Interventions
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:
- Take into account pre-injury bowel habits
- Set up a schedule of either daily or alternate days
- Take into account the fact that less frequent or irregular bowel management may contribute to constipation
(Coggrave 2007a) - 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.
