Constipation Tricks

Nurses General Nursing Nursing Q/A

Does anyone have any good ideas for post-op constipation (with narcotic use)? I see this so much and want to give my patients the best advice I can.

20 Answers

Specializes in long term care.

Where I work we do what we call "brown cows". Milk of mag mixed with warm prune juice. Usually results in 4-6 hours.

Smiles and hugs. ❤️

Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.

Methylnaltrexone bromide (relistor) injection for treatment of opioid-induced constipation,

I have given this medication to post surgical patients with constipation induced by narcotics. I found it to be extremely effective. I was skeptical at first, yet the results were..... Phenomenal. Omg I could not believe the results! Within 20 min. Of giving 12 mg sq, in the upper arm. In fact it was the highlight of the week on our unit. We could not believe the colon could hold that much... The patient did not experience any severe cramping or side effects.... Just relief. When it started it came out fast.

I have patients sit on the bedside commode and give them the shot. Also line the commode with a plastic garbage bag to make disposal easier.

Now for my old remedies from oncology days,

Psyllium powder in juice, daily to keep the bowels moving

Coffee or milk and molasses enemas, 4 parts to 1: warm to tepid temp. Instill and hold as long as you can.

It moves the rock of gibraltar.

Specializes in Critical Care.

I work on a burn unit, lots of opioid induced constipation. One of our surgeons does a "brown bomb" which is Lactulose 20g (one carton), Miralax 17g (one pack), and Senna 17.2mg (2 tablets) crushed - all mixed into 8 oz prune juice as warm as the patient can drink. Most don't complain about the taste. Works as you can imagine...BOOM! 

Prune juice! Lots of it!

Edit: milk can sometimes make you go, too.

Specializes in MICU for 4 years, now PICU for 3 years!.

Most all post-op's I've seen are either on colace or miralax or something to that effect. If they're not, maybe suggest it to the doc??

Specializes in ICU.

We use BD prune juice for ICU patients - works well. I have heard though, that pear juice is as effective and tastes better.

Specializes in pedi, pedi psych,dd, school ,home health.

Old nursing home trick ...8 oz of warm prune juice BID! the "brown cow " is effective but often results in cramping. ?

Specializes in Telemetry & Obs.

Something that's often overlooked is coffee. If your patient is a coffee drinker and hasn't been having their daily cuppa joe, they're especially prone to getting constipated.

Trust me...I know

Specializes in Med Surg, Peds, OB, L/D, Ortho.

Warm prune juice followed by a cup of hot coffee. Works like a charm!

Have a Bran muffin....a big cup of coffee...then get in your car...you are GUARANTEED to get stuck in traffic and... ?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

LOTS OF WATER! The colon needs plenty of water to absorb and soften material for passing .......

Early and frequent ambulation! you have to MOVE to get your BOWELS to move! Encourage frequent (q2 hour) ambulation while awake in your patient, if not contraindicated.

And an early course of stool softeners is in order. Esp with narcotic use, I just start all my patients on Colace as ordered, as soon as they can take PO food/meds. Don't overlook the value of stool softeners in a post-op medication regimen! If that fails, MOM is ordered as a backup for us. Usually this and lots of fruit juice seems to help where I am.

We give our patients "crappuccino." Milk of mag, prune juice, and molassses...all dumped into a coffee cup, mixed with a bit of warm water, and microwaved to a nice "coffee" temperature...

:no: :barf02:

I just love the barfy smiley...

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