Bowel Regimen

[MomRN0913]

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.

[FreckledCoffeeRN]

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 :rotfl:

Cassie

[tewdles, RN]

warm prune juice with MOM?

colace

senna

[MomRN0913]

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.

[momof2guys]

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.