Reduction in Bowel Program Time with Polyethylene Glycol-Based Bisacodyl
Steven J. Stiens,MD; Williams Luftrell,RN; Joseph E.Binard,MD, FRCS
The neurogenic bowel resulting from SCI frequently requires a bowel program (BP) with stimulant suppositories for effective defecation. The excessive time required for BP and bowel complications have limited quality of life after SCI.
Objective: The time required for bisacodyl suppository initiated bowel programs can be reduced by increasing the bioavailability of bisacodyl by substituting a polyethylene glycol base (PGB) for the traditional hydrogenated vegetable oil base (HVB).
Setting: Inpatient SCI unit.
Subjects: Fourteen chronic SCI men with a stable HVB bisacodyl suppository initiated BP.
Design: Crossover Controlled
Method: Subjects received HVB bisacodyl suppositories for five sequential BPs and then were crossed over to PGB bisacodyl suppositories for five more BPs.
Outcome Measures: BP event times were utilized to derive BP intervals: suppository insertion to first flatus = Time To Flatus, first flatus until begin stool flow = Flatus To Stool Flow, begin stool flow until end stool flow = Defecation Period, end stool flow until end of clean up = Clean Up, and suppository insertion until end clean up = Total BP Time.
Results: The data included two groups of BPs: HVB (N=84) and PGB (N=81). Mean time intervals and standard deviations were: Time To Flatus (HVB 33.4 minutes SD 33.2, PGB 12.8 minutes SD 85) and Total BP Time (HVB 102.2 minutes SD 31.2, PGB 51.8 minutes SD 17.1).
Conclusion: Preliminary analysis suggests that PGB based bisacodyl suppositories may stimulate reflex defecation sooner and shorten the Total BP Time as compared with HVB bisacodyl suppositories. Further statistical analysis will be presented.