Comfortable seating is important
20-45mins post meal, the gut is most active
Ensure adequate alone time to avoid feeling rushed
Establish a routine at the same time of day.
Try reading or listening to relaxing music.
EQUIPMENT for GOOD POSTURE
When transitioning to a shower commode on castors, ensure both comfort and security.
Include: head rest, arm rests and brakes.
Tilt mechanisms are available if needed.
Some prefer a hoist sling over toilet.
Seat cushions are not equal in softness. Order the softest seat.
While ambulatory, try squatting or leaning forward for a bowel movement. Knees may be raised. Add a handrail for stability.
Minimize transfers - toilet before shower
Eat mostly “live” food and only when genuinely hungry. Eat less cooked, frozen, canned, processed food.
Eating sufficient roughage by chewing and swallowing will become harder for youths. Take 1-2 teaspoons of soluble fibre every day or two or for short periods as necessary. e.g. Benefibre from the supermarket.
Try adding prunes or pears, berries or
other high fibre fruits to smoothies.
Pear juice is highly recommended.
Fibre is key to regularity. Aim to eat 70% fruits/veges for improved digestion.
Aim for 8-10 glasses of fluid per day. Fluids make up 50% of total daily hydration. Water is the best choice, adding no extra calories to daily intake.
Water is a transporter to cells, a temperature regulator and lubricant.
Sufficient intake is necessary for prevention of constipation.
Don't make a habit of limiting
fluid intake to avoid urinating.
Laxatives vary in their mechanism. Bulk forming laxatives work like fibre.
If there is no bowel evacuation for more than 48 hours, advice about alternate laxatives, suppositories or micro-enemas should be sourced from a doctor.
Regular gentle exercise and/or stretching.
Leakage can be perceived by you or your carers
as a sign of resumption of bowel regularity - wrong.
WARNING: Leakage is likely a sign of faecal impaction.
Backhouse, M (2005) A practical Guideline: Managing Toileting issues in people with DMD. Montrose Access. Brisbane.
* Bloch, KE. et al., Gastrointestinal
Dysfunction in Patients with Duchenne
Plos. Published: October 13, 2016.
"Both preventative and proactive measures should be taken, independent of perceptions, in order to prevent potentially life threatening constipation, particularly in older
DMD patients" *
Clark, A. (1998) The Poo in You. Oracle Press, Montville.
See also Swallowing tips: https://magic.piktochart.com/output/8023004-dmd-swallowing-food