Published Sep 19, 2006
SCgirl1962
28 Posts
Anyone have any great ideas for chronic constipation relief for a parkinson's patient who has been on Sennekot-S, Lactulose,( according to his wife ) and Docusate Sodium and MOM ( according to me ) in the past without success? I hate to have to give this patient an enema every few days. The stool is always very soft - like playdough - just no urge to push it out and very little peristalsis. I've even tried Mag Citrate! HELP>>>>> I'm up to my elbows in poop!
doodlemom
474 Posts
Unfortunately sometimes when people lose their ability evacuate their stool, routine enemas can be part of their routine - unless you get it to the point where it is very loose. I have taken care of para and quadraplegics that have an enema every couple of days. You probably have already tried dulcolax suppositories q 2-3 days.
EmptytheBoat
96 Posts
Senna and Lactulose are a good combination, may need to
increase dosage.
NurseyBaby'05, BSN, RN
1,110 Posts
When I worked on the Neuro floor. Monday, Wednesday and Friday were bowel regimen nights.
8pm Dulcolax suppositiry, if unsuccessful for BM, then
8:30pm Fleet enema, if still unsuccessful for BM, then
9:00 Soap Suds enema.
We usually gave things a little more time to work than 30 minutes, but you get the drift. (Also, who can get back to a pt room q30 minutes when you have 7 other patients, some of them also on bowel regimen? )
aimeee, BSN, RN
932 Posts
As stated above, once the body loses the urge to evacuate, you have to make some sort of suppository, enema, or digital removal a part of the routine. The alternative is to pull so much water into the colon that the stool runs out and that is unpleasant and unhealthy too. With MS patients I have had pretty good luck with the Therevac mini-enemas given just a bit before getting them up onto a commode. Often that is just enough extra lubrication and stimulation to get things happening once the body is properly positioned.
jCLNC
40 Posts
Are you still using thera vac enemas? We haven't had them for a few years. Thought they were off the market or not available anymore.
txspadequeenRN, BSN, RN
4,373 Posts
Duclolax supp works well to stimulate the bowel. Then there is always my favorite 30cc's lactulose ,30 MOM mixed with 8 ounces of warm prune juice....BAM..... Then if you have a hard stool problem nothing works better than milk and molasis enemas....
Oh, they might be. It was maybe 5 years ago that I had the patient that I used them regularly with. Wonder why they aren't around anymore?