Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
If you have a spinal cord injury, a sudden pounding headache, sweating, flushing, or marked blood pressure rise during bowel care may be an emergency.
Stop the bowel care and follow your emergency plan or seek immediate help.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent medical care for:
New or substantial rectal bleeding
Severe or worsening abdominal or rectal pain
Vomiting with abdominal swelling or inability to pass stool or gas
Fainting, severe weakness, or signs of dehydration
And for anyone, someone who:
has abdominal pain that is severe, constant, or getting worse
3
Does any of this apply?
Book an appointment
Contact your healthcare team during routine hours if you have repeated pain, worsening constipation, frequent diarrhoea, new leakage, skin breakdown, or no improvement after following the plan consistently.
Also call if the routine is too complicated or takes too long to manage.
Every sign above is quoted from the sofidex article on Bowel retraining. If you are not sure, err upward — it is always reasonable to be checked.