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The hospice doctor put Mom on the generic Senokot S (Senna Plus). But, since Mom is refusing to take pills, the doctor called in the liquid form. Mom would get impacted after 3 days. And, yes, it was like you described. (She is not on morphine or any other pain meds.) But, so far, the liquid is working better. She at least goes every 3 days.
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My mom had suffered with constipation and was constantly taking laxatives which didn't seem to help. After I moved in I added prunes and prune juice to her daily diet (after checking with the doctor) and voila, regular bowel movements. She had not reached the impacted stage yet so we were lucky.

A friend I worked with was impacted. She was my age (40s) and ate a healthy diet and worked out every day. She showed me her belly one day after work and you could see her swollen intestines filled with it. She was in so much pain. She tried everything and finally went to an enema clinic. Yes, a clinic specifically for enemas. One visit and relief.

For myself, I suffered a bad bout of constipation from stress. It became so bad that I ended up in bed for 3 or 4 days and my sister said the hospital would be the next step. Castor oil was my savior. It took 24 hours but it worked. I was not diagnosed as impacted though. Don't know if I was or not.

I hope you find the solution for your mom soon. Seeing a loved one in pain is heartbreaking.
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I'm 77 and have dealt with this personally for the last decade. Knew laxatives weren't the route. Doctors weren't helpful, bout after bout with very painful hemmorrhoids from straining. Several years ago, my Oncologist (breast) suggested Senokot evenings and Miralax mornings - daily whether I needed it or not. To that, I make sure to eat some greens (spinach or cabbage or green tea which are natural laxatives) and it works MOST of the time. Can't even begin to express how grateful I am. My oncologist said he had the same problem - and that Senolot and Miralax were not drugs, were natural, not addictive, and that I could take them the rest of my life with no side effects except, hopefully, regular soft bowel movements. Not the answer to a crisis, but maybe an ongoing prevention. Good luck.
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Swright2, glad all is okay now! I appreciated reading about all the different methods to combat this issue, and I encourage anyone facing this to discuss with a nurse or doctor BEFORE administering aid. Their exam and/or questions really help nail the proper solution. Same thing happened to my husband who was on antibiotics for 15 days. The nurse suggested Fleet Glycerin suppositories — it took just one and worked in 12 minutes! No prescription needed; we just needed to find a pharmacy open at 3am that carried this medication. And I followed up with the antibiotic-prescribing physician to let him know he should have warned us about the binding effects of antibiotics! Gheesh ...
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Along with Miralax - polyethylene glycol 350, try low dose of Generlac.
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So glad for the victory! Important to know that this is a two stage problem. First to get rid of the hard impacted ball, and then to stop it happening again by improving laxatives. Until the ball is gone, laxatives can make it even more painful -pushing harder against an immovable blockage. A less difficult blockage can be shifted by heat, squeezing (muscle or external), and enemas. However you may get rid of just enough just to let the back-up pass temporarily in a rush, then build up again (which is why people with constipation sometimes seem to have diarrhoea as well!) A really difficult blockage needs manual extraction by someone who knows what they are doing – perforation is a disaster. After that, go with the laxatives – prunes, apricots, fibre etc.
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This situation is unacceptable. I believe she is impacted. The nurse or doctor should be taking care of this before it gets to a week. If the nurse does not deal with it, call the doctor and insist that the doctor see your mom and deal with this. Have her taken to the ER if necessary. With morphine use constipation will occur. A remedy to prevent this should have been put in place when the morphine was prescribed. Possible remedies are Magnesium, colace, a fiber supplement etc. These have to be used daily to prevent the problem. If this does not resolve, complain to the omsbudsman responsible for this facility. Contact aging and adult services for your county.
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Dried apricots. I'd guess 5 for this in general 2 in evening. Dental surgeon told me this one and it works.
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Swright2, Congratulations! Now know that she is likely still constipated and that you need to continue working to get all that was stuck behind the offending ball out. Then, she is out of the woods:)
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The nurses should know how to properly position a patient for an enema. Yes manual extraction of stool not good idea( pt could faint or have heart attack). Surely her physician must know what to order! Should have been on that stool softener as soon as the morphine was ordered!
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Dried apricots. I'd guess 5 for this in general 2 in evening. Dental surgeon told me this one and it works.
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Sounds like a bowel impaction, I work in health care, only a physical therapist, but I know an ER doctor removes those.
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this dr. goes against "common" medical advice but he makes so much sense. gutsense is his website. I'm following his advice for myself and things are better . it's all about size of colon and size of stool. I hope your mom is getting relief.
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truthbetold Sep 2018
What is your age? Are you taking the supplements and is eating less working for you?
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I am no expert, but because my husband has had surgery for a blocked bowel and has had recurrences plus was on opioids (Vicodin), for over 10 years, he takes a powdered medication called polyethylene glycol 3350 NF, a daily dose of 17 grams stirred into his morning coffee, but any liquid is fine.bthis is the same as an over the counter product but is completely covered by Medicare. It comes in large bottles of 527 grams. He has been on this for several years now and it has really worked. Please ask your mom's doctor about this.
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I literally keep a log of Moms bowel movements for about a year now. Now, that she is bedridden she tends to have more problems with constipation. Long story short, she gets MIRALAX every day in morning. If by day 3 she hasn't gone then we give her M.O.M.
If no movement, then on day for another dose of Milk of Magnesia . Day 5, I set up everything, KY gel, a box of gloves, lots of chucks, to physically disempact her. Thr aide helps by holdong her and lubricating the glove. I only go in woth the glove one time and then throw it out and put on another one. I am extremely gentle with her. When Mom was hospitalised,at one time for something else, she got disempacted. The doctors tried everything but nothing worked. They were going to disempact her but I would not let them because it would've been too much for her. So they "let me do it and assisted me".
After I clean the canal somewhat , I give her an enema. Wait about 15 minutes and put her on the porto-potty. At that point every thing comes "down " with the help of gravity. It takes a tender touch and a big heart. If you cannot do it for her, seek out someone (nurse) that can.
PS: Guess I meant short story LONG..LOL
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If she can get on the toilet, elevate her feet with a box or stool. That should help a bit. I have prayed for her.
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My husbands doctor prescribed a bottle of magnesium sulfate which resulted in a bowel movement which also gave him diarrhea and now I do use it if necessary but only a half bottle. Works great. We were also in the ER on a unrelated problem but there was a man who came in who hadn't gone for 2 weeks and the hospital took care of it. This also might be an option.
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Give milk of magnesia or senekot ....& enema
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FYI - Miralax has an ingredient that is part drain cleaner!

