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QLD Government
QSCIS
Queensland Spinal Cord Injuries Service

Ongoing bowel management

Early bowel management

A regular bowel routine can help reduce neurogenic related pain. 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 understand where to start when trying to make improvements to 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 the 5 rights to help establish a good bowel routine.

Right time
Right place
Right consistency
Right amount
Right trigger