absence of paristalsys in the intestines and lower bowell (colon)

I am a spinal cord injury quadriplegic. I have always had a problem with constipation, but had developed a regimen of wheat bran and metamucil in water with breakfast and dinner along with insertion of a Magic Bullet supository (10 mg bisacodyl) twice weekly In the last several months, however, I have had severe consptipation which seems to be caused by lack of peristaltic movement in the lower bowell. Not even the magic Bullet stimulates enough motility to empty the bowell. Therfore I have had to resort to sodium phosphate enemas on my last three evacuations. This is a real problem since I can't get on a comode and have my bowell movements in bed.

There are two major changes/occurances that coincide with this recent problem with my bowell movements:
1. I had a Colonoscopy in May 2006, and
2. my cardiologist tried me on two different drugs to treat Atrial Fibrillation - Warafin and Sotalol. I could not tolerate the side effects of either drug.

I have no blood in my stool, but when my bowell is full I get sharp abdominal pain upon pressing in the lower abdominal area.

I have a two part question:
1. Could the Warafin and Sotalol cause such a loss of motivity  or peristalsis in the Lower intestine and Colon  (Bowell), and
2. Do you have any suggestions for restoring the action in my intestine and bowell and getting back to a regular bowell routine? I would prefer not to take precriptions drug(s) if possible.

[Kevin Pho, MD]

To answer your questions:
1) I am not aware of warfarin being associated with bowel problems.  Beta-blockers like sotalol may uncommonly lead to constipation as a side effect.  

2) Treatment for the constipation would be dependent on finding a cause.  The colonoscopy would rule out many of the major causes.  You can also consider more specialized testing to evaluate the bowel motility and other atypical causes of constipation such as a defecography, endoscopic ultrasound or colonic motility studies.  

These questions and options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_