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Do bowels get "sluggish" over time from SCI?

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  • Do bowels get "sluggish" over time from SCI?

    I've had a SCI for 9 years now, paralyzed from T4 down. I've tried/been on basically all the meds that seems most SCI people use....Baclofen, Flexeril, Gabapentin, Lyrica, Lamectal etc.

    In March of 2015 I starte having pain in my stomach when I would eat and my bowels were looser but still on schedule. We first waited because a stomach bug was going around. Then we eventually went to the hospital. They did x-rays and a CT scan, they showed that my bowels were full. Then we did an ultrasound and a HIDA scan, I have a gallstone, but I've had it for 3 years, the HIDA scan determined that it wasn't blocking the duct and was fine. Then we did an upper GI endoscopy and a colonoscopy. They showed nothing.

    In May the stomach pain went away and has been gone. But my bowels are still loose but on schedule. So my question is do your bowels get "sluggish" over time with a SCI?? I'm thinking just maybe they're like how our legs atrophy and other muscles weaken. I've researched and can't find anything. (I live in Alaska, so we don't have really a lot of doctors that specialize in spinal cord injuries.)

    I have one doctor that thinks it's because I'm on too many meds, mostly ones for pain. Which I can't function without things to calm the pain. So here's a list of my meds just for info:

    Docusate Sodium 100 MG 1 x a day AM


    Duloxetine 30 MG 2 x a day AM/PM


    Ranitidine 150 MG 2 x a day AM/PM


    Levothyroxine 0.075 MG 1 x a day AM


    Meloxicam 15 MG 1 x a day AM


    Morphine Sulfate 15 MG 2 x a day AM/PM


    Gabapentin 300 MG 8 tablets 1 x a day AM/PM


    Diazepam 2 MG 4 x a day (as needed)


    Tizanidine 4 MG 1 x a day PM


    Zolpidem Er 12.5 MG 1 x a day PM


    Hydrocodone/APAP 10/325 MG 4 x a day (as needed)



    Any answers, ideas, suggestions, or anything would be appreciated.

  • #2
    Morphine Sulfate 15 MG 2 x a day AM/PM Hydrocodone/APAP 10/325 MG 4 x a day (as needed)

    Those two will do it.

    Any changes in your opiate regimen lately? Opiates are notorious for causing constipation and loose bowels can occur when liquid stool leaks around a stopped up solid mass.

    Sorry I don't have an answer for you about SCI worsening bowel function over time (though I can't think of a good reason why it would).


    On a separate and self interested note, how easy is it to get around Alaska in a wheelchair? One day I'd like to head up that way.

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    • #3
      try mangos. no sluggishness for me anymore. much less of a sledge hammer than oatmeal. much more reliable as far as time is concerned..6-8 hours, everytime. and it's gentle on my stomach.

      Then there's the "nuclear option"....constipated? try a dish of instant oatmeal uncooked with only cold water added. more effective than a colonoscopy prep, I'm telling you. be ready for an hour on the thrown minimum. I've never experienced anything like it. Get a seat belt. T - Six hours and lift off

      My advice in general... be very careful before you take a drug to solve a problem. Ask your doctor what the method would be for someone who is not paralyzed. More often than not, it works for me. And frankly, most MDs don't understand the pathology of spinal injury and what it implies anyway....they google it.
      Last edited by JakeHalsted; 07-09-2015, 12:55 AM.

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      • #4
        Originally posted by funklab View Post
        Morphine Sulfate 15 MG 2 x a day AM/PM Hydrocodone/APAP 10/325 MG 4 x a day (as needed)

        Those two will do it.

        Any changes in your opiate regimen lately? Opiates are notorious for causing constipation and loose bowels can occur when liquid stool leaks around a stopped up solid mass.

        Sorry I don't have an answer for you about SCI worsening bowel function over time (though I can't think of a good reason why it would).


        On a separate and self interested note, how easy is it to get around Alaska in a wheelchair? One day I'd like to head up that way.

        Thanks. I haven't been sure the morphine does much anyhow, I take it with the Gabapentin, & Diazapam, so might see what my Doc thinks. It interacts with a lot of meds too, never good when you get UTI's and other crap all the time.

        About Alaska, the cities are easy to get around in, Anchorage or Fairbanks. I live in a little village about 5 hours from Anchorage, population about 80 people. But I get around pretty good, I had to get a power chair thanks to a syrinx making my left arm numb all the time & weaker. So the power chair goes on all our dirt trails, I go to my dad's gravel pit. Or even in the silky sand & grass over by our fish camp.

        I've gone four-wheeling & snowmaching a lot since my accident, and if you go with the right people it's easy. I took my manual chair so I could get out, and had my dad or cousins help me over any rough terrain. Also anymore they've made pretty much any town type of place have handicap accessible friendly buildings, even the tourist sites are. I went to the glacier near Valdez last week, and it had wheelchair access all the way to the glacier.

