We joke about "old people" becoming obsessed with BMs...what if it happened to you?

SmilingBluEyes · Oct 15, 2006

No pun intended about being "anal" I am sure....

BUT this gal could do with a consult w/a GI specialist---and maybe even a counselor/social worker (some bowel problems have their root in emotional issues related to eating disorders/mental distress). But make no mistake; she has PROBLEMS, serious ones.

leslie :-D · Oct 15, 2006

this woman has a severe psychological disorder.

and now, with her total dependence on laxatives/stimulants, it is now compounded with a physiologic impairment where she can no longer move her bowels independently.

a stat psyche consult asap would be the rx.

leslie

PeachPie · Oct 15, 2006

Ouch, I'd be paranoid too after that.

CoffeeRTC, BSN, RN · Oct 16, 2006

Isn't that a form of bullemia? I'd say it could be a psych issue.

gr8rnpjt, RN · Oct 16, 2006

Over-use of laxatives is definitely a form of bulemia. It could lead to devastating consequences as well. She will be losing vital fluids and electrolytes and is in danger of sudden death from cardiac arrest, depending on how much she uses and how often. She can also be setting herself up in the years to come for a more serious bowel problem. Sluggish bowels become more sluggish after long term use of laxatives. Some of the bowel can actually stop working all together. Another problem she could develop chronic paralytic ileus. This can cause severe abdominal pain, necessitating narcotic use, which will intensify the sluggish bowel. This is a regimen that will always fail. One cannot continue to use laxatives for the rest of ones life. Something bad will happen, eventually, No doubt.

Marie_LPN, RN, LPN, RN · Oct 16, 2006

If she's not drinking enough water, the fiber supplements could be making her problem worse.

rn/writer, RN · Oct 16, 2006

I know a woman in her early 30's who is quite a bit overweight. After some recent bowel irregularity, she took enemas for a few days. Noticing it made her lose weight, she started a regimen of spending about 30 minutes every night in her bathroom with an enema bag. She has lost about 15 pounds since this enema thing so she thinks this weight loss thing is a "plus." She claims she has suffered off and on from constipation all her life and now this is about the only way she can go. When she isn't taking enemas she is taking laxatives, drank a whole bottle of magnesium sulfate and nearly gagged on it, it made her sick and she swore she would never go "that" route again. She says the fiber supplements don't really help and she hates eating gritty bran cereal...
I'm not sure she is really doing this to lose weight as much as she is just obsessed with her bowels. She has confided she is absolutely mortified at the thought of being bloated and stopped up. She says her cousin once became so constipated she started vomiting feces.
Anyway, how far does it go before it is more than a matter of just being anal?
And I'm sorry if this grosses anyone out, but she is not satisfied unless she just goes and goes and goes...

Oh, dear. I hope you meant milk of mag and not mag sulfate.

Besides that, she may be coming close to an "addiction" to laxatives and enemas. This kind of behavior often shows up with eating disorder patients but can be present by itself.

As is also true with eating disorder patients, the presenting problem is not the primary issue, but because it's so alarming, that is where the attention goes. The real issue is that the person feels out of control in other parts of her life. Then, when she stumbles onto something--anything--that gives her a sense of power, she runs headlong into it, telling herself that if she can only master this one piece of her life, she will be in control again.

Unfortunately, these substitute behaviors take on a life of their own. They become addictive in nature because they supply a high followed by guilt followed by fear followed by craving followed by the behavior followed by a high, and so on, cycle after cycle, until compulsion completely replaces choice and family and friends are up in arms.

The more you focus on the elimination behaviors, the more entrenched your friend is likely to become. What you can do is learn all you can about these control-related issues and try to focus on helping your friend meet the real needs in her life. Give her information (about electrolyte imbalances and laxative dependency, etc.) in a matter-of-fact manner, and remove the emotional tension between you.

I used to work with anorexic/bulimic adolescents in a very good program. When they were admitted, they and their parents were so locked into an eating/not eating tug-of-war, that nothing else could be seen or worked on.The girls were put on an eating plan, and some attention was paid to compliance, but the main focus was shifted to family dynamics and other social/emotional issues.

As the girls dealt with the real problems, their eating or not eating took on less importance. The more control they began to feel in other areas, the less they needed to control every molecule of ingestion and/or elimination.

Learn what you can, and encourage your friend to learn as well. She is lucky to have someone who cares about her.

Altra, BSN, RN · Oct 16, 2006

I know a woman in her early 30's who is quite a bit overweight. After some recent bowel irregularity, she took enemas for a few days. Noticing it made her lose weight, she started a regimen of spending about 30 minutes every night in her bathroom with an enema bag. She has lost about 15 pounds since this enema thing so she thinks this weight loss thing is a "plus." She claims she has suffered off and on from constipation all her life and now this is about the only way she can go. When she isn't taking enemas she is taking laxatives, drank a whole bottle of magnesium sulfate and nearly gagged on it, it made her sick and she swore she would never go "that" route again. She says the fiber supplements don't really help and she hates eating gritty bran cereal...
I'm not sure she is really doing this to lose weight as much as she is just obsessed with her bowels. She has confided she is absolutely mortified at the thought of being bloated and stopped up. She says her cousin once became so constipated she started vomiting feces.
Anyway, how far does it go before it is more than a matter of just being anal?
And I'm sorry if this grosses anyone out, but she is not satisfied unless she just goes and goes and goes...

That would be Mag Citrate.

Vomiting feces is a sign of an obstruction, which is a surgical emergency.

This is definitely advanced bulemia.

BSNtobe2009 · Oct 16, 2006

Man, learn something everyday on here...vomiting feces? I cannot even imagine, but I guess it makes sense.

kukukajoo, LPN · Oct 16, 2006

This woman needs help- dependency is no joke and has serious aide effects. She needs help physically and mentally on this one. We just got done doing the chapter on elimination. It could actually kill her!!

My gram was vomiting fecal matter when she had an obstruction caused by cancer.

She looked 9+ mos pregnant and would not go to docs until I moved back to NH from CT!! I tell you I moved a house and three kids in a day!

Good news- that was three years ago and she is still allright!