How can you stop a supra pubic catheter blocking and faecal impaction? — Reeve Connect
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How can you stop a supra pubic catheter blocking and faecal impaction?

JenniJenni Member Posts: 1
I am using a bladder wash every other day for my sister with primary progressive M.S. and new catheter, snub end, size 18 ch.

Plus an enema every week for her bowel care.  Can clear 2 - 7lbs of faecal matter.  But her tummy is still huge.  Cannot see her intestines or colon on a scan just blackness.  Full and has been for 3 years!  

I am worried about bowel cancel or ?  Cannot get bowel consultation due to covid in hospital for her here in the U.K. even paying privately.  Nuffield hospitals have been taken over by NHS for covid patients too.

Any advice to try please?  Thank you.  I'm so worried 😟

Comments

  • AskNurseLindaAskNurseLinda Moderator, Information Specialist Posts: 128 Information Specialist
    100 Comments 25 Likes First Answer Name Dropper
    Hi, Jenni, the bowel always has some stool in it. When you eat, the food is digested and moves along the bowel at different rates depending on what you are doing. MS results in a spinal cord injury from a medical cause. The bowel slows down as the message from the brain to activate is not as strong. More stool collects. This can enlarge the bowel which makes it less flexible to move the stool along. Like a balloon, an overstretched bowel looses its muscle tone. 

    So, what to do. Fortunately for you, in England, you have a great home healthcare system. The nurses are expert in cleaning a bowel through enema and oral medications. It can be a mess but it does the job. Then a regular bowel program of suppository followed by digital stimulation every day or every other day should be done. If possible, be sure the evacuation occurs sitting up to enlist the aid of gravity. Continued enemas add to the over stretching of the bowel and actually slow the bowel even more as it becomes less able to make the contractions to move stool.

    Once the bowel is emptied, your sister will need to be checked to see if her bowel is so overstretched that megacolon has developed. This is an enlarged, kind of floppy bowel. But it can still be evacuated with a good bowel program. Movement added to your sister's daily regimen by doing range of motion exercises especially with her legs will help mimic the movement of walking. That moves the abdominal muscles stimulating the bowel to work.

    Taking oral stool softeners and adding bulk fiber to her diet will help the stool bulk up making it easier for the bowel to push it along. Since she has a catheter, try increasing her fluids, especially water but do so slowly over time. Be sure she does not have a heart condition, chronic edema or other health condition that would preclude her from increasing fluids as this can be dangerous in some conditions.

    This is a big issue. I can tell you have been dealing with it for some time. First, be sure to contact her medical care provider to get direction that will be specific to your sister's needs.  This is very important. Don't just try these plans on your own as your sister's bowel condition could worsen. We all want improvement. There is additional and more specific information about regulating and maintaining a bowel program on the Christopher and Dana Reeve Paralysis Foundation web site that you can use to discuss the issue with your sister's healthcare providers: https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/bowel-management
    Your will need to copy paste the link into your browser as it will not hyperlink here.

    You have taken the first step. A bowel that is as full as you describe can be difficult to empty and can have some medical issues that go with it such as blood pressure problems, autonomic dysreflexia and just out right discomfort. The home health nurse will be able to help you with monitoring your sister while this is occurring and afterwards. It is a big job but with the right direction and support, you can conquer this problem. Your sister will feel better. Just be sure you have contacted her physician first and have the support of the nurse. They may make arrangements to have this process occur in a hospital or other facility for her safety. Even though it is the time of COVID, they will know what arrangements can be made to keep your sister safe from COVID and this procedure. 

    You have taken the first step. Just do one step at a time. It may take several efforts to get this process accomplished but you are up to the task. Nurse Linda

    I'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

    Leave a comment any time below. Let's get the discussion going!

    Nurse Linda

    Register for my next webchat! Sign up here!

  • AskNurseLindaAskNurseLinda Moderator, Information Specialist Posts: 128 Information Specialist
    100 Comments 25 Likes First Answer Name Dropper
    PS, if fluids can be increased, that should help the catheter from blocking as well. Just be sure to check before upping the fluid. Once the bowel is clear, your sister will be more interested in eating and drinking. No one wants to put more food and fluid in when the bowel is full. Nurse Linda

    I'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

    Leave a comment any time below. Let's get the discussion going!

    Nurse Linda

    Register for my next webchat! Sign up here!

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