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Thread: constipation problem for weeks now.

  1. #1

    constipation problem for weeks now.

    hey wondering if you can give me some advice

    my mom is constipated and can't walk ( has a virus that attacks her nerves age 81) and the GI specialist said the colon is stretched out somewhat. so he said try

    500ml twice a day of peglyte
    lactulose 30ml twice a day
    enema twice a day for 2 days
    suppositories twice a day for 2 days

    there was a lot of pooh in the colon.


    i was adding Metamucil before we saw the doctor and i wasn't adding enough water so i think i made the problem worse-- haven't given her metamucil since we saw the doctor .

    now that had worked the first time we tried it and i stopped everything but the peglyte 2 days into it and she was poohing really well everyday. he said after 7 days cut down to 250ml twice a day so i did and she stopped poohing i went back up to 500ml twice a day and nothing. turns out her colon was twisted. they untwisted it. and said start with the peglyte (peg 3350) and find out what works for her.

    tried 500ml twice a day went as high as 1L twice a day and nothing also tried the enemas.. nothing suppositories nothing. colon is not twisted we checked. she is taking 2 senokot tablets a day. he said we have to talk about
    colostomy.

    anything else we can try?

    thanks

    phil
    Last edited by phil jackson; 02-14-2018 at 12:29 PM.

  2. #2
    Impossible to say but it is possible that your mother has an obstructive megacolon. This can be the result of long term constipation and over-use of bowel stimulants and strong laxatives such as PEG 3350 (called Miralax or Golytely in the USA) and lactulose.

    Is she passing any stool? If so, what is the consistency?

    What type of enemas? How much? Have you explored the Peristeen system?

    Does she have a physiatrist or did she attend an acute inpatient rehabilitation program after her paralysis? Were you told she had transverse myelitis or what other type of "nerve infection"?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    she is passing very little stool more watery with some very little "bits" (not sure of the right way to say it) tried the mineral and sodium phosphate enemas each for 2 days straight twice a day and nothing really came out at all. went to the hospital and she had a soap enema done not sure if that is like the peristeen system you talked about. only water came out. I have to check on the other stuff you asked about.

  4. #4
    No, Peristeen is not the same as a regular large volume enema (such as soap suds). A Fleets type enema is not going to clean out much beyond the sigmoid colon. If she is really impacted, she may need to be hospitalized. If she doesn't have a megacolon and still has some working peristalsis, I like to use Lactulose 1 Tb. every hour until there is a large formed bowel movement, but if she is actually obstructed (nausea, vomiting, abdominal distension, no stool passing at all) this could be dangerous unless done under medical supervision.

    Please update your profile to include what country your mother lives in! We have members from all over the world.


    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  5. #5
    she had a CT scan " no convincing CT evidence of sigmoid volvulus or high grade mechanical small/large bowel obstruction/perforation. moderate gaseous distention of the distal sigmoid up to 11cm as well as mild symmetric mural thickening of the distal sigmoid/rectum. appearances similar to prior and may relate to colonic ileus/chronic constipation,less likely infectious/inflammatory colitis. correlate with stool cultures. ischemia favored unlikely"

    that was her last CT scan about 6 days ago.

    no vomiting or nausea. we have a GI appointment for next tuesday so i can ask him about the 1TBsp every hour and the Peristeen system.

  6. #6
    Peristeen by Coloplast:
    https://www.coloplast.us/peristeen-a...tem-en-us.aspx

    https://www.youtube.com/watch?v=l6sWaD6d2Sk

    To get this system, you have to have a doctor's prescription and training by a Coloplast Pereisteen nurse. The tricky part about Peristeen is finding a nurse trainer (Coloplast certified) and getting Coloplast to respond to emails, phone calls, and snail mail inquiries about the system and where to find a trainer. I've seen on line prices ranging from about $300-$600. Medicare (and many private insurance companies) do not cover the Peristeen system or replacement parts.

  7. #7
    I don't believe that these restrictions on Peristeen use are in place in Canada as they are in the USA. The OP is in Canada.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    I don't believe that these restrictions on Peristeen use are in place in Canada as they are in the USA. The OP is in Canada.

    (KLD)
    Even so, to get the Canadian health service to pay for the Peristeen system, there is a document that needs to filed by the prescribing physician. Just a heads up to cross all the "Ts" and dot all the "Is."

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