Digital Bowel Stimulation

Post spinal cord injury (SCI) the signals passed between the brain and the bowel are often disrupted, causing a loss in, or elimination of, the ability to feel when the bowel needs to be emptied. This condition is referred to as neurogenic bowel.

For injuries at T-12 or above, when the rectum is full defecation occurs on a reflexive basis, leading to bowel accidents, and often a reduction in independence and quality of life. This type of neurogenic bowel is known as “reflexic” (or spastic) bowel.

People with neurogenic bowel require an effective bowel management program to pass stool on a routine basis.

What is Digital Stimulation of the Bowel?

Every person is different, and the methods that work best for emptying the bowel of stool will vary for each individual, depending on level of injury, mobility, and other health considerations. There are three common ways to evacuate stool with reflexic bowel:

  • Abdominal Massage
  • Manual Removal of Stool
  • Digital Stimulation

Because the anal sphincter remains closed with reflexic bowel, digital stimulation is one way to encourage a loosening of the sphincter in order to pass stool.

How do you Manually Stimulate a Bowel Movement?

To perform digital stimulation of the bowel, individuals or caregivers should insert a lubricated, gloved index finger in the rectum and slowly rotate it in a circular motion. The time spent stimulating will vary depending on the use of laxatives and the regularity of the patient. Maintain contact with the rectal wall to activate the bowel reflex, create muscle contractions, and empty the bowel of stool.

It’s important to perform digital stimulation with slow, gentle movements as the skin around the rectum is delicate. Perform digital stimulation every 5-10 minutes as required until no stool remains in the lower bowel. Finish manual stimulation of the bowel when no stool is evacuated after two procedures at 5-10 minute intervals, or if the rectum is closed tightly around the finger after evacuation.

It’s essential to wash hands, wear gloves, and use lubrication to avoid injury to the rectum every time manual stimulation of the bowel is performed.

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Ways to Support a Bowel Management Program

In order to support an effective and healthy bowel management program, there are several other elements to consider.

Routine

Performing a bowel management program at predictable intervals each day helps train the bowel to “go” on a routine basis. Schedule bowel management around lifestyle, work, family, etc. to allow for optimum quality of life and independence. First thing in the morning, before bedtime, and/or 30-40 minutes after a meal are common times for a bowel management routine.

If unplanned bowel movements increase, make adjustments to the bowel routine accordingly. Plan ahead for how to manage predictable disruptions in routine for things like travel, visiting with family/friends, etc.

Hydration

Drink plenty of water. Water helps to regulate the digestive system, keep stool soft and easier to pass, and helps prevent constipation and fecal impaction. It’s also important to avoid or moderate diuretic fluids such as caffeine and soda, as they dehydrate the body.

Fitness

Moving the body helps food and waste keep moving through the gastrointestinal tract. Range of motion and/or stretching exercises can help people with limited mobility.

Nutrition

Maintaining a healthy diet has a significant impact on healthy bowel movements. Consume a daily, balanced diet that includes fruits, vegetables, whole grains, and other fiber-rich foods. Fiber helps to promote health for the entire digestive system and also boosts the immune system.

Other foods can contribute to bowel problems such as constipation and diarrhea, so it’s important to moderate saturated fats, dairy, protein, and processed foods/snacks that are high in sugar, sodium, and/or fat.

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How Can Enemeez® Help with Bowel Stimulation?

Time-consuming bowel management reduces the quality of life, independence, and comfort. A bowel management program doesn’t need to take hours, and you shouldn’t need to plan your day around emptying your bowel.

Enemeez® has been a preferred and trusted formula assisting people to improve their bowel care needs for more than 15 years. The Enemeez® formulation is a stool-softening laxative that works by drawing water into the bowel from surrounding body tissues. The docusate sodium in this mini enema product prepares the stool to readily mix with watery fluids. Not only does it soften and loosen stool, it also initiates a normal, replicated bowel movement, typically within 2-15 minutes.

Both Enemeez® and Enemeez® Plus are easy to use, have a soft latex-free tube, and work well for people with reflux issues or nausea.

Disclaimer: The material contained is for reference purposes only. Alliance Labs, LLC and Summit Pharmaceuticals do not assume responsibility for patient care. Consult a physician prior to use. Copyright 2021 Summit Pharmaceuticals and Alliance Labs, LLC.

 

Sources:
  1. https://www.myshepherdconnection.org/sci/bowel-care/digital-stimulation
  2. http://www.braininjurysupport.org/living-with-a-spinal-cord-injury/bowel-management/
  3. https://livingwithsci.ca/bowel-management/
  4. http://www.spinalcordessentials.ca/handouts/digital-stimulation/