commode or toilet will usually shorten the time by about 2/3. Using a suppository will also bring stool down into your rectal vault for quicker evacuation with dig stim. Ideally a good bowel program should take less than 45 min. total, and result in no more than 1-2 accidents annually. Your bowel, and your bladder can change with time. As always, one change at a time. As always, it is better to eat more fiber and drink plenty of fluids so you can avoid use of laxatives like Peri-Colace. Plain Colace (DSS generic) will work to prevent stools that are too hard. Laxatives should be reserved for occasional constipation when you have not been eating well or are having medication side effects. (KLD)

10-18-2003, 08:46 PM	#5
tbdeaux Senior Member Join Date: Feb 2003 Location: Greenwell Springs La. Posts: 183	The reason I do my BP so late is because I try to do it right before I go to bed. (I'm a night owl) I am able to transfer to the toilet for this. While in rehab I was told to take 2 Pericolace each day. I don't like using a suppository because of the lingering mucous. Occasionally, I don't have to stim and have an almost "normal" BM. Just wondering why all of a sudden the accidents. Keeps me pAraNOiD !!

10-18-2003, 10:01 PM	#6
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,367	Accidents are often caused by incomplete emptying. This is especially true if you are having early AM accidents after doing late night bowel care. Delaying many hours after a meal will result in less complete emptying. What suppositories have you tried? (KLD)

10-19-2003, 10:36 AM	#7
tbdeaux Senior Member Join Date: Feb 2003 Location: Greenwell Springs La. Posts: 183	I have tried the Magic Bullet while in rehab, almost always leaving smelly mucous excretion the next day. (Sorry for the graphic details but don't know how else to describe it) I eat around 6pm. The reason I do BP so late is so I don't have to get dressed after I finish but that's another topic. Thank y'all so much for all the tips.

10-19-2003, 03:23 PM	#8
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,367	The Magic Bullet is pretty strong. I would suggest you try a generic bisacodyl suppository or a glycerine suppository to see if this would speed up your program. Doing it within 1/2 hour after a meal would also be very helpful. (KLD)

10-20-2003, 09:56 AM	#9
Hopkins Junior Member Join Date: Oct 2003 Location: Toronto, Ontario, Canada Posts: 1	I need help. I'm a T-10 para. I only have Bowel movements once a week. What kind of programs are you on? I take fibre pills, ex-lax when I need to (which is often and even still with limited results)...I'm desperate.

10-20-2003, 07:30 PM	#10
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,367	Jill H - I would suggest that you review KLD's points in the various posts on this topic. How long have you been injured and what were your bowel habits prior to your injury? Your long range goal should be to try to return to habits that you had prior to your injury. Other points include drinking at least 8 - 8 oz glasses of fluids daily (this should be exclusive of caffeinated or alcoholic beverages as both tend to deplete the body's fluid balance), planning BP about 1/2 hour after a meal that includes a warm liquid, using digital stim prior to BP, using some type of suppository prior to BP, use a commode chair or be upright for program. When you are trying to get your bowel program established, it is important to make only one change at a time. An excellent resource is available through the PVA, "Neurogenic Bowel: What You Should Know - A Guide for People with SCI". It can be downloaded (it is about 50 pages) for a $5 fee from their website: http://www.pva.org/cgi-bin/pvastore/products.cgi?id=1 or ordered for about $10 from their circulation department at 1-888-860-7244. Another good resource can be found at the University of Alabama, Spain Rehab Center: http://www.spinalcord.uab.edu/show.asp?durki=21479 Scroll down to InfoSheet #9 on Bowel Management. CRF