رجل عمره ٤٠ سنة عنده إصابة حبل شوكي قديمة عند T10، يستخدم كرسياً متحركاً. يعاني من إمساك وحوادث إخراج غير متوقعة تحرجه في العمل. الممرض يضع معه برنامج تفريغ أمعاء. أي إجراء يساعد على انتظام الإخراج؟

A 40-year-old man with an old T10 spinal cord injury uses a wheelchair. He has constipation and unpredictable bowel accidents that embarrass him at work. The nurse sets up a bowel programme with him. Which measure helps regulate elimination?

1. Waiting until he feels the urge
2. A strong daily laxative without a plan
3. A fixed daily time after a meal, fibre and fluids
4. Restricting fluids to prevent diarrhoea and leaks

Answer: C) A fixed daily time after a meal, fibre and fluids. Neurogenic bowel needs a regular programme: a fixed time using the gastrocolic reflex after meals, fibre and fluids, suppositories or digital stimulation as planned. Constipation can trigger autonomic dysreflexia.