Bowel Regimen

  1. 0
    I am new to home hospice and palliative care. My background is mainly ICU.... where bowel issues are more excessive diarrhea, rather than constipation.

    What is a good bowel regimen for a hospice patient? I can't seem to figure it out, not having experience with it and I am a little embarrased. What should be daily and PRN? If a patient has not been eating, hasn't had a BM in 4 days and has positive BS and abdomen is soft and po senna is not making a BM, do we go to a suppository?

    I'm almost embarassed to really tell my bosses who have been doing this for 20 years, I don't know what the best combos are for patients.

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  2. 4 Comments...

  3. 1
    I'm no expert in the least but a fellow nurse that I work with, has like a 15 yr history working in nursing home (We work Tele) said that what always worked with her patients was warm milk and prune juice mixed (1:1 ratio, but must be warm) and when what always worked didn't work warm milk and molasses.

    I don't know if your patients are able, or want to eat/drink anything but it's a nice nonpharmacological measure to try, and if not- then maybe you can take the tip home with you for whenever you have that family member that knows you're a nurse and asks you to look at every scratch, bump, and constipation issue. lol

    Cassie
    tewdles likes this.
  4. 0
    warm prune juice with MOM?
    colace
    senna
  5. 1
    Thanks! Senna seems the to be the popular go-to in our hospice. That was working for a patient who was also drinking fresh made apricot juice. Then they broke out the MOM and said she used to use this with success, so I said go for it.

    I called and found out it did the trick. My patient really did not want a supository, so I am glad it worked! I think I am scared of overstimulating their bowels and that they are going to get harsh dehydrating diarrhea.
    tewdles likes this.
  6. 0
    At my company how we deal w/constipation is base on what disease process is creating the problem ie: pain meds vs liver disease. If pain med we start senna plus then advance toward ducolax supp after rectal check for impaction. If liver issues we start w/ lactulose TID daily. Hope this bit of info helps.


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