Proper hygiene is necessary for everyone whether an intestinal invalid or not. Attempts should be made at definite times each day and at other times when the desire to defecate is present attention should be given immediately to this condition. If the colon is sluggish it is quite reasonable to stimulate defecation by means of suppositories of soap. Defecation should not be hurried and at least fifteen minutes should be devoted to this act if the patient is at all constipated.
In cases where the adhesions are so dense that the colon is badly kinked short of an abdominal section will give results. Fortunately, in private practice, surgery of this sort is seldom indicated. The purpose of the operation is the liberation of the pericolic bands by cutting them down to, but not into the mesentery. In this manner, no raw surface is left and the adhesions should not reform unless the peritoneum is traumatized or infected. Patients having one bowel movement in two or three days have had defecations increased to two or three daily by this procedure. The mortality is practically nil if done properly.
Fortunately, most patients do not need to be placed on the operating table. It is quite possible to treat the colon locally by means of colonic lavage or irrigation. This does not mean simple enemas. It is quite necessary to have the proper apparatus consisting of a table, receptacles for water, a three-way valve, large rectal tubes and means of disposing of the excrement. Such an apparatus can easily be purchased from regular supply houses.
Colonic lavage should be used two or three times a week for approximately fifteen treatments. No limit is set as the best criterion is the condition of the patient, in regard to weight and general improvement.
Following each irrigation the patient should expel all fluid and then a pint of acidophilis milk should be inserted in the colon. After this the patient should lie still for two hours.
While water alone is valuable in cleansing the gut it is often better to add medicaments is indicated. At the start a normal or hypernormal saline solution is useful but after two or three treatments a solution of Lactic acid, one teaspoonful to the quart, is better. This gives a more favorable medium for acidophilis to grow on.
Best results are obtained by starting with the solution at 100 degrees F., gradually cooling the solution until it reaches about 60 degrees F. Colder water can be used but cramps will occurs and your patient is likely to go elsewhere.
To summarize, the normal person should have three movements daily; food should not stay in the body longer than thirty-six to forty-eight hours at the most; many obscure pains and aches are the result of colonic stasis and regardless of location of symptoms to colon should be treated in such cases; stasis is the result of pericolic adhesions which should be severed in cases that do not respond to local therapy; the diet should be increased; regular morning exercise using the radio is quite helpful and finally colonic lavage, properly given, is of utmost importance.
