Suppositories lubricate the anus and rectum and stimulate the rectum to empty. They can be useful as part of a daily bowel management program, a tool to help progress a clean out, or for quick relief from occasional constipation. Keep in mind they only clean out the rectum and not higher into the colon.
Parents of children with SB as well as adults with SB usually concur that solid glycerin suppositories do not work in this population. These solid suppositories are supposed to melt inside the rectum, but something about the looser anus and rectum that usually accompanies Spina Bifida does not melt the suppository, and it ejects in the same form it was inserted. Instead, we recommend liquid glycerin suppositories. They are much more effective.
Suppositories are generally mild and gentle and can be used for infants to adults. They are often the first tool used to combat constipation in infants and babies. Pedia Lax Suppositories are designed for children ages 2-5, but many pediatricians and urologists recommend them for infants as well. Ask your doctor. Some parents keep them on hand to use at the first sign of constipation, others use them every few days to help prevent constipation, and some use them daily as part of a bowel program (often along with a stool softener or laxative) to make sure their child has a good daily bowel movement.
At potty training age (around 3), some children may be able to use suppositories as their primary bowel program. Typically these would be children with very low lesions who do not experience constipation but may not be able to feel or control bowel movements. Admittedly, this is probably a small minority of children with SB, but they do exist. To establish a bowel routine, give the child a suppository at the same time every day, about 30 minutes after a meal.
Fleet liquid glycerin suppositories have exactly the same ingredients as the Pedia Lax, except they contain almost twice as much glycerin. These are designed for ages 6 to adult, but you can ask your doctor about using them for younger children.
Because glycerin is not technically “medicine”–it’s made from plant oils or animal fat–suppositories are safe to use anytime, even multiple times a day when you are dealing with constipation and need quick relief while you wait for the oral stool softener to kick in.
Those who use liquid glycerin suppositories often know the cost can add up. Some people choose to wash the empty bulb in a sink of hot soapy water and refill it with glycerin they purchase separately to save money.
Enemeez are “mini enemas,” but they should not be confused with high volume cone or balloon enemas or the Peristeen that clean out the descending colon, not just the rectum. The ingredient list of Enemeez tells us they contain docusate sodium (a stool softener, think: Colace), polyethylene glycol (an osmotic laxative, think: Miralax), and glycerin. So, in addition to lubricating the rectum and stool, Enemeez also stimulates the bowel to move, making them more effective for some people. Insurance may or may not cover Enemeez, so cost can be a factor if these are used regularly.