Bowel Management. Are you getting it right ?

Suppository insertion and Digital Stimulation (DS):

Aim for a Type 4 stool if you manage your bowels with DS.

Lubricate one gloved finger
Lubricate end of the suppository
Gently insert suppository in an upward and slightly backward direction along the rectal wall
Place suppository 2-4cm into the rectum
Repeat if second suppository is used
Leave for 15-30 mins
Gently insert 1 lubricated, gloved finger
Rotate finger in circular motion, maintaining contact with rectal wall, until internal sphincter is felt to relax
Do not stimulate for more than 1 minute at a time
While faeces are moving down or out, remove finger
When no more stool is expelled, resume DS, and repeat process
Repeat DS every 3-5 mins. Until reflex activity stops
Finish with a manual evacuation if necessary
If reflex activity does not occur do not repeat DS more than 3 times (proceed to manual evacuation)
Carry out a final rectal check, using a finger to ensure the rectum is empty

Bristol Stool Scale
Type1		Seperate hard lumps like nuts
Type 2		Suasage like but lumpy
Type 3		Like a sausage but with cracks in the surface
Type 4		Like a sausage or snake, smooth and soft
Type 5		Soft bits with clear cut edges
Type 6		Fluffy pieces with ragged edges, a mushy stool
Type 7		Watery, no solid pieces

Aim for a Type 3 stool if you manage your bowels with ME

Lubricate one gloved finger
Gently insert finger into rectum
Type 1 stool: remove a lump at a time
Type 2 stool: push finger into the middle of the faecal mass and split it. Remove small sections of faeces at a time
Type 3 and 4: break up large faecal mass and remove smaller sections at a time
Soft faeces: continuous gentle circling of the finger may be used to remove stool
Do not over stretch the sphincter by using a ‘hooked’ finger to remove large pieces of stool
Continue until rectum is empty
Carry out a final rectal check, using a finger to ensure the rectum is empty