Quadriplegic involuntary bowel movements

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I have a patient who is a recent quadriplegic. He suffered a C4 incomplete break in May. Upon completion of his bowel program each night I get him in bed and get him properly positioned for the night. Twice in one week he has had an involuntary bowel movement in bed after completing the bowel program and doing a rectal clear. He is quite distressed over this, as you could imagine. I was wondering if anyone has any advice to help prevent this.

A little about his bowel program: Once positioned in his bath chair, I perform a rectal clear to make sure the rectum is clear of feces. Once clear, I insert a Bisocodyl suppository and he stays in position for about 30-45 minutes. On the 2 nights he had the BM in bed, he was actually in the chair for almost an hour and everything felt clear.

I appreciate any and all suggestions.

Thank-you,

Cara

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

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