Bowel Management

retusn · 05-20-2005, 12:58 PM

I'm a c3-4 incomplete quqd.

For 3 yrs my stool was very loose. Was on Chlorystamine (sp ?) and imodiun to bind things up. Well now I'm bound up.

I don't feel any pain, but it's been almost a week since last good bm. Yesterday, tried digital stimulation, 3 enemas, and Ducolax suppository. Some came, but not a weeks worth. There was some stool left in the rectal, but it just wouldn't come, so we quit for the day.

I know I need to get it out, but how?

SCI-Nurse · 05-20-2005, 07:19 PM

I recommend an Enemeez or magic bullet. Also, you might try a stool softener or mild laxative to get things moving again.

CWO

retusn · 05-21-2005, 07:50 AM

Tell me more about Magic Bullet and Eneneze.

Thanks

SCI-Nurse · 05-21-2005, 08:15 AM

Bowel meds
All are used to increase peristalis, the normal wave-like motion needed to empty the bowels.

1. Glycerine suppositories do NOT "soften" the stool. Glycerine is a chemical irritant of the mucosa, and as such needs to be in contact with the mucosa to work. The irritation causes increased peristalsis. It is true that excessive lubrication of a glycerine suppository can interfere with this contact, so we teach only dipping in water, rather than the use of water soluable lubricant for this type of suppository (for the few patients who actually find it helpful).

2. Bisacodyl works by stimulating the myenteric plexus of the bowel
integral nerves, also causing peristalsis but not from irritation.

3. Magic bullet(had a shortage & couldn't get recently)Internet order recommended.
It's 'generic' is 'bisacodyl'; the only difference between the Magic Bullet(MB) and Dulcolax (ie Generic -Bisacodyl) is the suspension; Dulcolax is suspended in glycerine, and MB in water, so it dissolves faster & works better.

4. CE2 suppositories- work for some, but not most SCI.

5. Enemeez,(super mini enema) as it contains both medicinal soap and liquid glycerine, primarily works by irritation similar to the glycerine suppository action.

6. Fleets- over the counter from any pharmacy
There is no one "best"product or bowel program for everyone. It must be individualized to the patient, and
often by trial and error, but it is important to actually know how the products work.

CWO

05-20-2005, 12:58 PM	#1
retusn Member Join Date: Jun 2004 Location: W. Friendship, Maryland Posts: 62	Bowel Management I'm a c3-4 incomplete quqd. For 3 yrs my stool was very loose. Was on Chlorystamine (sp ?) and imodiun to bind things up. Well now I'm bound up. I don't feel any pain, but it's been almost a week since last good bm. Yesterday, tried digital stimulation, 3 enemas, and Ducolax suppository. Some came, but not a weeks worth. There was some stool left in the rectal, but it just wouldn't come, so we quit for the day. I know I need to get it out, but how?

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05-20-2005, 07:19 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,306	I recommend an Enemeez or magic bullet. Also, you might try a stool softener or mild laxative to get things moving again. CWO

05-21-2005, 07:50 AM	#3
retusn Member Join Date: Jun 2004 Location: W. Friendship, Maryland Posts: 62	Tell me more about Magic Bullet and Eneneze. Thanks

05-21-2005, 08:15 AM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,306	Bowel meds All are used to increase peristalis, the normal wave-like motion needed to empty the bowels. 1. Glycerine suppositories do NOT "soften" the stool. Glycerine is a chemical irritant of the mucosa, and as such needs to be in contact with the mucosa to work. The irritation causes increased peristalsis. It is true that excessive lubrication of a glycerine suppository can interfere with this contact, so we teach only dipping in water, rather than the use of water soluable lubricant for this type of suppository (for the few patients who actually find it helpful). 2. Bisacodyl works by stimulating the myenteric plexus of the bowel integral nerves, also causing peristalsis but not from irritation. 3. Magic bullet(had a shortage & couldn't get recently)Internet order recommended. It's 'generic' is 'bisacodyl'; the only difference between the Magic Bullet(MB) and Dulcolax (ie Generic -Bisacodyl) is the suspension; Dulcolax is suspended in glycerine, and MB in water, so it dissolves faster & works better. 4. CE2 suppositories- work for some, but not most SCI. 5. Enemeez,(super mini enema) as it contains both medicinal soap and liquid glycerine, primarily works by irritation similar to the glycerine suppository action. 6. Fleets- over the counter from any pharmacy There is no one "best"product or bowel program for everyone. It must be individualized to the patient, and often by trial and error, but it is important to actually know how the products work. CWO