Each person’s bowel programme should be individualised, taking into account the diagnosis or nerve damage, as well as other factors.

It is important to establish a routine

There are 4 principles to bear in mind when putting together the routine:
    1. Take into account pre-injury bowel habits
    2. Set up a schedule of either daily or alternate days
    3. Take into account the fact that less frequent or irregular bowel management may contribute to constipation
      (Coggrave 2007a)
    4. Don’t alter an established routine without clinical reason or advice from a specialist centre.

NOTE: Most people perform their bowel programme at a time of day that fits in with their prior bowel habits and current lifestyle.

What should the routine involve?

Bowel programmes typically require 30-60 minutes to complete:
    • Insertion of either a suppository or a mini-enema
    • This is followed by a waiting period of approximately 15-20 minutes to allow the stimulant to work.
      Preferably, this part of the programme should be done on the commode.
    • After the waiting period, digital stimulation is done every 10-15 minutes until the rectum is empty.

NOTE: Those with a flaccid bowel frequently omit the suppository or mini-enema and start their bowel programmes with digital stimulation or manual removal.