How does a paralyzed person poop

When designing your own bowel program decide on the aids that you plan to use and stick with them. The more consistent you are with every aspect of the bowel program the more consistent your results will be.

Any change, no matter how small, can have a big impact on your bowel results. Decide how you will do the program and be consistent! Nails, both natural and artificial, should be kept clean and gloves used.

Hands should be washed with each glove change. Polished nails should not be chipped or cracked. This will assist in prevention of physical issues at the anus. Many factors determine healthy bowel management. Going to the bathroom is necessary for cleansing and health maintenance. Regular emptying of the bowels is the primary goal of a bowel program. Being consistent with your diet, fluids, activity, medications, timing, positioning, and aids will help you achieve the right consistency for your injury and bowel program.

Download PDF Version. Bowel Program for Spinal Cord Injury We understand that you are at a time in your life when thinking about going to the bathroom may have been a thing of the past. What is a bowel program? Lower Motor Neuron vs. Upper Motor Neuron Injury The first step in establishing a bowel program is understanding your spinal cord injury and how it has affected your body. Lower motor neuron LMN injuries are usually T12 and below. These injuries are flaccid in nature; the muscles are loose and involuntary bowel movements are very common because the colon has lost its muscle tone.

People with LMN injuries may not respond to usual bowel interventions such as digital stimulation or suppositories because the spinal reflex arc is diminished or absent. The goal of bowel care for a person with LMN function is to keep the stool well formed, the rectal vault clear, and to prevent embarrassing accidents. People with this type of injury sometimes have to do a bowel program once or twice a day to keep the lower colon free of stool.

Upper motor neuron UMN injuries are injuries that are usually T12 and above. These injuries are spastic in nature; muscle spasms are common and the colon is really tight. People with this type of injury usually need to do digital stimulation and use suppositories to help stimulate the reflex to defecate. Getting the right consistency These factors include: Diet and fluid Intake Activity Medications Timing of the program Positioning and aids used Diet and Fluid Intake Eating a variety of foods throughout the day will give your body the nutrients it needs for healthy functioning.

Fiber Fiber is extremely important in regulating the bowels. Other really high fiber foods you can eat are beans, nuts and seed almonds, sesame, peanuts, pecans, walnuts , popcorn, and a baked potato with skin Water Water is often over-looked as a nutrient.

Physical Activity All physical activity stimulates bowel function, whether competitive sports or activities of daily living such as transfers.

Medications The medications you are taking may have side effects that can influence bowel elimination. Timing of the Program Your bowel program must be done at regular times in order for it to be successful. Bowel Program Position, Aids Used, and Fingernail Length Sitting up during your bowel program is the best position so gravity can help in the elimination process. Final Thoughts When finished with the dil, wipe rectal area and buttocks with toilet paper; wash with soap and water; dry with a towel.

The dil may cause dysreflexia in persons with spinal cord injuries at T6 and above. Always observe for symptoms of autonomic dysreflexia:. If dysreflexia goes away, continue the bowel program as planned. If dysreflexia continues or gets worse then proceed with the treatment plan described in the Autonomic Dysreflexia section. Introduction Digital stimulation is a way to empty the reflex bowel after a spinal cord injury.

How to do a Dil digital stimulation 1. Gather supplies Gloves Dil stick if ordered Lubricant Soap, water, washcloth Toilet paper, underpads if done in bed Plastic bag to throw away waste Raised toilet seat, commode chair or shower chair if done in the bathroom 2. Wash hands 3. Prepare all needed supplies and place on a towel 4. Position yourself If doing the dil in bed: If doing the dil in bed, lie on the left side with knees flexed right leg over left leg and place disposable pad under the buttocks.

The last part of the digestive system is the large intestine which consists of four parts the ascending colon, the transverse colon, the descending colon, and the sigmoid colon. The large intestine begins with wet waste in the ascending colon and removes water, bacteria, and salt as it travels through the other sections of the bowel turning the chyme into stool by removal of fluid.

The large intestine is much wider in diameter than the small intestine because it is forming a soft, semi-solid stool for elimination. The same type of peristalsis muscle contractions action is used for propelling waste through it. The end of the large intestine is the sigmoid colon, or rectal vault, which stores the stool until there is a socially acceptable time and place to empty. Two important sphincters help control the expulsion of stool. The internal anal sphincter is composed of smooth muscle tissue.

