Medication Guide App

Bowel Management Program After Spinal Cord Injury

What is a bowel management program?

A bowel management program helps you have bowel movements at regular planned times. This will help prevent or decrease accidents. A bowel management program is made up of 4 parts:

  • Activity helps you to have regular bowel movements. Change positions often. Move from lying to sitting to standing if possible. Do your range of motion exercises several times a day or as directed. Sit up to have your bowel movement if possible. This will allow gravity to help the bowel movement move down your intestines naturally. Use arm rests or safety straps if needed.

  • Food and liquids are important in your bowel program.

    • Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Good liquids to drink are water, juices, and milk. Limit caffeine. Liquids help prevent constipation and soften your bowel movement.

    • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet.

  • Medicines , such as iron supplements, blood pressure medicine, and pain medicine, can cause constipation. Talk to your healthcare provider if you have problems with constipation. Your medicine may need to be adjusted.

  • A routine bowel care program helps you to empty your bowels at a specific time. It can be done every day, every 2 days, or every 3 days. The program should take about 1 hour. Do the bowel care program at the same time each day. Eat or drink about 30 minutes before you start to stimulate your bowel.

How should I do bowel care if I have spastic bowel?

Wash your hands at the beginning, after each step of the process, and at the end. Start by emptying your bladder.

  • Put on gloves and lubricate the suppository. With a gloved finger, insert the suppository into your rectum. Push it up as high as possible and remove your finger. The suppository should stay in your rectum.

  • Sit up on a toilet and massage your abdomen for 5 to 10 minutes. Place the palm of your hand on the lower right part of your abdomen. Press in and move up to your ribs and straight across to the left side of your abdomen. Continue to press and move your hand down the left side of your abdomen. Repeat 10 times, waiting about 30 seconds in between.

  • Use digital stimulation if you have not had a bowel movement in 15 minutes. Put a lubricated, gloved finger 2 to 3 inches inside your rectum. The goal is to massage the inner ring of muscle. Point your finger toward your belly button and move it in a circle for about 20 seconds. Repeat this every 5 to 10 minutes until you have a bowel movement.

  • Completely empty your bowel. Perform digital stimulation 2 more times, waiting 5 to 10 minutes in between. This makes sure your bowel is as empty as possible.

How should I do bowel care if I have limp bowel?

Do your limp bowel program 1 or 2 times a day to prevent accidents. Remember to wash your hands at the beginning, after each step of the process, and at the end. Start by emptying your bladder.

  • Put on gloves and lubricate a finger. Gently insert your finger into your rectum and scoop out the bowel movement.

  • Stimulate your bowel. Insert a lubricated finger 2 to 3 inches inside your rectum. The goal is to massage the inner ring of muscle. Point your finger toward your belly button and move it in a circle for about 20 seconds. Repeat this every 5 to 10 minutes until you have a bowel movement.

  • Do the Valsalva maneuver to help push out the bowel movement. Take a deep breath and bear down. Try to tighten your stomach muscles at the same time. This maneuver increases the pressure around the bowel which pushes bowel movement out. Do it for 30 seconds at a time until you have finished having the bowel movement.

  • Move around to help push out the bowel movement. Lift yourself and bend forward and sideways if your upper body is strong enough.

  • If you have not had a bowel movement within 15 minutes, insert a suppository.

  • Completely empty your bowel. Perform digital stimulation 2 more times, waiting 5 to 10 minutes in between. This makes sure your bowel is as empty as possible.

Why should I keep a bowel care record?

A bowel care record helps you and your healthcare providers know whether your bowel program is working. Write down the following information after each bowel care session:

  • Date and time of the bowel movement

  • Duration of the bowel movement

  • Description of your bowel movement

  • Position during bowel care

  • Stimulation methods, such as abdominal massage, a suppository, or digital stimulation

  • Any comments, such as cramps, spasms, or accidents

When should I contact my healthcare provider?

  • You have a fever.

  • Your abdomen is swollen and hard.

  • You have blood in your bowel movement or coming from your rectum.

  • You have vomiting or diarrhea for 2 or more days.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have severe pain.

  • You have blurry vision or are seeing spots.

  • You have cold, clammy skin below your SCI.

  • You have red, sweaty, flushed skin above your SCI.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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