REDUCTION IN BOWEL PROGRAM DURATION WITH POLYETHYLENE-GLYCOL BASED BISACODYL SUPPOSITORIES

The neurogenic bowel caused by spinal cord injury frequently requires a bowel program (BP) with stimulant suppositories for effective defecation. Objective: The effectiveness of bowel programs initiated by hydrogenated vegetable oil based bisacodyl (HVB) suppositories was compared with that of polyethylene glycol based bisacodyl suppositories (PGB). Design: Single subject, randomized treatment. Setting: Outpatient. Subject: Chronic T2 complete spinal cord injury (SCI). intervention: The suppository for the every third-day BP was randomized to PGB or HVB. The times in minutes of the following BP events were recorded: suppository insertion, first flatus, begin stool how, end stool dow, and transfer off toilet. Outcome Measures: BP event times were used to derive BP intervals: suppository insertion to first flatus = Time to Flatus, first flatus until begin stool flow = Flatus to Stool Flow, begin stool dow until end stool flow = Defecation Period, end stool flow until the transfer off the toilet = Wait Until Transfer, and suppository insertion until transfer off the toilet = Total BP Time. The number of digital stimulations required and the amount of stool results were recorded. Results: The data included two groups of BPs: HVB (N = 13) and PGB (N = 13). Wilcoxon's rank sum tests were used to compare mean tines for each of the BP intervals: Time to Flatus (HVB 37 minutes, PGB 10 minutes, p < .0001), Flatus to Stool Flow (HVB 6.0 minutes, PGB 5.9 minutes, p = .9578), and the Defecation Period (HVB 31, PGB 21, p = .0043). The average Total BP Time was HVB = 85 minutes and PGB = 46 minutes showing a statistically (p < .0001) and clinically relevant difference. (C) 1995 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation