Bowel Management



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Performing Bowel Care

Reflexic Bowel
Aim for soft, formed stool that you can pass easily with minimal rectal stimulation. The bowel routine usually starts with digital stimulation or a stimulant medication, e.g. suppositories or enema. Digital stimulation involves inserting a lubricated gloved finger into the rectum and gently rotating it against the sphincter wall.
Procedure

Always keep nails short and neat to avoid puncturing gloves and possibly tearing rectal membranes.

Move your urinary drainage equipment away from the anal area to avoid stool contamination.



If possible, sit up. Gravity helps empty your rectum.

If you don’t sit up, lie on your side. Lie on the side that leaves your dominant hand free.

Check for stool by sliding a gloved well-lubricated finger into the rectum and remove any stool that would interfere with inserting the prescribed suppository or enema.

If you have ab reflex bowel
use digital stimulation, insert a lubricated suppository or squirt a mini-enema high in your rectum. To keep stool coming, repeat digital stimulation every five to ten minutes as needed, until all stool has passed.

To make sure the rectum is empty, do a final check with a lubricated gloved finger. You’ll know that stool flow has stopped if o no stool has come out after two digital stimulations at least ten minutes apart, o mucus is coming out without stool o the rectum is completely closed around the stimulating finger and you can feel the internal anal sphincter.
Flaccid Bowel
Aim for firm, formed stool that can be removed manually with ease and doesn’t pass accidentally between bowel routines. Bowel care doesn’t usually need chemical stimulants because the response would be very sluggish. People with ab flaccid bowel
should perform a manual evacuation


Managing your bowels
The science bit
Upper motor neuron or reflex bowel
Lower motor neuron or flaccid hypotonic bowel
Coffee, tea, cocoa or soft drinks
Other factors
Manual evacuation
Medication stimulant laxatives
Osmotic laxatives
Complications
Flatulence



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