Your Bowel Program
Going to the bathroom is a normal body function. Stool (feces) moves in a wave-like motion through the intestines and out of the body. This wave-like motion is called peristalsis.
Many people with a disability are not able to control their bowels as they did before their disability. Your bowel program will help your bowels be more regular.
The goal of your bowel program is for you to have soft, formed bowel movements at regular times. This will help you prevent accidents.
There are five parts of your bowel program.
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Timing
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Diet
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Fluids
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Activity
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Medicine
Each part may affect the others. For example, a change in your activity may need a change in medicine. Change only one factor at a time so you know how it affects you. You will soon know how to use each factor to keep your bowels regular.
Timing
Think about your bowel habits before your disability. Then begin a routine that fits into your daily life.
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How often you have a bowel movement now may be close to the number of times you had one before your injury.
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If you need help going to the bathroom, think about when your helper will be available.
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Always make sure there is enough time so you won’t feel rushed.
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Set aside a time of the day that is best for you. Plan for it to be the same time every day.
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Your digestive tract is more active 15 to 30 minutes after eating. Take advantage of this when you plan your bowel time.
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Most people start with an every other day bowel movement.
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You may need to adjust how often you have a bowel movement (BM) if you change what you eat or how active you are.
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If you try to have a BM every day and find that you are not able to do so on the second day, then you may need to plan on having a BM every two days. Some people have good success with every 3 or 4 days.
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If you have accidents, you may need to switch to having a BM more often. You may also try to allow more time to empty your bowels. Do not plan a bowel movement more often than once a day.
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If you are trying to change your schedule, it may take a week or two to get used to it before you stop having accidents.
Diet
Good food will help to keep your stools soft, formed, and on a regular schedule. Vegetables, fruits, and whole grain foods will keep your stools softer and more regular. Make these foods part of your meals and snacks. But be careful. Too much of these foods may make your stools too soft or loose. This may cause you to have accidents. Do not eat foods that cause you problems.
Fluid
You may stimulate your bowels by drinking a cup of hot or warm liquid such as water, coffee or tea, about 30 minutes before you try to have a BM. Be sure to drink 8-12 cups of liquid a day to help keep your stool soft. If you need to limit how much liquid you drink in order to control your bladder, then drink as much as your bladder program allows.
Activity
Your activity may be limited. But staying as active as possible will help keep your stool soft and regular.
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Do active or passive range of motion exercises with your arms and legs.
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Change position. You might turn in bed, sit, stand or walk. These help keep your digestive system working.
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You may need to change how often you move your bowels if you change your activity level.
Medicine
The most natural method of having a bowel movement is best. But there may be times when you need medicine to get a regular pattern started. We may try different medicines until we know what works best for you.
Change only one medicine at a time. Watch its effects for 5-10 days before making another change. After your regular routine is set, you may be able to take less medicine or stop taking it.
The common types of medicines are stimulants, stool softeners, bulk formers, and suppositories. We do not advise regular use of enemas. They make the muscles in your bowel less able to function on their own.
Stimulants
These medicines help your intestines move the stool better. An example is Pericolace.®
Stool Softeners
These medicines help your stool absorb more water and fats from your body. This keeps the stool soft. An example is Colace.®
Bulk Formers
These medicines make the stool larger. Make sure you follow the directions about how much to drink when you take bulk formers. Examples are Metamucil®, Fibercon tablets® and Citracel.®
Suppositories
These medicines stimulate your lower colon and rectum and help the muscle around your anus to relax.
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Glycerin works because it irritates the wall of the rectum. It also lubricates so your stool can move easier.
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Ducolax® stimulates the nerves in your lower bowel. It acts faster and is stronger than glycerin. It may also cause cramps.
Note
Digital stimulation is often used by itself or with a suppository to help the bowels move. This is done by placing a lubricated, gloved finger into the rectum and moving it back and forth or in a circle. You can read more about this in the handout “Suppository Insertion and Digital Stimulation.”