Consitpation

Another first. Larry’s had a very hard time having a bowel movement. Even with lots of fiber, enemas and a laxative things were backed up. Over the last few days there had been little movement. Last evening he tried again with no success. On getting up as he stood at the sink for me to clean him up I could feel the movement right there. Told him to push. I used toilet paper to pick it out. Hope this helps with today’s movements. I may be picking out more.

[Satt2015]

Hi Jeff, hate to say this, but a manual evacuation may be required..........(not done by you, unless your experienced in such things)

Don’t leave this too long else (and I hate to say this) it can come up via the mouth!

This is another absolutely despicable part of Psp, and is bloody hard to manage!!

Dunno if this helps, lets see what others say

I’m sorry your both experiencing this, so unfair! X

[Hidden in reply to Satt2015]

I talked to a nurse practitioner today at our local GP. She recommended miralax and senecot which I had on hand and gave him. Another senecot tonight. I expect to be up in the middle of the night for the results.

[SuzanneA]

Hello Jeff. I sometimes 'pick it out' with Preperation H 'lubricater'.

[Hidden in reply to SuzanneA]

It came out fairly easily when he pushed. I didn’t force anything.

[Suebatt]

Hi Jeff

Archie had problems with bowel movement and he had senna docusate and movicol

He could go five days without movement

Matron who used to see him always up the movicol and more water to lubricate things

Finally when he did go I think he went for the whole street

The Matron did say that because he’d lost his mobility that was one of reason and also other medications he was on

Hope you can get things sorted out

Sue x

[Hidden in reply to Suebatt]

Larry was on a theee day schedule. He was going every three days well enough. The last week or two things changed. I hope the stool softeners I gave him help by monring.

[easterncedar]

My guy couldn't sit to go after a while, so he would stand at a bar and I would "play catch." It worked, and was not as bad as you'd think. The things a person can get used to...

Suppositories helped. The palliative care staff said that if he was given suppositories on a schedule, eventually his system would develop a routine even without any ability on his part to help. They said that is what is done with paralyzed patients. We never had the time to test that.

[Hidden]

Thanks for the information about suppositories. I will raise this with the medical people. It would be nice to get him regular. He never was.

[Jdjdjd]

I give my husband 2senna most nights, and moviolas if needed, but the senna keep him loose and he goes daily now, good luck, honestly the things we do😬

Janet

[Hidden in reply to Jdjdjd]

The combination of senecot and miralax seems to have worked.

[Jdjdjd in reply to Hidden]

Yippee, just keep it up and it should be ok, I just worry about too much and having to deal with it 😂

Janet

[nayook]

I so love this site; the refreshing openness and preparedness to talk about anything. It's always comforting to know that others have walked the same path. Rob has similar issues. He has more success standing, and it only happens about every 3or 4 days. I'm always either playing catchies or pick-up. There are times too, when I have to drag it out. So far it hasn't caused any issues. Good luck.

[Hidden in reply to nayook]

Nothing is off the table to be discussed on this site. All kinds of things happen.

[LuisRodicioRodicio]

Hi jeff166!

In our case, we have not had such a severe case of constipation.

Our experience is this:

•She has had some episodes of constipation that have been corrected by applying an intensive Mediterranean diet based on fruits and vegetables, abundant liquids (In particular, around 100 c.c. liquid before breakfast) and helped by the drug Duphalac (lactulose, an oral osmotic laxative). Yogurts with pieces of plum (at lunch) have been of special help and maintenance. Avoiding lemon juice, chocolate, bananas and rice, helps.

Staying quiet favors constipation. A program of gymnastic exercises, especially walking, favor regularity.

In case of not “open bowels” in 2 or 3 days, it is advisable to apply a Micralax cannula (citrate / lauryl sulfoacetate) rectally.

Hugs and luck.

Luis

[Hidden in reply to LuisRodicioRodicio]

He did have luck with the combination I gave him yesterday.

[Kathleen52]

When my husband has not been for a few days I give him 1tablespoons of Epsom salts in a glass of orange juice . This always works and then I give him stool softeners until the next time

[Hidden in reply to Kathleen52]

I had luck with the miralax senecot combination. I will keep giving him that with the approval of the nurse practitioner I will call back today. See how things go. It’s day to day.

