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Managing Changes in Bowel Habits after Stroke

After suffering a stroke you must give careful attention to cleansing and practice good hand washing while managing changes in bowel habits.

What Can You Do for an Unplanned Bowel Movement?

After a stroke, bowel habits may be different than before. It may be more difficult to hold a bowel movement until you can get to the bathroom. Be prepared for an unplanned bowel movement. (For basic information about leaking bowels, click on this American College of Gastroenterology website:

http://www.acg.gi.org/patients/gihealth/fi.asp

Take a plastic bag, disposable vinyl gloves, an extra clean pair of underwear, and wet wipes with you when you go out away from home. Bring a towel to sit on in the car.

Person Washing Hands
  • If you have an unplanned bowel movement, you will need to go to the nearest bathroom.
  • Use the handicapped stall because it is usually larger and may have a sink.
  • Put on your gloves.
  • Remove the soiled underwear and scrape off any solid fecal matter into the toilet.
  • Put the soiled briefs into the plastic bag.
  • Clean your perineal area (per-a-nee-al), between your legs from front to back, using toilet tissue and your wet wipes.
  • Pat your skin dry with toilet tissue.
  • Put on the clean underwear.
  • Wash your hands thoroughly with soap and warm water.
  • When you get home soak the soiled underwear in warm water until you have the time to use a washing machine.
  • Machine wash the underwear in hot water and use bleach in addition to the laundry detergent. 

How Can You deal with Constipation?

Constipation (con-sti-pa-shun) means that you are not having regular bowel movements and/or have hard stools or no stool 2 days in a row. For an inexpensive food mixture you can make at home to ease constipation and make having a bowel movement easier use the following recipe:

  • 1 cup applesauce
  • 1 cup unprocessed bran
  • ¾ cup prune juice

Mix all of the ingredients. Take 1 or 2 tablespoons daily and swallow it with 8 ounces of water or juice, or put it on your cereal. Refrigerate the unused portion. To read some comments about this remedy, click on The People’s Pharmacy website: http://www.peoplespharmacy.com

You can train your bowels to move around the same time each day.

Foods that may be helpful:

Cup of Tea
  • Eat 3-5 servings of fresh fruits and vegetables daily, for example a serving is: 1 cup of a raw leafy vegetable, 7 cherry tomatoes, ½ cup of beans, 1 medium apple, 1 medium banana, or 1 cup of fruit juice as well as 6-11 servings daily of whole grains. A serving of whole grains is: 1 slice whole grain bread, ½ cup cooked cereal, like oatmeal, or 1 cup of ready-to eat cereal.
  • Drink a hot drink with your meal or snack such as hot tea, hot apple cider or warmed prune juice.
  • Drink 6-8 glasses (8 ounces each) of water every day.

Allow time for complete bowel activity:

  • If you have a caregiver and cannot speak, make a signal that you both understand that tells of your need to have a bowel movement.
  • If you can not speak, communicate with your speech therapist your need for a picture board with a picture of a toilet to help communicate the need to use the bathroom.
  • Ask for privacy in the bathroom.
  • At the same time every day, 30-40 minutes after a meal, sit on the toilet and relax.

 Further actions you can take to avoid constipation include:

Exercise:

Exercise every day. Move around and get out of bed every day. If you can walk, try to take a walk each day and gradually increase the amount of time you walk each week.

Medications:

  • Avoid the use of laxatives like Milk of Magnesia, Ex Lax, and Senokot because they can have unpredictable results.
  • Stool softener pills such as Colace, Phillips Liquid gels, or Dulcolax Liquigels can help and make having a bowel movement easier.
  • Some medications such as pain pills with narcotics for example, Darvocet, Tylenol #3, or Oxycontin and vitamin tablets with iron like Stresstabs with Iron or Centrum Ultra, can cause constipation.
  • Drugs for depression, for example, Zoloft, Elavil, Wellbutrin Prozac, and Effexor, can cause constipation.
  • Some antacids that contain aluminum or calcium can also cause constipation. Some aluminum containing antacids are: Alternagel, Maalox, and Mylanta. The following are popular calcium containing antacids: Rolaids and Tums.

 Additional Resources:

Talk with your health care provider for more information if these ideas do not help with your constipation. For more information about bowel care after a brain injury go to this Ohio State University Medical Center website: 

https://patienteducation.osumc.edu/Documents/bowel-care.pdf


References:

Harvard University. (2011). Healthy eating plate and healthy eating pyramid. Retrieved from, http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/

Hoeman, S.P. (2008). Rehabilitation nursing prevention, interventions, & outcomes. (4th ed.). St. Louis, Missouri: Mosby Elsevier.

Jacelon, C. (2011). The specialty practice of rehabilitation nursing. Glenview, IL: Association of Rehabilitation Nurses.

Norton, C. (2006). Constipation in older patients: Effects on quality of life. British Journal of Nursing, 15(4), 188-192.

Ohio State University Medical Center Patient Education (2005). Bowel care after a brain injury. Retrieved from, https://patienteducation.osumc.edu/Documents/bowel-care.pdf

Ohio State University Medical Center Department of Women & Infant Nursing (2003). Perineal care.

Developed in 2009 by Julie Jessop, MSN, RN at the University of Toledo for the Caring~Web.
Revised 2012

Last Updated: 5/26/16