This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Managing Bowel Function After Spinal Cord Injury. Patty Zuba, O.T.R., clinician, discusses A Typical Bowel Program.

Patty Zuba, O.T.R.

Occupational Therapist

University of Michigan

I guess what would constitute a perfect bowel program would be having a specific routine. So it might include — let’s say they’re doing the bowel program in the morning. It might include taking some medications at night because usually the oral medications take about eight hours before they actually kick in or have an effect. So taking medications at night maybe right before they go to bed, the stool softeners or their laxatives, the MiraLAX, different things like that, making sure that they have plenty of fluids throughout the day.

Making sure that they have a good well-balanced diet to help with the stool formation. They wake up in the morning. They have their breakfast. They might have a small amount just to kind of stimulate the digestive tract to function and get the bowels moving.

They might drink some coffee because the caffeine can kind of be a stimulant for a bowel program or just the warmth of something hot like coffee or tea. They might insert a suppository or an enema. Some people do it while, you know, like maybe they’re in bed, and then they transfer onto their commode and then wheel over to the toilet and do their bowel program there. Some people might wait and get up in the morning and get onto their commode chair and then go over to the toilet and do their bowel program — or insert the suppository or the enema right there. So it just totally depends on their technique.

Usually a good program, usually within 20 minutes to 45 minutes should be done. Anything that is longer than that, something isn’t right, so they need to reevaluate that, see what kind of medication, see what kind of food, you know, how much fluid, all that stuff. And that would be a good regimented bowel program. They’re done. They might do a digital or rectal check just to make sure there’s nothing in the vault. They wipe. Might take a shower, get back to bed, get dressed, and they’re off for the day and no accidents. And then do it again the next day.

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