It is about three inches from the opening of the rectum. The internal anal sphincter is not under your control involuntary. This means it will open to let stool pass when there is a sufficient amount present in the rectal vault. The external anal sphincter is composed of striated muscle which is voluntarily controlled through use the pudendal nerves.

If you feel the urge to have a bowel movement, you can control the external sphincter to hold stool until you find an acceptable location for expulsion. One of the main concerns for individuals with injury or disease affecting motor nerves nerves for movement is neurogenic bowel.

This is a condition where the nerves of the body are not communicating effectively to and from the brain with the bowel. There can be a complete nerve transmission malfunction with no messages passing or just partial transmission of messages. Therefore, bowel management is essential for health. Nerve function to the bowel is complex due to the length of this huge organ. The ANS is the part of the nervous system that works automatically or without your voluntary control.

A plexus branches of intersecting nerves of nerves control movement in the esophagus, stomach, and intestines. Some of the nerves for digestion include the vagus nerve cranial nerve 10 which also has some input to the stomach and upper bowel.

The lower bowel is controlled by sacral nerves S2, S3, S4 of the spine which includes the splanchnic nerve. Sensation of the external genitalia and skin around the rectum and perineum, motor supply to pelvic muscles, including the external anal sphincter is provided by the pudendal nerve. Most of the work of the bowel is accomplished through peristalsis or rhythmic muscle contractions as directed by the vagus and splanchnic nerves, among others. When food enters the stomach, the gastrocolic reflex is stimulated which causes the bowel to increase movement intensity.

The bowel is constantly working to remove fluid in the digestive process without thinking about it. With paralysis, the bowel tends to slow the peristalsis process. Even though the bowel slows its movement of chyme digesting food through it, the body is still removing fluid. The farthest end of the bowel is controlled by specific nerves. Thoracic nerves T9-L2 reduce peristalsis while contracting rectal sphincters.

Spinal nerves S will speed peristalsis while relaxing the rectal sphincters to release stool at the appropriate time and place to evacuate your bowel unless interrupted by neurogenic bowel. This is an efficient process when nerve messages are able to be transmitted.

In the nervous system, communication occurs by motor nerves carrying messages from the brain to the body for movement. Sensory nerves carry messages of sensation from the body to the brain. This cycle is how messages are relayed. Moving your body is directed by the brain through motor nerves.

Messages of sensation that something needs to happen to your body is sent to the brain by sensory nerves. Injury to the motor nerves creates a disruption resulting in neurogenic bowel. The source of injury, brain, spinal cord, or other neurological condition provides an indication of the type of neurogenic bowel function. Although they share the same name, motor neurons, there are more differences than similarities.

LMNs are in either the brain stem or spinal cord. They are the connectors between UMNs and the target muscle for movement. There are three types, one for each of your muscle types:.

In spinal cord injury, reflexic UMN neurogenic bowel is typically at the cervical or thoracic levels. The bowel and internal rectal sphincter are hyperreflexive or spastic tone. Because of spasticity tone , the anocutaneous reflex contraction of the anal sphincter by stimulating the surrounding skin and bulbocavernosus reflex assessment of S function are present or increased. This causes the bowel to retain stool, with only small amounts spontaneously released due to spasms tone. Not all stool will be expelled leading to involuntary small bowel movements at erratic times.

A bowel program using stimulation is initiated to empty the bowel completely at a predictable time. In spinal cord injury, the motor neuron injury is typically in the lumbar or sacral area or below the conus medullaris L1 or L2. The anocutaneous reflex contraction of the anal sphincter by stimulating the surrounding skin and bulbocavernosus reflex assessment of S function are low functioning or not present.

Stool will collect in the rectum without spontaneous evacuation no reflex release. The flaccid bowel does not respond well to stimulation.

If the lower bowel becomes full of stool, the bowel will stretch to accommodate the overload. However, at times, a small amount of stool might be released as incontinence because of absence of tone in the rectal sphincters or there is no more room in the bowel, but a large amount of stool remains. The stool remains in the rectum with water constantly being removed so it becomes very dry and hard. In an areflexic LMN bowel, stool is manually removed during the bowel program.

