3-2-1 bowel regimen is used by patients with cervical spinal cord injuries who can not evaculate their bowels normally. To prevent obstipation and the possible autonomic
dysfunction that can accompany it, physiatrists (rehab physicians) have developed several strategies for helping their patients have regular bowel movements. One coomonly used regimen has been dubbed the “3-2-1” regimen.
Protocol of 3-2-1 Bowel Regimen
In this regimen, Colace is given three times a day. Colace is a stool softener and is given to ameliorate the effects of a prolonged transit time for stool to travel through the small and large bowel. Because the transit time is increased, there is more water absorption and the stools tend to become hard and dry.
The “2” stands for the two Senna tabs given at noon daily. This drug is a promotility agent and increases peristalsis. It has peak activity after eight hours (or at 8PM if given at noon).
The “1” in 3-2-1 bowel regimen stands for one rectal stimulation a day. This can be an enema, digital stimulation, or more commonly a Dulcolax suppository. Placing this suppository will stimulate the rectal/colic reflex.
This regimen should produce one soft, formed stool nightly about 30 minutes after the suppository is administered.