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    #1

    Bowel Program Issues & Concerns

    Now in addition to some bladder issues I’m having bell challenges. My injury was 25 years ago and that time I’ve managed my balls with suppositories (Magic bullet and another type) and the usual stool softener like colace , Then of course deep invaluable help of a devoted caregiver digital stimulation.

    in recent years I’ve been using collacs, benafiber gummies once a day (though I’m not sure if I should be taking these) MiraLAX the night before a bowel movement and enemeez (Though sometimes I need two of these to move things along). I have been having a bowel movement every third day since my body doesn’t seem to want go more than that. Laswell program I had a very large bowel movement and then last night I developed some dysreflexia two days after the bell program because I needed to go a lot again.

    I need to find a more regular approach and make sure I’m doing the right things so as not to cause myself major problems as I’ve had a neurogenic bowel for a long time now.
    C4/5 incomplete, 17 years since injury

    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust
    Tags: None
    #2
    Routine, long-term use of laxatives such as Miralax may put you at risk for obstructive megacolon.

    Have you done a "poor man's" transit study? Eat some frozen or canned corn, and time how long it takes for the hulls to pass through your gut and show up in your stool.

    Up to 3 days is normal for someone with a neurogenic bowel (8-24 hours for someone with a normal bowel). If it is much longer than 3 days, you should see a GI physician who can determine if you have developed obstructive megacolon. It can sometimes, ironically, be managed with more and stronger stimulant laxatives, but in the long run this is often a reason for someone with a SCI to consider a colostomy.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
    • 2 likes

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      #3
      I’ll try the poor man’s transit Study with corn you suggested. Now that I think about it I am not on benafiber, it’s a fiber non-laxative supplement. I have read about obstructive make a colon.

      Of course this has me worried but information is important. If routine use of laxatives by people with SCI causes problems what’s the typical alternative to using a suppository or enemeez & miralax?
      P

      on a related note when I was backed up a physiatrist recommended Gas-X to help move things through. Is this OK for long-term use or short term only?
      Last edited by KyleP2112; 6 Feb 2021, 5:57 PM.
      C4/5 incomplete, 17 years since injury

      "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

      "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

      Comment

        #4
        Originally posted by KyleP2112 View Post
        I’ll try the poor man’s transit Study with corn you suggested. Now that I think about it I am not on benafiber, it’s a fiber non-laxative supplement. I have read about obstructive make a colon.
        Fiber products, high fiber foods, etc. are not laxatives or stimulants, and are not associated with megacolon.

        Originally posted by KyleP2112 View Post
        Of course this has me worried but information is important. If routine use of laxatives by people with SCI causes problems what’s the typical alternative to using a suppository or enemeez & miralax?
        P
        Stimulation from above (bisacodyl tablets, senna, etc.) and osmotic laxatives (Miralax, milk of magnesia, etc.) appear to increase the risks for obstructive megacolon, which suppositories (including Enemeez) are not associated with this.

        Originally posted by KyleP2112 View Post
        on a related note when I was backed up a physiatrist recommended Gas-X to help move things through. Is this OK for long-term use or short term only?
        GasX is primarily simethicone and is used for relief of gastric (not bowel) bloating and gas. It really does not work as a laxative either for routine or occasional use.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
        • 1 like

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          #5
          Is collace stool softener one that can cause obstructive megacolon?

          Thanks for all good info
          C4/5 incomplete, 17 years since injury

          "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

          "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

          Comment

          • SCI-Nurse
            #5.1
            SCI-Nurse commented
            6 Feb 2021, 8:08 PM
            Editing a comment
            No, DSS (Colace) use is not associated with obstructive megacolon. It is a stool softener, not a stimulant nor a laxative. (KLD)
          #6
          What would be a typical amount of Colace to take? Seems like things are moving through me too slowly. I’m currently taking two Colace a day.
          C4/5 incomplete, 17 years since injury

          "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

          "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

          Comment

            #7
            I need to be able to have more regular consistent bowel movements. What would be the best way to get this done Without using laxatives? I know the risks of MiraLAX and the condition called obstructive megacolon but sometimes it seems like what’s the alternative?
            Sometimes I’ll have OK bowel movements when I do them which is every third day. Then I may have very little to nothing happened another time.
            C4/5 incomplete, 17 years since injury

            "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

            "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

            Comment

              #8
              After not going for six days and feeling bloated with gas discomfort I used mag citrate, which worked. The poop was firm, formed into nuggets. Maybe this is due to the fact that I’ve been in bed more healing a butt wound.