Mixed motor neuron bowel is a mixture of injury to upper motor neurons and lower motor neurons. Individualized plans for bowel evacuation using strategies for reflexic UMN and areflexic LMN bowel evacuations are established depending on the function of the mixed neurogenic bowel. Diagnosis of reflexic UMN , areflexic LMN , or mixed motor neuron bowel is treated with a bowel program to safely and effectively remove stool, to avoid social embarrassment and skin breakdown and to keep stool from backing up into the bowel leading to impaction or nausea and vomiting of stool.

Reprinted with permission. Causes of neurogenic bowel can include any disease or trauma to the brain, spinal cord or peripheral nerves nerves outside of the Central Nervous System CNS. Disease sources can begin as issues with bowel function and progress to neurogenic bowel whereas neurogenic bowel onset from trauma is typically sudden. Indications of the presence and type of neurogenic bowel is often first identified by medical diagnosis or trauma. Neurogenic bowel diagnosis includes a history and physical examination.

Your healthcare professional, a neurologist or a specialist in physical medicine and rehabilitation physiatrist will perform the examination. This includes a history of symptoms, gastrointestinal issues both in the past and now, bowel habits frequency, consistency, flatus gas , incontinence, time spent in toileting, fecal impaction, laxatives or antidiarrheal use, diet, fluid intake, activity and limitations on quality of life.

Details of current toileting assistance, medications and aids should be described. Physical examination consists of an assessment of the entire abdomen area. A digital rectal examination will be performed which provides an assessment of rectal filling, resting anal tone, reflexes, and ability to produce a voluntary contraction.

Evaluation of the anocutaneous reflex contraction of the anal sphincter by stimulating the surrounding skin and bulbocavernosus reflex assessment of S function discriminates between the types of neurogenic bowel. An X-ray of the abdomen will indicate the amount of stool present, blockages, or other structural issues in the bowel. Retaining stool is one sign of neurogenic bowel. Average transit time without neurogenic bowel is hours.

Slower transit times can indicate neurogenic bowel. Muscles of the pelvic floor including sphincter, anus and rectum can be assessed using anorectal manometry. A colonoscopy prep is performed prior to the procedure. A flexible catheter with sensors measures pressures while you contract and relax your rectum. Lower pressures can indicate neurogenic bowel. After an injury to the nervous system from trauma or a medical condition, there are often disruptions to the motor neurons and sensory neurons.

Establishing a diagnosis of the source of the issue is important to understanding the type of neurogenic bowel that is present. Being able to discuss stool frankly and openly with your healthcare professionals and caregivers is essential to obtaining the treatments you need. Some individuals are hesitant to discuss bowel movements. The Bristol Scale is a standard language to describe stool using consistent terminology.

A stool diary is helpful to track consistency and timing of your bowel movements. This is a tool to share with your healthcare provider for treatment decisions. If you have multiple healthcare providers and caregivers, they can also review your patterns.

There are many options available without charge. They can be downloaded from your app store. Establishing a bowel program is the treatment for neurogenic bowel at any age from birth through adulthood. Bowel programs are designed to work in the intestine and rectum to parallel natural bowel movement and evacuation.

The goal of a bowel program is to expel or remove stool from the body in a safe and efficient manner with no breakthrough incontinence. Using a lubricated, gloved finger, check the rectal vault to be sure stool is not blocking the bowel.

If stool is present, very gently remove it so the stimulant can reach the bowel. Insert the stimulant gently against the bowel wall about 20 minutes after eating to take advantage of the gastrocolic reflex. Stimulants used are a suppository or mini enema.

Most individuals use a suppository, bisacodyl Dulcolax or Magic Bullet for adults, glycerin for children or elderly. If a suppository appears to be too strong as indicated by harshness, cramping or excessive mucous discharge, it can be cut long ways in half. Some individuals prefer use of a mini enema Enemeez or Therevac as they feel it provides quicker and more efficient results.

Full enemas are not used because they do not mimic or stimulate natural bowel function. Suppositories and mini enemas are effective when placed against the bowel wall. If the suppository or mini enema is placed in the center of stool, it will not melt or stimulate peristalsis or movement of the bowel.

Move to a commode or toilet after insertion of the stimulant in about minutes, you will learn the amount of time needed prior to your suppository beginning to work. Then begin digital stimulation. Digital stimulation should be done gently for 10 to 20 seconds, minutes apart, up to four times, until stool is expelled.