I use Traditional Medicinal "Smooth Move" tea (health food store) for my dad. Even for the challenging BMs.

All the best!!
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I had a similar problem. Not as bad. Mom passed very hard lemon like stool, glove assisted. After, alot of waste matter and blood. Everyday in a small juice glass I give my mom aloe vera juice with the chunks in it and a tablespoon of olive oil. It comes in many flavors. It's kept this impacted stool at Bay.
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Don't think Mom should be on Senna. In reading this, it will make her worse. I think the ER would be the best thing.

"Bulk-formers—Bulk-forming laxatives are not digested but absorb liquid in the intestines and swell to form a soft, bulky stool. The bowel is then stimulated normally by the presence of the bulky mass. Some bulk-forming laxatives, like psyllium and polycarbophil, may be prescribed by your doctor to treat diarrhea."
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Everytime Mom was in the hospital, if she didn't go everyday they started her on Senna and Colace. They never worked. My daughter says Senna is a bulk laxative, whatever that means. Milk of Magnesia was the only thing that worked. Mom was on iron which causes constipation. So that didn't help. I agree with one of the post, don't do anything without talking to the dr. Miralax was too much for Mom. I think the ER is needed at this point.
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Thankful the situation is resolved! That can be scary.

I wanted to share what had worked with my mom EVERY time, as last resort.

