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