Old 05-06-2014, 03:06 PM #1 (permalink)
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Default bm trouble

Help! My pals has a very soft stool every three days. Uses miralax daily (adjusted to 1/2 capful), lots of h20, and glycerin suppositories on the third day.

Weak diaphragm so difficulty pushing--using gait belt to add in that briefly.

Should we use dulcolax supp instead (we'll check with our hospice rn just Getting your opinion)? Should we try and make sure we get things going at least every 3 days? Can a person become impacted with soft stool or is that just a prob with constipation? Any other ideas to "move things along"?

Sure is exhausting for pals! Cals too!
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Old 05-06-2014, 04:38 PM #2 (permalink)
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Default Re: bm trouble

I am the queen of "poop patrol". I still haven't figured it all out. He had an obstructed bowel in January of this year. He went into the hospital and it was cleared. I was told to give him Miralax daily. His stools are soft and mushy since he is on a peg with only fiber source. We will go along fine for a couple of weeks then here comes the diarrhea. I have meds to control that -then here comes the constipation. Then that usually results in a suppository or enema and we start all over again. I have been battling this for the last 6 months. My pals is bedridden so you can imagine the toll it takes on both of us. Thankfully my sister lives 2 doors down and she can help me turn him and clean him up. Please share if you receive any ideas or suggestions......

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Old 05-06-2014, 05:00 PM #3 (permalink)
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Default Re: bm trouble

About six months after becoming paralyzed below the neck I lost the ability to push it out . when I feel it right about at the opening , I get raised in the sling and with a few manual pushes near my anus, it comes out
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Old 05-06-2014, 05:01 PM #4 (permalink)
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Default Re: bm trouble

It sounds awful, but sometimes you have to go in there and get them. Use KY jelly on your gloves.
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Old 05-06-2014, 06:17 PM #5 (permalink)
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Default Re: bm trouble

Marie, how much is he eating? everyone doesn't have to go everyday but I don't think you have to worry if the stools are soft. I also think that dulcolax is just like miralax. I have a script one called generlac solution. it was amazing when we used it in the hospital but it did make him cramp up a little it was so strong. If he ever gets really backed up again I am going to use it. my husband likes to go every single day. If he can't then the second day is harder LOL (in a couple of way). Does he only get the urge every 3 days or do you just insist he try? maybe you could start trying to go every day.

We do a daily enema and a daily 1/2 dose of miralax and we have not had any problems in several months (knock on wood)
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Old 05-06-2014, 06:26 PM #6 (permalink)
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Default Re: bm trouble

My wife had extensive back surgery followed by severe post surgery constipation. We tried water enemas, just water in return but just before the Home Care Nurse came for digital intervention I tried a 'mineral oil' enema. Give it a few minutes. That did the trick. All three of us were relieved.

PS. Most enema bottles have a little rubber one way valve in the cap. In a case of hard stools that's gotta go! (take it out). Slight movement of the bottle (mineral oil) with a steady squeeze... it make take a minute or more of steady squeezing but the mineral oil will dispense.
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Old 05-07-2014, 02:04 AM #7 (permalink)
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Default Re: bm trouble

Because Tim is a quad it is very easy for him to get constipated, and very hard for him to push it out. He is still able to eat so I give him a smoothie with ¾ cup of yogurt with 4TBS of coconut oil, ⅓ cup of hemp hearts, ¼ cup of chia seed, 2 TBSP of ground flax, ⅓ cup of prune juice, 1 apple, and ½ cup of frozen fruit in it. After he finishes that he has a cup of coffee and usually has to go with in 15 minutes. If we get interrupted and he doesn't go it can get a bit dicey. He does not tolerate sitting on the toilet very long so if he hasn't gone after 5 minutes I insert a dulcolax suppository and put him in his chair for at least 15 minutes and when he feels like he can go we try again. We don't have to go that route very often because of the smoothies. If that doesn't work he gets 2 stool softeners and 2 senna at bed time and he usually goes the next day.

Now having said all of this I want CALS to know that if their PALS is oozing stool they are probably impacted. Soft soft stool is good except if there is a fairly constant ooze. In that case a fleet enema may be in order. I try to stay away from laxatives or enemas as much as possible as the bowels can become dependant on them. With a peg tube you can get Docusate syrup a stool softener that is not a laxative, to use. I hope this helps, as manual disimpaction is not pleasant for either person. I hope this helps.

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Old 05-07-2014, 09:30 AM #8 (permalink)
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Default Re: bm trouble

Mom used Senna tablets, two tabs twice a day. We had to use suppositories twice on her. She had such trouble with taking fluids (No feeding tube) that the Miralax was effective. The Senna was a lifesaver. The dose was higher than recommended on the bottle, but Hospice instructed us to do the two pills twice a day. Might want to check with your doctor about the dose, but Senna worked wonderful for mom.
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Old 05-08-2014, 03:51 AM #9 (permalink)
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Default Re: bm trouble

Thank you for the invaluable input!

Our RN recommends the dulcolax suppository and then senna if that is not working. You guys are way ahead of any info I ever get from the med team! Love it!

Pals has always gone every 3 days, eating puréed food now and intake down some, we will try the smoothie and maybe senna before the dulcolax--we'll see what he wants to try! He would like a 4 on the amount and wt rating system 1-5! And reducing distention would give him some relief on the diaphragm as well!

Not afraid of the grab and glove and get to it approach just want to make sure we have everything in place to add in the soft stool moving in the right direction! Timing seems to be another important key! He was interrupted the other day, held back and now we will return to the throne today! Lol

Thanks again!
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Old 05-08-2014, 04:24 AM #10 (permalink)
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Default Re: bm trouble

Interruptions in the bowel routine get us every time. I have basically told friends not to call or visit the house until after 11am, so that we have that out of the way.

Having been an RN myself for over 30 years, I have plenty of experience with bowel issues.

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Old 05-08-2014, 08:01 AM #11 (permalink)
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Default Re: bm trouble

Large bowls of Raisin Bran twice daily
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