Geriatrics and constipation

pieWACKet · Dec 11, 2003

I worked in home care for 15 years [good for you still doing it despite the misery of paperwork that forced me leave a job I once loved] in Manhattan, and most of my patients were elderly. I can't tell you how many times I encountered persons who reported no BM x 5-7 days, and on review of the discharge medications, would discover that PERHAPS colace was included, but an obvious inattention to serious constipation indeed was evident. I can't count either, the number who were in fact impacted on my first visit, less than 24 hours after they left the hospital. Gross job, the disimpacting part. These people ALL talked about their bowels first thing, but it was understandable.

But then I learned that Dulcolax can move rocks and the moon to further orbit. I never again had to disimpact, I would inform the MD, suggest Ducolax Suppository to be repeated x 1 within 6 hours if no response, and assured I would return the next day.I always went back, and I never had to do the dirty disimpaction work again.

But your question had more to do with prevention and fixation...and much good advice was here given.

The oral stuff mentioned re fiber, water etc is good for moving the stuff down, keeping it soft, and so is great for prevention, but if its stuck at the end, then dulcolax suppository is the thing. And dulcolax oral to move it down is sometimes required. Of course, the problem is if people use this too much and become dependant..but for constipation post the inactivity of hospitalization and facing a recovery period of just barely increased activity, both are sometimes merited.

Quads have the same reputation of being bowel fixated. I think sometimes that when people have lost control of their health and functioning, they fixate on the things that they can control, ie, when to initiate the bowel regime they prefer, and how to make it more effective.