Q. I’m in my 15th year as a C7 quad. I was at a local SCI support group and the discussion turned to “plumbing” and how often to do a bowel program. I mentioned I do my BP every fourth day with a suppository and get good results and rarely have accidents. Another person in our group said they go every fifth day. Somebody said that regularly waiting more than three days is too long and that waiting more than every other day and/or being chronically constipated can lead to something called megacolon. I did a web search on megacolon, and I’m still not exactly sure what it is. What is it? What causes it? Are there any symptoms? How is it treated? Also, how frequently should you do a bowel program?
— Matt

A. Great questions, Matt. Megacolon is a condition where stool backs up in the colon, stretches the colon muscle, and damages the colon, which loses the ability to return to normal size. Colon enlargement and loss of muscle tone slows stool movement. For someone with SCI, stool usually takes around 48-72 hours to move through the body. Megacolon slows transit time to a week or longer, according to Kathleen Dunn, a retired clinical nurse specialist and rehab case manager.

Spinal cord injury is listed as one of the conditions that can