              my question is, how would I go about preventing this from happening again? I’ve been taking two Colace at night at bedtime. I think I need to improve the food I’m eating. What would be a good dieI typically if someone want to do have a bowel movement every other day as opposed to every third day as I do now?
              C4/5 incomplete, 17 years since injury

              "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

              "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

              Comment

                #9
                I would agree that lack or decrease in activity may have been the trigger for your bowel program problems. A diet that is rich in fiber is your best alternative. High in fresh vegetables and fruits - a fiber rich diet can initially cause gas and bloating so you may want to increase your intake over a week or two. You should shoot for 5 servings a day. Also, make sure that you drink plenty of fluids - especially water.

                See if this helps and let me know.

                ckf
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
                • 1 like

                Comment

                  #10
                  My bowels are going really slowly. It’s been five days & a half days since I last had a bowel movement.I tried having a BM last night and there was nothing in the rectum. Even using an enema didn’t produce results. Not sure why things are going so slowly. Maybe it’s being in bed to heal a wound? I’m definitely having good bowel sounds, passing gas and I’m not having symptoms like dysreflexia.
                  I’ve been trying to have additional fiber in my diet with fruit, some vegetables and a couple prunes each day. I’ve also tried taking additional fiber in the form of bena fiber.

                  When it’s been five or six days since the last BM can a person isn’t having problems like dysreflexia is the best approach just to wait for things to “move down“ or is it better to try and take something to move things along like Metamucil?
                  Last edited by KyleP2112; 19 Feb 2021, 1:56 PM.
                  C4/5 incomplete, 17 years since injury

                  "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                  "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                  Comment

                    #11
                    No, you have to help them move down. You should be doing a bowel program every day. If stool is hard you should be on stool softeners. Consistency of stool should be like a snake or a milky way bar.
                    Prune juice or eating prunes actually canhelp.
                    What type of enema? Clean out the lower part first with Fleets 4 oz, enema with saline or mineral oil, Fleets Phospha soda 4 oz. enema is ok if you did not already use it and for one time- due to possible electrolyte imbalances with routine use.. You should have some results. Then you should take something stronger -laxative- then what you are currently on- should probably be on stool softener Laxative-.Magnesium citrate, Polyethelene glycol- numerous names- MIralax, Consider 500-750 mls. of tap water enema. If you start to be nauseated, more bloated, have pain in abdomen or chest.
                    Yes to the fiber and more water intake. I recommend stool softner- dose- start low and slowly go up till consistency of stool is right, Rectal medication- Enemeez /Enemeez Plus if you have AD during bowel movement or Magic Bullet suppository. Daily until regular then some prefer every other day.
                    CWO
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment

                      #12
                      Had a little poop move down but not nearly enough. This is frustrating. This morning I had benafiber and miralax which will hopefully help more move down. I’ll also drink more water. Thanks for laying out the best BM approach.
                      What about adding sennacot to help deal with the problem of having a bowel movement before autonomic dysreflexia sets in?
                      C4/5 incomplete, 17 years since injury

                      "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                      "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                      Comment

                        #13
                        I think since has been so many days I would take the Senokot. Senikot S has a laxative and a stool softener in it.If think you need a daily laxative then Miralax as an osmotic laxative-draws water in to the colon. If you haven’t been taking a fiber and/or high fiber diet, I would start, drink water and start Docusate Sodium-a natural stool softener. You can slowly increase if needed to twice a day and then start increasing the dosage. CWO
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                        Comment

                          #14
                          I did take senikot about eight hours ago and had miralax. it’s definitely starting to work but no results yet while trying get things going using an enemeez. I do take two collace stool softeners daily already. I’ve also been on a higher fiber diet for several days now. A major factor is that I’ve been in bed a lot more staying off a pressure wound that I’m trying to heal.
                          what do you think about using meta-mucil to get things more regular?
                          Last edited by KyleP2112; 20 Feb 2021, 11:16 PM.
                          C4/5 incomplete, 17 years since injury

                          "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                          "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                          Comment

                            #15
                            Never Metamucil. It is a bulk forming laxative and can make matters worse. MIralax, Sennokot which both take several hours. I would give another hour or two or if you want to try another dose of Sennokot but the area of most concern is the lower colon so rectal medication-Enemeez plus, Bisacodyl or 4 oz. enema recommended before taking more laxative. When this is resolved, if consistency of stool is hard which I am sure it will be, I recommend increasing Colace to 200 mg twice a day.
                            CWO
                            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                            Comment

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