No Colostomy Output X7 days....stomach cancer

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Specializes in Med Surg, Hospice, Home Health.

Patient with colostomy since 2006, months of nausea and vomiting, then it is controlled with levsin q4h. stoma is beefy red, stomach is not distended.....intake has declined, he is now bedbound...................

no stool from colostomy x7 days, he is passing gas, but no stool----doc ordered miralax 17gm/daily, he has had 2 doses.....

diagnosis is stomach cancer....any thoughts. Bowel sounds are just as active as when he was first admitted x2 weeks ago.

linda

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Specializes in home health, hospice, clinic, telemetry.

Any chance pt has obstruction????????????

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Specializes in Med Surg, Hospice, Home Health.

partial, I believe. He had some stool coming from his stoma yesterday. He has good color and doesn't feel bad, considering, afebrile.

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Specializes in home health, hospice, clinic, telemetry.
partial, I believe. He had some stool coming from his stoma yesterday. He has good color and doesn't feel bad, considering, afebrile.

AtlantaRN,

I too believe your pt has at least a partial as well. I'm wondering though how effective Miralax is going to be at this point. I know that our pts who are "use to" their conditions don't present the way other may as well. I would be looking at some for a definite dx or treatment. Let me know how this turns out. I had a patient with just about the same exact symptoms. She was on hospice and declined any treatment so I'm very interested in knowing what you do from here. My pt was not ambulatory and had a host of others things going on but the bowel sounds and output (or lack of) was still the same. As well as stoma appearance.

AK

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Is he a candidate for a gentle "enema" or other stoma irrigation?

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Specializes in Med Surg, Hospice, Home Health.

decreased levsin to 1 sl q4h prn as this causes gi motility slowing (he has been on 2 sl q4h for about 10 days with good results).....ordered a colostomy irrigation set today, should arrive tomorrow. he has been on reglan qid for months. Levsin was the only thing that relieved his nausea and vomiting (he has had n/v x 6 months without relief until the levsin--and he is allergic to phenergan *causes hallucinations). Nurse going out today was going to give a pediatric enema through stoma to try and move things along.

thank you all for your assistance. med director added the miralax last week at idt--i had always thought you didn't use a laxative on a colostomy patient.

Again stoma is beefy red and it is easy to insert a digit, it looks just as it did on admission. I'm the weekend call nurse and do my best to figure it out.....his color looks real good--better than the pasty white he was from 6 months of n/v.

Thanks again!

linda

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