Sauer Kraut Juice.
Yep. Warm it a little and drink. This had NEVER failed us.
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truthbetold Sep 2018
Hi, Can you please explain why it works ? Or theoretically? If it is too sour for some elders with ALz or dementia, can it be diluted in any way or will it lose its effectiveness.
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I would go to the hospital. It probably needs to be dug out. The longer you wait the worse it's going to get. Also, give her Miralax daily until she starts to become regular, then if she starts to get to loose stools change to every other day. It had really helped my mom.
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When my Husband was on Hospice one of the remedies suggested was.."The Bomb"
1/4 Cup prune juice
1/4 Cup Milk of Magnesia
1/4 Cup Orange Juice
Heat this gently until it is about body temperature then drink.
(I tasted a bit it really does not taste as bad as it all sounds)

One of the prescriptions I did end up getting, through the VA, was Lactulose it is a more gentle product on the kidneys than something like Magnesium Citrate. Magnesium Citrate works great, works fast pretty much like the product you take to prep for a colonoscopy. You can get Magnesium Citrate at any store, I got mine at Walmart, think it was less than $1.00 a bottle and there are flavors now not just lemon.

Is she being given a stool softener daily?
One of the products I used to give my Husband was Smooth Move Tea that is Senna based so it also is gentle.

I looked up some of the "cleanses" that are sold over the counter and most contained Pineapple and Papaya so I purchased a pineapple and a papaya and pureed them and froze them in 1/2 Cup portions and I would give him one of those if I though we were going to need a little help.

Side question for you..Is your Mom on Hospice? If so there should be a nurse assigned to her and the nurse should be consulted, they can aid in a fecal impaction.
If she is not on Hospice the nurse at the facility should be doing more they can manually aid in an impaction.
The last resort would be a surgical intervention and that should be avoided at all costs as it is possible that your Mom may not survive the surgery or the recovery process.
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We took my mom to ER and they found she had a twisted bowel and it was closed so nothing could pass. They did a procedure to blow it open. Now we are on strict orders if one day passes and no bm to up the laxative (senna) to
get production. It must not be allowed to close shut again. Drinking water
seems to be an important ingredient. We were doing miralax but it caused too loose stool, so we switched to senna. Finding the right combination is the challenge. One time I gave her a foot massage and that got a production. I
applied a series of 3 impressions at each point on the ball of the foot from the
big toe to the little toe and continuing on down that side of the foot to the heel.
I do not always get results but a foot reflexologist should be able to do it. We have had to resort to an enema. This is a very serious thing. A perforated bowel is not what you want to risk. If they can get up and walk, walk as much as possible. Any kind of exercise would be good unless there is more to the story and that would compromise the situation.
Am praying you find the right answer.
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I've personally had the problem of too large or hard of stool to be able to eliminate it. The rocking back and forth sometimes help, but I've had to manually remove it myself. I use a glove while on the toilet. For someone who is disabled, I don't know if they could do this. There is a drink you can buy that one of my doctor's called, "liquid dynamite" - it is magnesium citrate and you can get it at the drug store. I have used it and it definitely works. Think of the stuff you drink for a colonoscopy. Kind of works the same way.
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Victory! The ball was born yesterday! The nurse dug a little out and the rest followed.
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i always rely on mineral oil give her 4 table spoon's of it you also need to make sure she drink a lot of water ..if you can get it called linzess so if you can get it do what they say if she need so go real bad but not moving .give lenzess & 2 table spoon of oil with in the hour make sure to get her on the toilet in 4 hours ..my mom was alway constipated a lot linzess & mineral oil = a atomic bomb for bowels ..i know i did it sometimes even the colace & mineral oil together can work to just 1 pill & 2 to 4 tablespoons //it will work ..make sure she drinks a lot of water ..good luck ..is she on hospce care //?? you could also do a colonsocpy to get her ready for it but she will not need to a doctor could tell you what to get that will get her going to just ask a doc ..let me tell you my mom i give her linzess & the mineral oil it will break up what she has in her to the runs ..so that is why need to make sure she is on the toilet in time & it will be a lot... so good luck
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Lactulose is what they use at mom's nursing home cetude, it is probably the only thing we never tried at home. Chronic constipation can be so challenging, I hope swright2's mom has gotten some relief by now.
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