The purpose of digital stimulation is to accelerate bowel function and to relax the internal sphincter which is held closed due to spasticity tone. These actions allow the stool to pass. The external sphincter can be seen while the internal sphincter might be felt when the finger is inserted. Be sure to use enough lubricant to create a smooth pass along the full length of your finger.

This should be a calm movement as aggressive action will increase spasticity. If finger and hand function are difficult, adapted rectal stimulators and inserters can be purchased. Individuals with areflexic LMN injury usually in the lumbar or sacral spinal cord have a flaccid bowel and sphincters absent rectal reflexes therefore typically do not respond to stimulants or digital stimulation.

The bowel program consists of manual removal of stool using a well lubricated, gloved finger. Insert a lubricated, gloved finger into the rectum. To prevent injury to the delicate bowel tissue, lubricate the entire length of the finger. Try to break up stool internally for easier passage. Depending on your bowel function, gently remove stool daily, or more frequently. Many individuals check their bowel several times during the day to ensure continence.

The technique for a bowel program with mixed motor neuron issues will be use of either of the reflexic or areflexic bowel programs or a combination of techniques used in motor neuron bowel programs. This will be individualized to your specific needs. In the past, abdominal bowel massage and Valsalva straining were techniques that were promoted for stool evacuation. However, complications of hemorrhoids, abdominal pain, anal fissures and rectal prolapse were noted with these techniques.

Valsalva is also a factor in urine reflux backup into the kidneys. Therefore, these techniques are no longer recommended. If you are using these options, check with your healthcare professional to assess their continued use in your bowel program.

Consistency in timing is the rule for training the bowel to work effectively. However, sometimes life changes and a new schedule is needed. Changing your bowel program should not occur very often as consistent timing is needed for your bowel program to work. However, on that rare occasion, it is possible to change your bowel schedule. Start your bowel program at your newly selected time.

Stop, your usual program. Perform the bowel program at the new time daily until stool is evacuated on the new schedule for days or a week with no incontinence in between. You may not have results daily and might have bowel incontinence around your original bowel program time. Even with incontinence, perform the bowel program at the new time. When you reach a point of no incontinence between daily bowel programs, usually between days or a week, you can move to every other day at the new time.

It can take weeks or sometimes a month to regulate your bowel to the new schedule, but success will happen. Accidents in between can be frustrating so be prepared for that consequence. Most people think of the bowel program as just being the process of elimination of waste from the body. These are other considerations of the total bowel program process.

Individuals with a spinal cord injury above T6 or even as low as T10 can have bouts of autonomic dysreflexia with their bowel program. The second cause of AD, behind bladder issues, is bowel concerns such as an overfilled bowel, diarrhea, gas, impaction or even due to the stimulation of the bowel program itself. The most common signs of AD are a pounding headache and elevated blood pressure which is higher than your individual normal.

There are other signs as well. Sometimes silent AD can be occurring which is an elevated blood pressure with no other symptoms. Be well aware of all of the signs of AD by checking the AD wallet card. AD is a serious medical emergency that requires attention. If you have multiple episodes of AD with your bowel program, medication can be prescribed to control AD as well as a topical rectal anesthetic to control the bowel program as an AD trigger.

Bowel programs may function well for years without any issues when, for no apparent reason,that changes. Part of the issue can be the effects of long-term neurological issues and aging. As individuals age, the bowel can slow. Combined with the bowel challenges of neurological issues this can be a compounding complication. Starting from the beginning might help in creating an improvement. Review your diet, fluid intake, medications, and activity level. Talk with your healthcare professional to review your techniques and medications.

Sometimes people get caught in a cycle of adding things to make the bowels move and adding other things to stop it. Let the bowel do its natural processing with minimal intervention if possible. Individuals with neurological issues have difficulty with their bowels because of slowing of the bowel function by the nerves of the Autonomic Nervous System ANS.

This nerve system slowing combined with decreased body movement affects bowel function. Many people think that because the bowels are slow, the problem is constipation. This is not the source of the problem. Treatment for constipation will not assist a neurogenic bowel to work more efficiently.

Individuals with or without neurogenic bowel can become constipated. Neurogenic bowel does put you at higher risk for constipation. A bowel program will result in controlled bowel movements with a neurogenic bowel.

Individuals with neurologic disease, incomplete spinal cord injuries or with partial preservation of some nerves may have some sensation in the rectal area causing discomfort with the bowel program. Messages may be transmitted that something is going on in the bowel or messages can be mis-transmitted as pain. A first line treatment is to use a rectal topical anesthetic at the time of the bowel program.