        So I would say Alaska is wheelchair accessible in most places, and if you're adventuring off road just bring some buddies with you to help you out.

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        • #5
          I would want to know if an ileus was evident

          An Ileus is a disruption of the normal propulsive ability of the gastrointestinal tract. Although ileus originally referred to any lack of digestive propulsion, including any bowel obstruction, up-to-date medical usage restricts its meaning to those disruptions caused by the failure of peristalsis, rather than by mechanical obstruction.

          so yes over time the propulsion of your intestines can be an issue. The key is to keep it moving. Pain medications are a contributing factor.

          pbr
          Last edited by SCI-Nurse; 07-10-2015, 09:30 AM.
          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.

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          • #6
            Originally posted by SCI-Nurse View Post
            I would want to know if an ileus was evident

            An Ileus is a disruption of the normal propulsive ability of the gastrointestinal tract. Although ileus originally referred to any lack of digestive propulsion, including any bowel obstruction, up-to-date medical usage restricts its meaning to those disruptions caused by the failure of peristalsis, rather than by mechanical obstruction.

            so yes over time the propulsion of your intestines can be an issue. The key is to keep it moving. Pain medications are a contributing factor. t

            An Ileus is a disruption of the normal propulsive ability of the gastrointestinal tract. Although ileus originally referred to any lack of digestive propulsion, including any bowel obstruction, up-to-date medical usage restricts its meaning to those disruptions caused by the failure of peristalsis, rather than by mechanical obstruction.

            so yes over time the propulsion of your intestines can be an issue. The key is to keep it moving. Pain medications are a contributing factor.

            pbr

            Wouldn't they see any sign of an ileus when they did the endoscopy and colonoscopy in May on me?? No one mentioned it.

            I am agreeing that pain meds are a factor, so my next appointment with my doctor I am going to see about getting off the morphine sulfate. I am not sure that it really does much, I take it at the same times I take other pain meds, so not sure. But it interacts with too many other medicines so I'd rather get rid of that.

            Also my diet I have been trying to change, more foods with fiber and so on. Yet I started that in April and have seen no change in the bowels since the diet changes.

            Thank you everyone for any suggestions, answers, or ideas.

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            • #7
              I'm not on any meds but Miralax but after 15 years SCI am experiencing much worse bowel function. Takes longer and only partially empties. Kind of turning me into a grump and a hermit.

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              • #8
                same here.....bowels got slower and slower about 6 years post injury. lack of movement and pain meds are the main causes by far.....got to the point i was constantly having to repeat EVERY night....started to have a real effect on my quality of daily living. eventually opted for a colostomy...its not a cure but makes it MUCH easier to deal with. no more bowel proogs, digital stim, pain and anxiety. BEST decision i ever made...my bowels no longer rule my life.
                C6/7 Complete

                14 years post injury

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                • #9
                  This is much more common in those who have had years of using strong stimulants and laxatives for bowel care, or who have done bowel care less than 3X weekly for years. It is called obstructive megacolon. Sometimes you can buy some time by using more and stronger stimulants for a while, but many people ultimately end up needing 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.

                  Comment


                  • #10
                    yep....guilty as charged...its a damned if u do or don't situation. I recommend taking miralax daily...this lets you use less stims thus less cramping. Osmotic laxs are better (much less cramping) but are less predictable....can 1 day or 3 days.
                    C6/7 Complete

                    14 years post injury

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                    • #11
                      Miralax is a pretty strong laxative (and is a osmotic laxative). It is exactly the same chemical as Golytely, just in a smaller dose...

                      (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.

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                      • #12
                        goes to show just how lazy my bowels have become over the last 14 years...i take one heaping dose daily and 3 doculax on the morning of 'bowel day' and even then my stool isn't watery, just thick. have always preferred osmotics over stimulants but they just are not predictable enuff for me...all except a bottle of mag citrate...you WILL be going in 4 to 8 hours. the tricky part is knowing when you'll stop....lol
                        C6/7 Complete

                        14 years post injury

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                        • #13
                          eat mangos

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                          • #14
                            I am 7 yrs post and going through the exact same thing. By day 2, I feel so painfully bloated, I can't even think about eating. I need serious stim and fleet enema every other day. I generally take one dose of miralax daily and 2 colace, senecot and prunes. My bowels give me horrendous nerve pain that affects my daily living. I've gone to a gastroenterologist, but he had no knowledge of neurogenic bowel. Such a bummer.

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                            • #15
                              Instead of fleet, use magic bullet or enemeeze...MUCH faster/complete results...can be a god send.
                              C6/7 Complete

                              14 years post injury

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