Right trigger
When the Right place and Right time are aligned, a ‘trigger’ can help to empty the rectum effectively.
There are various ways to trigger defecation and deciding which one to use can depend on the following factors:
- Level of injury and functional ability – suppositories are often wrapped in foil or plastic, and can be difficult to access or insert if there is impaired hand function. In some cases, aids can be utilised to assist with insertion of Enemas or suppositories. Stimulation during the insertion process can encourage the defecation reflex.
- Time constraints – suppositories are ‘bullet-shaped’ wax, impregnated with medication. There is a waiting period for the wax to heat and melt, before the medication can be released and absorbed by the bowel. This absorbed medication then ‘irritates’ the bowel wall, stimulating the defecation reflex. This process can take between 20-45 minutes and is best attended while in bed, only moving to the toilet towards the end of the routine, when the bowel motion is expected. Alternatively, enemas can be inserted while seated over the toilet and can take between 5-20 minutes to work.
- Personal preference – the right trigger for defecation often comes down to personal preference. Most medications used to assist bowel emptying come in either enema or suppository form. More commonly used enemas (Microlax/Micolette) are mild and do not contain medication to irritate the bowel. People requiring medicinal irritation often use suppositories (e.g. Dulcolax, Bisacodyl) or the enema form (Bisalax).
- Care agency considerations – some care agencies will have restrictions over who can or cannot administer certain types of medication, which can also be a factor in determining the right trigger.
- Additional stimulation – Inserting an enema has the advantage of providing additional rectal stimulation, through a gentle stimulation and stretch when removing the enema.