Seven weeks!

[JDinVirginia]

Hurrah, yesterday I pooped my diaper!

Actually, that does not sound quite right. Yesterday I pooped my diaper. Hurrah because the last time was seven weeks ago!

Although some are averse to the idea of using enemas to control fecal incontinence, they can be very effective. I do not think that I will be breaking my seven week record any time soon. My colorectal surgeons and gastroenterologists could not offer anything nearly so effective (and they don't make a dime off of my enemas).

--John

[RobertH]

Hi John

I had to do a double take when I read your post Glad to hear your enemas are helping you not to have bowel issues when out and about. Sorry you broke your seven week strech of no issues, hoping your next bowel issue is not for a long time and you can break your new seven week record.

[Patrick]

Congratulations and best wishes, I guess. My gastroenterologist suggested that I use enemas also when I'm on a liquid diet, and I agree, it does work. Seven weeks without an accident is cause for a celebration, indeed. Keep up the good work; next time, you may go eight weeks, or more.

[JDinVirginia]

TMI follows.

It may be useful for others who find this discussion via Google to know that what really made a difference was finding an anatomically correct retention enema nozzle. It took me two years to locate one. The nozzle takes most of the strain off of my sphincter muscle and enables me to hold the enema solution for greater effectiveness, in spite of cramping and without leaking. Upon insertion, the sphincter just "locks" into the valley on the shaft and the plugging effect holds everything nicely in place.

--John

[Patrick]

Can you give us more information on this anatomically correct nozzle? I could certainly use it.

[JDinVirginia]

NOTE: If you are not fecal incontinent, the following is TMI.

The anatomically correct enema nozzle I use is a retention nozzle from siliconenozzles.com. Be advised that we will not find these items in medical supply shops. I have tried that and failed. It took me about two years of looking to find this one. The source sells a staggering variety of enema nozzles intended for the fetish market. However, they offer several "retention" nozzles, of which this one is the best (at least for me). Just ignore the fetish items and look for what will work.

The benefits of a retention nozzle are that it reduces or eliminates leaks and it helps one retain (hold) an enema solution. For those who do not know, holding the solution for a period of minutes increases the effectiveness of the enema. I also use mild Castile soap (Dr. Bronners's) in my saline enema solution. That causes peristaltic cramps that cause the procedure to be much more effective (you do not have to do this), but more difficult to retain for the recommended 10 to 15 minutes. Do note that as I am taking the enema to prevent fecal accidents, I need to clear the colon much higher than normally is the case for ordinary constipation. That is why using a retention nozzle is so helpful to me. Also, as I have some nerve damage to my sphincter muscles, I need the plugging effect of a retention nozzle in order not to leak excessively (or worse).

My nozzle is listed as the "4.75” Oval Flange-Style 1.6” (41mm) Small Diameter Enema Nozzle." There are others in other sizes.

Note that the base of this nozzle is a T-bar shape so that it fits between your butt cheeks without poking into the sides. This means that you can use the pressure of your cheeks to help keep the nozzle in place during cramping instead of placing that strain completely on your sphincter muscles. The nozzle looks large, and it is, but once inserted the shaft is about the right size for the sphincter to contract around. I insert the nozzle slowly and with a generous amount of lube. Once inserted, I find the nozzle to be neither comfortable nor uncomfortable as, once the anus fits into the valley of the shaft, the slopes on either side cause a snug fit, as it must in order to be effective.

Also, these silicone nozzles are available in a variety of "softness." A semi-soft silicone formulation should be more comfortable that a completely rigid nozzle.

Other similar nozzles from other suppliers also should help, but getting the T-bar base is highly recommended.

The URL is:
http://siliconenozzles.com/475-Oval-Fla ... e-OF-1.htm

Of course, as we all are so different and our medical situations are different, I cannot guarantee that this nozzle will work for you. However, IMHO, it is worth a trial. Good luck to all. If you obtain a retention nozzle, please be brave enough to give us your feedback, either positive or negative so that we all will learn.

--John

[JDinVirginia]

Note: This will be TMI for those who are not fecal incontinent.

I should add for those who are not experienced with traditional enemas (not Fleets), that they are very safe, but you should check with your physician to be sure that you do not have any underlying conditions that would contraindicate the use of enemas.

In taking old-fashioned enemas, there are three priorities, in this order: Safety, Comfort, and Effectiveness.

I want to emphasize the need to put safety first. Be very careful in inserting the narrow enema tips that usually come with drugstore enema kits. I do not trust them and recommend that, instead, you use the douche nozzle. The larger retention nozzles all have a safely rounded tip and will not be a problem when inserted slowly and with lubricant. Use small volumes of enema solution and hang the bag low so that the water pressure will be low. Remember, low and slow are safe! You can slowly experiment with increasing volumes until you achieve satisfactory results.

For both comfort and effectiveness, it is best to administer the enema while flat on the floor on a rug covered with towels and an absorbent pad. You can take an enema in any position, but for the management of fecal incontinence I recommend that you do it while lying on your right side, rather than your left. That way the solution will flow down the transverse colon to the ascending colon and achieve an optimal washout to prevent you from having a fecal accident many hours later. Unless you already use soap, you might begin using only a saline solution (one teaspoon of sea salt per quart of warm water). If you begin using soap for the first time, start with small amounts of mild Castile soap. If you don't find Castile soap, try baby shampoo. If you use soap, I recommend a second or "rinse" enema to insure that any lingering soapy solution does not cause later irritation to the colon.

Re comfort, be kind to yourself. If you are uncomfortable you are unlikely to continue using the procedure. Feel free to light scented candles and play your favorite music. Perhaps Handel's "Water Music" might be appropriate? Or the "Fountains of Rome?"

When you are ready to get up from the floor and move to the toilet, do not remove the retention nozzle. If you do, you are almost sure to leak a lot as your anus has been temporarily dilated by the retention nozzle. Rather, leave the nozzle inserted and expel it into the toilet. You then retrieve it by the hose.

Sorry for the TMI but I though someone might benefit from the above.

[getting off my soapbox]

--John

[HotDogg55]

JD I'm so proud of you. Well I'm not sure if I should be proud per se or what but ¯\_(ツ)_/¯
One day I'll join the enema crowd...

[Patrick]

Whew! Your epistle reminds me of the instruction my gastroenterologist's nurse gave me, followed two years later by the pelvic floor physical therapist, who said about the same thing. I resist going on a liquid diet, because, every time I do, bowel accidents and the enemas that manage them become necessary. However, when my medications stop working, I vomit in my sleep, which makes going on a liquid diet absolutely necessary. I find the knee-chest position works best for me when I need enemas because a liquid diet has made them necessary.

Again, thanks. Your account was useful, courageous, and appropriate.

[JDinVirginia]

Thanks for your very kind and encouraging comments guys.

--John