Clinical management

Once daily:

• (administer stimulant (oral) laxative 8–12 hours before planned care if necessary)
• rectal stimulant suppository insertion
• gastrocolic reflex* stimulated by hot drink
• abdominal massage in the direction of the bowel motion (if trained to do so)
• digital rectal examination (DRE), and digital removal of faeces (DRF)
• single digital check to ensure rectum is empty after last stool passed

* Gastrocolic reflex – this is one of a number of physiological reflexes controlling the motility, or peristalsis, of the gastrointestinal tract. It involves an increase in motility of the colon in response to stretch in the stomach and byproducts of digestion in the small intestine. Thus, this reflex is responsible for the urge to defecate following a meal. The small intestine also shows a similar motility response. The gastrocolic reflex helps make room for more food.