This analgesia can be inserted prior to the initiation of the bowel program or it can be used as lubricant, depending on your specific needs.

If there is no success with this treatment, neuropathic pain medication, spasticity tone medication or other treatment may be necessary. Fiber building powders, cookies and wafers have been initiated for many individuals with neurogenic bowel to increase bulk in chyme and stool with the goal of propelling these through the bowel. These products require eight ounces of fluid to be consumed to be effective. Without adequate fluid, the bulk fiber tends to harden the chyme and stool which can lead to slower bowel function, more difficulty in passing the waste and even to impaction.

Therefore, fiber building products are not being prescribed for those with reflexic neurogenic bowel. Individuals with areflexic neurogenic bowel can continue with bulk fiber use as long as including the recommended fluid. Many individuals with neurogenic bowel may also be monitoring their fluids for bladder management, heart conditions, extreme edema, or other health issues.

Because it is a contradiction to control fluids for one health issue and increase fluids at the same time, bulk fiber is no longer an automatic recommendation for those with fluid restrictions. It has been found that most individuals will process chyme and stool without the conflict of the bulk fiber. Check with your health professional to see if you should continue with bulk fiber. Some healthcare professionals might recommend it but with divided doses so water intake can be achieved.

If you are having constipation issues, discuss a plan with your healthcare provider for switching to alternative treatments such as a change in diet or stool softener, among others.

When a person reaches their 45th birthday, a gift from your healthcare provider will be the recommendation of a colonoscopy. Colon and rectal cancer are the fourth most common cancer. The symptoms of bowel and rectal cancer can be hard to detect. There appears to be a genetic factor for colon and rectal cancer.

Risk is increased if someone in your family has bowel or rectal cancer. One of the major risk factors for colon and rectal cancers and other types of cancer is cigarette smoking.

Manage risk factors by eating a diet high in fiber and stopping smoking. Giving up smoking, chew, vaping, e-cigs and reducing exposure to second hand smoke will help reduce cancer risks.

Inherited factors can be managed but not eliminated. Symptoms of colon and rectal cancer might be feeling tired, blood in the stool, excessive bloating, gas, feeling that your bowel does not empty, nausea and vomiting. Stools that are very thin in width can indicate a blockage which may or may not be cancer.

These symptoms can all be signs of other problems as well. Therefore, it is good to have these issues checked out by colonoscopy if they are persistent. Most individuals will be sedated during the colonoscopy. You will not know it is even happening. Sometimes, you might be told that you will not feel the procedure because of your spinal cord injury, however, your body will still respond to the procedure. Light sedation should be provided. Discuss sedation possibilities with your healthcare professional who provides care for your neurological issue as well as the person performing the procedure to see what will be right for you.

Autonomic dysreflexia AD is a concern during the colonoscopy prep and procedure. It typically occurs in individuals with SCI above T6, however, it has been noted in some people with injury levels as low as T You may have never had an episode of AD until the prep or colonoscopy procedure. Both the prep and the procedure can trigger an episode.

Careful monitoring is required during the prep and the procedure. In preparing for the colonoscopy, your bowel needs to be clean so that the person performing the procedure can clearly visualize the bowel wall.

The preparation for a colonoscopy varies by examiner. There are many products that are used to cleanse the bowel. Follow the instructions specifically provided. Check with your healthcare professional about hospitalization prior to your colonoscopy.

Some payors will cover this option especially if you are at risk for AD, must be on a longer clear liquid prep, and need assistance with the bowel cleanse. Resume your bowel program routine as instructed by your healthcare professional. Most people will resume their bowel program within the next day or two. Keep your bowel program working. Anyone can become constipated with or without neurogenic bowel. Constipation is stool that is too dry.

The cause can be from too slow of a transit of chyme and stool through the bowel or not enough hydration in the body or both. Slow transit time through the bowel or lack of fluid will dry stool as the entire time chyme and stool are in the bowel, water is being extracted. Constipation can also be caused by a stricture or narrowing of the bowel, colon cancer or other structural issue.

Sometimes, people have a temporary constipation. Temporary causes of constipation include being out of routine and not taking in enough fluid one day, over drinking alcohol which will dehydrate the body or exercise or work with an overproduction of sweat. People become dehydrated for a variety of reasons, even illness such as fever. The result is seen in your stool which becomes very dry. Treatments for constipation include fluid if not on fluid restriction , diet of unprocessed foods, body movement or activity, and stool softening medications.

