poop problems again!

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Barbie

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I know this subject comes up every couple of months--but I need some ideas. husband hasn't gone since sunday night and now it is thursday. he is very uncomfortable! HE has had enemas one or two each of those days, and Mirlax each day as well (twice yesterday). I have a call in to the GP but am waiting for a call back...other than going to the ER for an impaction what to do? I am willing to try to get it out manually but not sure how to do that.

B
 
Have you tried citrate of magnesia? It is what they use before a colonoscopy to clean out the intestines. It is a harsh laxative. I would ask the dr first but it might help.
 
It looks like constipation is very common to PALS because the sedentary lifestyle the disease forces upon us.
I've had serious constipation problems every now and then.
I try... just try to keep them under control by increasing my liquid intake (orange juice, water, etc.) but, when it comes to the point is going to give me some problems I try Milk of Magnesia or better yet, I try Metamucil dissolved in an 8 ounces glass of water.

Since I'm still...somewhat ambulatory (but ONLY if I use a rolling walker), I try to walk a little each day in the house to promote some exercise that would help me go to the restroom more easily.

Also, if he has a high carb diet, it's going to contribute to constipation.

Also, try to make him eat some yogurt, I know some promote regulate the intestinal flora that would make easier to go to the restroom.
And, lastly tell him not to ignore urge of going, even if he has to sit on the toilet for half hour as that will "educate" (so to speak) his intestines and will make easier fir him to pass stools.

I hope this helps.

NH
 
Maybe digital stimulation: use lots of lube, gently insert finger (should not be painful) and do circular motions to help sphincter to relax and give the "urge" to go...can take up to 30 mins. Use castor oil and massage in circular motion going clockwise. Put a heat pad on lower abdomen. Repeat if necessary. Is it possible to bring knees to chest and do gentle spinal twists? I hope you get to talk to your doc soon.
 
Sorry your husbands having problems barbie.
I agree if meds dont work then manual removal maybe the only option.
I get this problem time to time,last week i had to take laxatives for a few days as it had been over a week since i could go ....stomach was swollen and i had severe back pain.
As cricket said heat helps,i use a hot water bottle.
Hope you get it sorted soon.
 
Hey Barbie, we had to deal with that a few times. I gave Annie psillium fiber in a little bit of orange juice everyday, and for the most part that kept the problem at bay. Plenty of fluids and fiber for bulk help a lot. I know that if the impaction is allowed to persist laxatives tend to just bypass it rather than cause it to be softened and expelled.

I resorted to manual extraction a few times. My technique was to hoist her over the toilet leaving her suspended in the sling, don a double layer of gloves and as gently as I could extract it a bit at a time. I think you'll find it isn't that difficult to do and that your sense of feel will pretty well guide you. I was able to do it pretty easily - it just takes patience on both your parts. Certainly it wasn't comfortable for Annie, but she didn't find it particularly painful and tolerated it quite well. Personally, I'd opt to do it sooner rather than later to avoid a more difficult situation.

Be aware that a branch of the vagus nerve goes to the lower bowel and stimulation of it can cause fainting due to lowering the blood pressure (called vagaling out, or technically, vasovagal syncope). That never happened with Annie, and I don't think it's dangerous as long as the person is supported and not in danger of falling. I don't think it's very common in digitally removing impaction anyway - just wanted you to be aware of it in case it did happen.
 
Oh boy...so sorry to hear it! I think you're absolutely right in starting the manual extraction and then doc call, as you've already done. Another friend here in MN had to head to the ER for help and they advised that additional enemas and or laxatives can be very harmful if there is an impaction. I wish I was more help, but please know I'm thinking of you!
 
Doctor finally called back--said we should go to the ER and not try manual extraction myself. Ha! I am a CALS! I am not afraid of that--I face a lot worse than that every day!

I went to the pharmacy and bought Citrate of Magnesium--called for 1/2 bottle to 1 full bottle (10oz) to 8 oz of water. So I started with the 1/2 dose. told poor husband that if this didn't work we would be going to the ER tomorrow (that will scare the ---- out of anyone!). About an hour later, he said he felt like going. I got him in there and suggested I try to extract some. I have tried it one other time and was not successful (my fingers are too short!) but he thought he would try on his own first. gave him an enema, and glory be he went! Not a lot, but I think the main trouble maker got out.

He has struggled with constipation for several years and I buy enemas in 6 packs every week! Miralax usually works if things get tough and we don't worry if he misses a day, but it starts to get scary when it has been 4 days. We have tried so many things to get him able to go on his own==lots water, prune juice, no bananas, very little milk, not many carbs (too thick and hard to eat when pureed anyway), he has a standing chair and changes positions regularly, nightly ROM and stretches, and unfortunately the enema is what we have to rely on for regularity.

He feels better now and that is what matters!
 
Wow.... We have had the same issue this week as, well.... MUST be global warming....LOL or at the very least the barometer.... We were on a 5 day of NO GO. I increased his fluids, A LOT, did the manual stimulation, increased apple sauce, warmed prune juice in the microwave, had him drink an extra glucerna , gave fiber... etc.

We are really finding that if he sits for awhile on the commode and then we Hoyer him and have him suspended over the toilet that, that helps tremendously. It must be something about having the HOYER sling pressing against his abdomen.

Jeesh... I continue to be amazed over the human body and the implications that this nasty disease has for our loved ones and for us, the caregivers. I have learned so much about poop extraction that I never dreamed I would need to know.

Good Luck. Let us know what the medical people advise.
 
I am glad to hear he's feeling better now.
I do sincerely hope he doesn't have to come to that point again.

An once of prevention is much better than a ton o cure.
I say it because if he keeps drinking plenty of fluids, eating fruits, and stretching (if he can no longer walk) he has chance of not getting constipated so often (it could happen every now and then but, the idea is not to let it happen very often).

I think Psillium fiber (as the one in Metamucil) has helped me a lot because it's not as drastic as other saline laxatives, it's basically a stool softener that also helps lowering your blood pressure and increases the fiber intake for your bowels.

NH
 
I think I will try adding the metamucil to his diet NH.
 
I put fiber powder in my coffee every morning. It works great and it is not thick and has no taste.
 
Hey Barbie, beware that the brand Metamucil contains a lot of sugar. I buy plain psyllium powder with nothing added. It's a lot cheaper and you're not loading up on sugar.
 
Sorry for the poop problems Barbie. Giving two or three magnesium citrate capsules daily will work wonders. Even Dr. OZ who gets constipated uses it regularly LOL. Helps with muscle cramps and aids in a good sleep too. It is a substance that is often really missing in our diets. If you have to manually disimpact again, make sure he is laying on his left side with his right knee bent. The colon empties in that direction. Lots of lubricant and just reach gently in with gloves on that are well lubricated too--using just a couple of fingers. Sometimes just lubricating with the glove will stimulate things to move later once he sits on the commode. Metamucil if fine too, but the mag. citrate is so much better. Seems like we all have lots of experience with poop eh LOL.

Laurel
 
Thats good to know, thank you. Where do you find it?
 
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