How to Manage Neurogenic Bowels

Beautiful Bowels

The underrated, down-under operation of human anatomy is one of the most important functions of the body … the bowels.

Regular, frequent bowel movements are fairly standard for an uninjured human body, however a spinal cord injury can change the game entirely. Depending upon a person’s level of injury, this bodily function can become the bane of existence.

In part two of my bladder & bowel article (you can find part one here), I describe my guts, feelings and lifestyle around my neurogenic bowels.

Neurogenic Bowel

As I explained in part one of this article about the bladder, neurogenic bowel is similarly described as a lack of nervous control which prevents the bowel from functioning correctly resulting in fecal incontinence, chronic constipation or both. Neurogenic bowel can be caused by a spinal cord injury, spina bifida, multiple sclerosis, diabetes mellitus and a variety of other ailments.

When I was newly injured and laying in the hospital bed, I would cringe when the nurses would say, “It’s time for your BP!” which meant – Bowel Program, AKA “time for number two.” This was no small task. For a bodily function that usually took only five to ten minutes of private relief before injury, it now took two or more hours of excruciating, pride-crushing work that involved two or more parties.

Explicit Warning:

I apologize in advance for disclosing the following TMI, but if not me, then who?

Here We Go!

Each day – or every other day, if all goes well – I insert a highly potent suppository called The Magic Bullet™ (the most powerful suppository available – I call it a “red-hot chili pepper”) into my anus. Ten to thirty minutes later, I begin to experience early Autonomic Dysreflexia symptoms such as chills, headache and profuse sweating. There is no turning back when the “bullet” is loaded … a toilet MUST be near by.

Dulcolax® and the other bisacodyl suppositories have the same active ingredient (10mg bisacodyl) as The Magic Bullet. The base, or carrier, of the active ingredient in the suppository is what makes the “Bullet” different. The Magic Bullet uses a polyethylene glycol (PEG) base which is water-soluble. This base allows the bisacodyl to be activated by the body’s own moisture shortly after insertion. The Dulcolax and other bisacodyl suppositories use a vegetable oil base. This type of base takes longer to work because it needs time to be melted by the body’s heat.

This regular, self-masochistic routine may seem slightly brutal, but for me it is my opportunity for independence with self-care. Initially, I relied upon a caregiver or nurse to digitally stimulate a bowel movement by inserting their cold, rubber gloved fingers into my you-know-what, wiggling, turning, stretching and pulling until the job was done … I prefer the “chili pepper.”

For consistent control purposes I do not influence my bowels with any other additives or laxatives. My main source of bowel health is a balanced diet including raw fruits and vegetables, juices and probiotic yogurt. I am prone to excessive gas build-up because of a slower moving system, therefore foods that may breakdown slowly and/or ferment over time like red meat, fish and heavy greens such as kale are consumed just prior to a bowel movement for immediate evacuation.

Control is King!

When most things in life are beyond control … control the bowels first!

Experiencing a bladder accident in public is one thing, but dealing with bowel incontinence is on a whole other level.

Personal Experience:

In the early days of my recovery, before I had an understanding and consistent routine for my bowel program, I was at the mercy of an unpredictable rear end. This meant I was severely insecure and extremely nervous to go anywhere in public in fear of having a bowel accident. My fear would be realized one night when a group of well-intended friends took me out to a Los Angeles dance club.

From the moment my buddies scooped me up out of my wheelchair and loaded me into the car, my mind was focused on my guts. I had not yet had a thorough bowel movement that day and I knew my body was trying to tell me so. The confusing, mixed signals my mind and body were sending were not clear enough for me to understand yet. I surely did not want to let my friends down and cancel this potential good time, so we carried on. Sure enough, just as the music went up and the lights went down, the boys began to get loose – and so did my bowels. I sat there in my big, archaic hospital wheelchair, in the middle of a flashy disco dance floor, sulking, soiled in my own humility and waste. With the music too loud to communicate and my hands too weak to gesture, all I could do was wait until the warm stench caught the nose of the right friend for help. Unfortunately, the smell alerted almost everybody in the club. Man, what can I say? “(**)It Happens.”

From that moment forward I was determined to find the right solution for my peace of mind. I have trialed most every type of suppository on the market, landing on The Magic Bullet for my needs. Based on my activity level and diet, a routine that takes place every other day, early in the morning, works best for me. I make my BP (Bowl Program) the priority of my day and it gives me confidence moving forward.

Since this human experience is rarely, if ever, spoken (or in this case, written) about I am happy to share mine. And by doing so, I hope to expose myself as a mirror for others to face. I honor the process of self-evolution, even when the dance floor beat drops the brown note.

Rise Above-
Aaron

More resources to manage your body:

• Managing My Neurogenic Bladder
• How to Safely Catheterize in a Public Restroom | Ask Aaron
• Spasticity & Spasms: Part 1 – Insight Into My Spastic Paralysis
• Spasticity & Spasms: Part 2 – How I Manage My Possessed Body
• Spinal Cord Injuries and Urological Issues
• Autonomic Dysreflexia: A Dangerous Secondary Complication of Spinal Cord Injury
• Temperature Roller Coaster: The Ups and Downs of  Thermoregulation
• Nerve Pain | Spinal Cord Injury

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