[Coach]

I've been a C-6, -7 quad since 1963. My first bowel routine comprised colace, diet, and a bisacodyl suppository every other day. In the 1970s or 1980s I added a senna tablet nights before chores (digital evacuation), and by the late 1990s was doing 4 senna nights before chores. Then, miraculously, I was able to reduce that to 3, then 2, and eventually just 1 senna every other night. In 1998 I started using Fleets enemas as needed on chores days and daily metamucil.

Then in 2002 I started once-a-week Actonel with 500 mg calcium either nightly or with the Actonel, to strengthen bones--and my bowel routine went to Hell. After 3 months I stopped the calcium but had to continue doing both 4 senna and 4 bisacodyl tablets nights before. I stopped Actonel a year ago.

My present regime is metamucil once a day; Miralax once a day; colace 100 mg. twice a day; 2 bisacodyl suppositories chores-days, fleets as needed chores days, and, nights before chores, 8 bisacodyl and 10 senna tablets. I do 25-45 grams of fiber daily, avoid some cheeses completely, and limit my other dairy. (I have 3 or 4 symptomatic UTIs a year that I treat with antibiotics; the antibiotics mess with my bowels and more often than not I come out of a treated UTI needing an extra senna or so. The bisacodyl pills seem to have more effect than the senna, so adding a bisacodyl is about like adding 2 senna.)

Skipping the metamucil or colace or miralax now and then has no immediate effect, and I think the 2nd suppository is probably unnecessary. But taking a single bisacodyl or senna tablet more or less has immediate consequences.

What I would like to do is find some way to reduce the stimulant/irritant bisacodyl and senna pills. I tried enulose/lactulose, a large-sugar-molecule laxative but had a lot of probably gas-related discomfort and accidents. I've abandoned that experiment. Among other effects of enulose is that the stool's pH is lowered, so it is more acid and accidents are a greater threat to skin. What I'd like most is to find something I can take the night before chores that will let me lower the senna/bisacodyl dosage. Senna and bisacodyl are irritants, and I don't want to replace them with other irritants. Are there non-irritant oils--mineral oil?--anyone has taken? My problem seems not to be constipation but bowel sluggishness. I wish me luck, you too.