Ongoing bowel management
Early bowel management
A regular bowel routine can help to reduce neurogenic-related pain. Furthermore, a healthy bowel routine can prevent damage to the colorectal structures, including haemorrhoids, anal fissure, rectal prolapse and/or the development of megacolon.
To help identify the best place to start when improving a bowel routine, bowel management has been broken in to 5 categories that need to be working well together to put the person back on the ‘Right’ path.
Neurogenic Bowel Intervention Progression
1. Lifestyle
Diet, fluids, positioning
2. Aperients
Additional oral supplements to help form and stimulate the progression of stool along the bowel
3. Rectal Stimulation
Manual (digital) or chemical (enema, suppository)
4. Transanal Irrigation
Balloon or cone, low or high delivery systems
5. Surgical
E.g. Antegrade colonic irrigation
6. Stoma
Ongoing use of ostomy bag
Wicks, K. (2019). Traversing Transanal irrigation. Sydney, NSW: BrightSky Australia
Good bowel routines
A good bowel routine combines both predictable emptying and effective emptying. A routine should factor in the following 5 considerations.
Time
Place
Consistency
Amount
Trigger
The 5 rights of bowel management
Work through these 5 ‘rights’ to help establish a good bowel routine: