Consider the Facts

“Who among us would feel confident at work if we could not trust our continence? Instead of five to ten minutes per day to attend to bowel needs, how would we tolerate planning every day around a process that takes several hours?”

~ Kenneth C. Parsons, MD Chair, Spinal Cord Medicine Consortium

Planning the day around continence is a dilemma for many people with Spinal Cord Injuries (SCI), who face a lifetime of using laxative treatments as part of their bowel management program. For people with SCI, safe and effective bowel management is no small matter.

As many as 61% of individuals with SCI consider bowel dysfunction a major life-limiting problem, studies report. For facilities and patient care providers, bowel management can be a major source of delay in rehabilitation when it comes to the reintegration of patients back into everyday life post-injury.

The Problems with Stimulant Laxatives

A bowel management program should relieve and comfort a person as much as possible, not cause discomfort and rehabilitation delays. Frequently, medical protocol for bowel management involves placing an SCI patient on a daily bisacodyl stimulate suppository, which works exactly as the name implies: by irritating the lining of the intestine wall causing muscle contractions that move along stool mass. This process occurs whether bisacodyl is taken orally or as a suppository.

To appreciate the corrosive nature of bisacodyl, one must only look at the precautions taken when manufacturing the product. It’s so harmful that extra precautions are taken in its production. When working with bisacodyl powders, production personnel must wear full hazmat suits.  Any direct contact with the skin or eyes requires immediate flushing of the affected area with water.

The corrosive nature of bisacodyl products renders them unsuitable for long-term bowel programs. The list of common side effects speaks volumes: rectal irritation, GI bleeding and obstruction, diarrhea, significant abdominal cramping, cathartic colon, fecal impaction, mucous discharge up to 2 hours after evacuation.

While facilities, patient care providers, nurses, and doctors often cite lower product costs for use of bisacodyl products, it’s time to talk about a more effective bowel care management program with an improved delivery system that can also provide SCI patients with a better lifestyle, less discomfort, more peace of mind, and a faster transition back into normal routines.

Clinical Facts on the Usage of Bisacodyl with SCI Patients

Here are some other startling facts about bisacodyl usage:1

  • Bisacodyl provides a reproducible model of acute injury to human rectal mucosa within 30 minutes of exposure.
  • For up to 30 hours after administration of bisacodyl, there was still histological evidence of mild inflammation, specifically in neutrophils.
  • Stimulant laxatives such as bisacodyl are not recommended for use as a regular part of a bowel program.
  • Studies provided no evidence to indicate the usefulness of bisacodyl in bowel retraining and that the full range of possible toxic effects from long continued use was not fully known.

The Enemeez® product has shown to provide benefits in SCI Patients.

With ever-progressing treatment protocols and technologies, SCI patients can be discharged from acute care in as few as 3-6 weeks after an SCI injury, and bowel care products must keep pace by providing patients with more independence, confidence, and comfort in their bowel management program.

Using Enemeez® as a first-line bowel care regimen not only improves the quality of life for spinal cord injury patients but maximizes time spent with rehabilitation. This allows patients to focus on other obstacles without the worry of an incontinence episode or mucosal discharge interrupting the schedule.

The Enemeez® formulation is not evasive. It does not irritate the mucosal lining to provide an evacuation. Instead, it draws water from surrounding tissues, incorporates the water into the stool, softening the stool, initiating a replicated “natural” evacuation.

Enemeez® will not produce a mucosal discharge. The active ingredient found in the product is docusate sodium, which is a stool softener, not an irritant. Many consumers experience mucosal discharge from the ingredients found in other suppositories or laxative products.


1 Gastrointestinal Endoscopy, Volume 36, No. 2, 1990, Northwest Regional Spinal Cord Injury System, 1994, Revised 1998, 2006, Federal Register Vol. 50, No.10

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