Bowel Care

 

Bowel Care Step by Step

Step 1: Exercise–Fluid–Fibre–Toileting Regimen

Step 2: Bulk-Forming Laxatives

Step 3: Stool Softeners

  • Docusate sodium (Colace)100 to 400 mg daily

Step 4: Osmotic Laxatives 

eg. Lactulose and Magnesium Sulfate 

  • Lactulose (Cephalac) 70% liquid solution 30-45 ml OD or BID
  • Sorbital liquid* 15 ml TID, then OD
  • Magnesium sulfate* 10-30 mg OD

Step 5: Stimulants

eg. Senokot 0.5 to 2 grams OD or BID

Step 6: Suppository Enema

eg. Glycerine, Dulcolax, Fleet = Sodium/Phosphate enema.

  • -Glycerine suppository* – one rectally PRN (Semla et al., 1997)
  • -Bisacodyl (Dulcolax)* 5-10 mg suppository – one rectally PRN
  • -Sodium/Potassium phosphate enema (Fleets)* 133 ml(21.3 grams)
  • instill rectally PRN (Gibson et al., 1995)

Bowel Care Day by Day

Day #3 without bowel movement

  • In combination with Step #1:
  • Begin at step #2 and proceed through step #5 as needed.

Day #4 without bowel movement:

  • Repeat steps #2 through #5.

 

Day #5 without bowel movement:

  • Go to step #6.

Toronto best practice in long term care initiative. 2006. Policy and Procedure manual for bladder and bowel management. Retrieved December 11, 2010 from http://rgp.toronto.on.ca/torontobestpractice/Policyprocedurebladderandbowelmanagement.pdf

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