If you have temporary constipation, you might not need to change your typical routines. Individuals with neurogenic bowel issues may need to increase some of the above listed treatments. To increase treatments, add just one item at a time and wait awhile for results. Changing all at one time or adding too quickly can lead to diarrhea episodes.

Diabetes is a disease that can affect nerves of the bowel. Eating food containing large amounts of carbohydrates and sugars will result in loose stools or diarrhea when the sugar hits the bowel.

Since diabetes affects nerve function, over the long term, diabetes can affect the nerves to the bowel and within the bowel leading to slower bowel movement and eventually bowel dysfunction.

If you have diabetes, follow your diet, take prescribed medication, and add activity or movement into your lifestyle. If you notice your bowel program becoming slower or less effective, it is time to discuss alternatives with your healthcare professional. Diarrhea seems to come for no apparent reason and certainly will appear at the least opportune moment. It can be caused from a bacteria or virus in the bowel, diseases such as diabetes, and changes in physical and mental wellness.

Diarrhea is a result of stomach flu, any gastric illness or just from how our bodies react with certain foods. Diarrhea can also come from stress. The bowel is programmed to eliminate when a person is frightened which is the same process as stress. Diarrhea will typically resolve when the illness is over or when you are no longer under stress. Remember, happy, exciting events can be stressful, also. If severe diarrhea appears, you can skip your bowel program for that day if you feel your bowel is completely empty.

Then return to your routine. If the diarrhea is prolonged, you will need to see your healthcare professional to get to the source of the issue and to avoid dehydration. Antidiarrheal medication can be taken but use with caution. Antidiarrheals slow the bowel which makes return to your normal function slower.

Rectal bags can be worn to keep the caustic diarrhea stool off your skin. Washing with soap and water will clean your skin but is drying. Use skin prep or lotions containing zinc oxide to protect skin and help to keep it intact. Eating a healthy diet is key to your general health as well as to bowel function. A person with neurogenic bowel often does not feel hungry because the slow bowel creates the sensation of fullness. Changing your eating habits will have an impact in a bowel program. The daily fiber requirement for individuals under 50 years is 25 grams for women and 38 grams for men.

After age 50, people tend to eat less on average, so the fiber requirement is lower, 21 grams for women and 30 grams for men. One of the top changes should be to reduce your intake of processed foods.

Instead eat fresh items, especially produce. This adds a tremendous amount of fiber to your diet. There are certain foods that help move stool through the bowel. Beans have a pronounced effect on the bowel because of their fiber content. You can easily slip them into other dishes such as adding them to salads, casseroles, soups, stews or just as a side dish.

Do not forget beans are popular as dips with fresh vegetables. Other fiber rich foods are lentils, cooked potatoes, squash, seeds and nuts, bran, broccoli, cauliflower, cabbage, peas, and celery. Cereals are designed to add fiber. Just be sure to check that the sugar content is not high. Individuals with neurogenic bowel can develop a secondary complication of diabetes due to a variety of factors including lack of movement in their bodies. Limit carbohydrate and sugar intake as once the diabetic bowel senses sugar in any form, it tends to spontaneously speed its work which can lead to incontinence.

You do not have to eliminate sugar and carbohydrates, just eat them in moderation or according to a diabetic food plan. A technique for individuals with a reflexic UMN neurogenic bowel is digital stimulation.

The goal of digital stimulation is to relax the inner sphincter and to trigger bowel function. The inner sphincter is about three inches from the rectal opening. You may or may not feel the inner sphincter relax with digital stimulation, but a gentle process close to the inner rectal sphincter will relax spasms tone.

Aggressive digital stimulation can slow the bowel elimination process by increasing spasms tone in the inner rectal sphincter. Gentle digital stimulation using lubricant can avoid triggering spasms, tearing delicate bowel tissue, hemorrhoids, and other bowel issues.

Gentle removal of stool also avoids these issues. Some individuals cannot perform digital stimulation due to heart conditions or severe autonomic dysreflexia AD. If your cardiologist or healthcare professional recommends no digital stimulation, you may still be able to perform a bowel program, but you will need specific instruction from your healthcare professional which might include use of a topical rectal anesthetic.

