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.

Specializes in Med-Surg, Wound Care.

4 ounces of apple juice mixed with 4 ounces of prune juice warmed up! Gentle and effective and doesn't taste all that bad!!

Specializes in Rehab, Neuro, Travel Nurse, Home Care.

I mix Lactolose with warm prune juice. It works really fast, but this after I tried water, ambulation, and stool softners.

The patients I am referring to are all on stool softeners, I always suggest prunes/juice, coffee, ect, and I am just looking for more tips - exactly like what you all have provided, Thanks!!!

The Bomb!!!

MOM 30cc

Lactulose 15cc

Cascara 15cc

Mix. Shake. Administer and then stand back.....

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 MICU/SICU.

Walk 'em, if at all possible. If not, sit them up in a chair. Most uncomplicated postops can get OOB into a chair at least...

And, try not to take away thier morning coffee :)

Specializes in Critical Care, Burn, Telemetry.

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! 

+ Add a Comment