Bowel basics

WILLIAM GEORGE examines the products and methods that wheelchair users should consider when planning their bowel programme.

There are various methods to approaching bowel management for wheelchair users with spinal cord injury (SCI).

A wheelchair user may need to consult a health-care practitioner or gastroenterologist to find the best bowel-management methods.

The SCI affects the nerves that control the lower body, resulting in reduced or no control over bladder and bowel functions. This is typical of injuries that have an impact on the lowest part of the spinal cord, the sacral area.

Sian Storey, nurse advisor at Tena South Africa, says: “Every aspect of a bowel management programme needs to be looked at and designed for a specific individual, since every wheelchair user has a different spinal cord injury, affecting different parts of the nervous system.”

She notes that advice on bowel management should be sought from a specialist, who is usually best placed to share information and offer guidelines.


A common method to assist in the passing of stools involves the use of an enema which helps in softening and lubrication with water to pass stool. This can be prescribed by health practitioners.


Diet is one of the key contributors to bowel movement, and it is important to eat healthy food and food that contains plenty of fibre.

Laxatives and stool softeners

There are a number of laxatives and stool softeners available, but make sure that you consult a doctor before using them, as some may have adverse side effects.

Incontinence pads

“In general, most wheelchair users should not have to use incontinence pads, as their management programmes should obviate the need for them,” says Storey.  However, if the individual is going to undertake long-distance travel, which will disturb their routine and could cause an upset tummy, a product like Flex would be ideal. “Flex is designed for individuals who are experiencing, or may have the potential for, faecal leakage,” she says.

“Flex is a breathable belted product that allows for more ergonomic changing, regardless of the individual’s position. It secures a perfect fit, supported by the belted system that adapts to a wide range of body shapes. The comfortable and discreet fit makes it easier and quicker to change than traditional products. The belted brief is designed to minimise the need for lifting and has been proven to reduce the risk of back strain on carers, while also making changing less intrusive for the wearer. It contains less material than other types of incontinence pads, the result of which is a less bulky, more discreet product that leaves the hip area exposed, allowing air to circulate.”

Planning a routine

People with SCI injuries should plan their diet, fluid intake and a stool-passing schedule. Rushing or changing routines may result in accidents and stress, which may further cause difficulty in passing stools.

Ask your doctor

if you notice irregular stool passing, or adverse effects from medication or methods, you may need to consult a doctor, who will be able to suggest helpful alternatives.

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