Diverticulitis is the development of small pouches along the wall of the bowel which can become infected and inflamed. How the small pouches develop is unknown but there is some evidence that they develop from weakened spots along the bowel.

Allowing stool to collect in the bowel without a bowel program for elimination can supply pressure to the bowel wall. Diverticulitis can lead to pain, discomfort, bleeding and even eruption which allows stool to enter the abdomen. Symptoms of diverticulitis are pain if sensation is intact, fever and chills if the bowel becomes infected, an increase in bloating and gas, diarrhea or constipation, nausea and vomiting or not feeling like eating.

Diagnosis of diverticulitis is made though x-ray or colonoscopy. If you do develop diverticulitis, antibiotics can treat small infections. If the infection becomes an abscess or a large pocket of infection, it may have to be drained. Fistulas can develop if the bowel attaches itself to another part of the bowel or another body part. Prevention of diverticulitis is achieved by eating a high fiber diet to move waste through the bowel more easily.

Adding water to your routine will help moisten your stool. Maintaining your bowel program routine is imperative. Anxiety, stress, nervousness, happiness, being upset, or just a change in your daily routine can affect the bowel program. Your mental wellbeing affects your bowels. Everyone has good days and disastrous days which will affect your bowel function.

Ongoing stress and other mental wellness should be addressed with therapy to gain skills in dealing with challenges. Full enemas should not be routinely used for neurogenic bowel management because they do not mimic the natural action of the bowel. Instead, they wash out the bowel reducing healthful bacteria.

If the bowel does not perform its rhythmic motion, the function eventually becomes weaker leading to even more difficulty in completing the bowel program. Mini-enemas Enemeez or Therevac work only in the lower bowel or rectal vault. These are appropriate as alternative stimulants for bowel programs.

Additional fluid helps to keep chyme and stool moist for the entire length of the bowel. Check with your healthcare professional to see if you can increase your fluid intake. A bladder program, heart conditions, and some instances of excessive edema among other diagnoses can lead to fluid restrictions. Increasing fluids should start slowly. Taking in large amounts of water too quickly can overload your entire body system and even lead to incontinence.

Small sips throughout the day is the best way to increase your intake of water. You do not need to increase by cups of fluid quickly, increase slowly, just a sip or two at a time. A sip or two every hour when you are awake can add fluid to help your bowel function. Water is the best option for keeping a moist stool. Consider the effects of other liquids. Alcohol causes dehydration that affects stool as well as the rest of your body.

Caffeine can also dehydrate. Sugary and artificially sweetened drinks will cause the stool to move more quickly through the bowel. You can still enjoy these drinks, just use them in moderation. It is important to keep up with your fluid intake to keep your bowels moving efficiently and effectively.

If you have the ability to sweat, you may need to take in a bit more fluid such as on a hot day. Do not forget humidity can dry your body without sweating even if the temperature is not high. In the winter, you can dehydrate from being in a room with dry heat. Electrical stimulation can be applied to the body through electrodes placed on the skin. Electrodes placed on the abdomen may have an impact on bowel function, but this is still being explored by research.

FES to other parts of the body, such as the legs, helps stimulate the bowel through body activity. Epidural electrical stimulation occurs using implants in the body. This is an emerging field of study. Preliminary results indicate improvement in bowel function with this technique.

Sacral anterior root stimulation SARS and sacral nerve stimulation SNS are implants for stimulation of the sacral nerves with improvements in bowel function and continence. These implants are currently directed for individuals with areflexic LMN neurogenic bowel. Bloating and gas can be an issue for individuals with neurogenic bowel. Slowing of the bowel can lead to a buildup of gas which appears as bloating.

Movement can help resolve some of the issue because it pushes gas along in the bowel. Eating foods that produce little gas can help. Adding movement through range of motion exercises, pressure reduction techniques and activity assist with gas movement in the bowel.

Gas reducing tablet medication simethicone is available. Take gas reduction medication when needed, not as a routine, if possible.

Gas in the bowel is one of the ways waste is propelled through the bowel. It is a necessary action. Eliminating gas can reduce bowel propulsion. Gravity is often overlooked as one of the biggest aids in bowel movements. You might have been taught to do the bowel program in bed. However, sitting upright will help stool pass from your body by taking advantage of gravity. To accommodate sitting, request a commode chair or shower chair which can be dually used for your bowel program.