Medications and suppositories

Authors: SCIRE Community Team | Reviewer: Bonnie Nybo | Published: 20 March 2018 | Updated: 23 October 2024

Medications and suppositories may be added to your bowel routine if hands-on techniques and diet changes are not enough.

Stool softeners are a type of laxative that increases the moisture in the stool to make it easier to pass. Stool softeners are usually taken once or twice per day or as needed. Some common stool softeners include Polyethylene glycol 3350 (PEG) and Docusate sodium (Colace).

A suppository is a solid (usually cone or cylinder-shaped) form of medication or other substance that is inserted into the rectum to absorb. Suppositories must make contact with the bowel walls to work, so care should be taken that they are not placed into a stool.

Alternatively, a micro-enema is a liquid form of a drug administered into the rectum before a planned emptying. These methods are used to allow for quick and direct action on the bowel walls.

Micro-enemas are administered into the rectum before a planned emptying.¹⁸

Stimulant laxatives increase the movements in the intestinal wall that help move the stool along. There are many different stimulant laxatives that may be taken by mouth or as a suppository or micro-enema. Some common stimulant laxatives include Bisacodyl (Dulcolax) suppositories and Sennosides (Senokot).

Stimulant suppositories contain medications (such as Dulcolax) which stimulate the bowel reflex. Suppositories are usually inserted 15 to 30 minutes before planned bowel emptying. However, the medication used and even the base that the medication is dissolved in can affect how quickly the medication is absorbed. For example, Dulcolax in a water-soluble polyethylene glycol base (such as a Magic Bullet) allows shorter times to emptying than Dulcolax in a vegetable oil base.

Lubricating suppositories contain non-medicated substances (such as glycerin) which holds water in the bowel to make the stool softer so it is easier to pass.

Similar to stimulant laxatives, prokinetic agents are medications that increase digestive tract muscle activity to move the stool through digestion. However, prokinetic agents also speed up movement through the upper digestive tract as well as the bowel. Prokinetic agents are not routinely used and considered as a last resort for constipation or in preparation for a bowel procedure, such as a colonoscopy.

There is moderate evidence that the prokinetic agents fampridine, neostigmine, and metoclopramide help provide relief from constipation in people with SCI. There is also some evidence that prucalopride can help SCI individuals with impaired bowel emptying but may cause abdominal pain.