[hubetsy]

Bowel issues have changed over the years. Just when I think I've got it figured out, wham! : D

Constipation was initially managed with diet: lots of fluids and fiber. Then the added the magic 1 part applesauce, 1 part prune juice, 1 part unprocessed wheat bran (although I've heard oat bran too) -- started with a tablespoon each night, increased to maybe 2 or 3 TBS. That was years ago. Patient always had lots of fiber in a vege fruit smoothie that he had everyday along with a huge bowl of oatmeal. That was then.

As swallowing became increasingly problematic, diet solutions were less effective. C. is on a thickened (pudding) and puree diet now. Even with that, there are days he can only eat (swallow) in the morning. Most days, in fact.

At one point, thinking he had diarrhea, I gave him the BRAT diet (BANANA, RICE, APPLESAUCE, TOAST). After a week, an ER visit doc discovered he was blocked up and the "diarrhea" was just seepage around the blockage. My brilliant solution probably contributed to the constipation!! Miralax (daily or almost) was added. Even with that, days go by without a BM. Most recently, 6 days went by. I resorted to a suppository which was successful after about 60 minutes. Our regular caregiver (6 to 8 hours per week) was there. She told me that she had to "help" at the end and was kind enough to explain. (I could write a book on what I've learned from this loving, kind, knowledgeable, angel who over these months feels like a family member -- she is a family member). She described how she (with gloved hand) pushed gently around the anus allowing the remainder to evacuate. (I should have given a "warning" at the start of the post.

Someone here described "catching" as her patient stood. I actually love when that happens because my patient hasn't been sitting on the toilet "trying." This is a practical solution for someone who can stand even with help. I have found that my C. continues to try to stand from the toilet (and has fallen too many times), we now have to stand guard with the bathroom door open -- oh, the indignities for these PSP patients!) We try always to "walk" to the bathroom as it seems to help with a success on the toilet. We've also had the unexpected success after sitting on the toilet without a BM) while "walking" to the shower (HATE THAT!) --We keep gallons of bleach in the house!--

We are now figuring out the next phase of our bowel program. I would love a schedule and have tried to manipulate it so he goes in the evening when I'm with him. He attends a senior day program two days a week. While I have full confidence in the staff there I would prefer that he "go" at home so that I can shower his bottom (a wound care situation-- tear on his scrotum (WHAT! I know, how in the world??) I've altered the times I've given him his Miralax and Senna but his bowel doesn't comply! The advice in this string about a suppository on a regular schedule will train the bowel. (Thank you easterncedar!) I will try that.

We who care for a PSP patient deal with situations we never dreamed of. It's amazing how much we grow and learn to cope. Poop strategies -- really! Who would have thunk it!

[Hidden]

In India there is a Natural Plant based thing people use to solve constipation problem. It is called Isabgol Psyllium Husk. But please do check with your Physician whether PSP patients can use it. You may please google for information

[Hidden in reply to Hidden]

I was giving him a cellulose laxative. Switched to a stool softener. That worked last night.

[Hidden]

I figured out the gentle bowel removal the other night rather quickly. Last night the miralax senecot combination seem to have worked.

Larry has told me I hover. He’s right I do. Left to his own he would have fallen any number of times. On some level his won’t see his limitations. He says as long as he doesn’t try to walk or talk he feels fine.

Reading posts on here whatever they are about is useful for future possible scenarios. I did read that diarrhea could indicate a bowel blockage. With his not going easily more than usual it was suspect. Talking to the nurse practitioner she mentioned that if I gave him the miralax senecot combination and it resulted only in diarrhea he should go the the emergency room. That he might have an impaction. The movement he had last night makes me think he’s OK so far. Will see how today goes.

[ketchupman]

I know this is a difficult subject. My wife would get severely constipated and would sometimes not go for over 2 weeks. She was on PEG tube feedings, so her waste would appear slightly different from normal, but still, it needs to come out. I tried most all the things mentioned by others in this post. The one item that often provided movement success was a digital stimulation. I would put on a rubber glove and slightly lubricate it with some of the jelly that I used for her urinary catheterizations. I then had my wife lean forward while sitting on the toilet and insert my finger in her anus. I would then stimulate it by wiggling and moving my finger in and out. I could usually feel the feces eventually and with a little coaching to my wife to push, out it would come. Once she would start, at times it seemed like it wasn't going to stop and would be amazed how much she was holding. By the time we were at this stage in the disease, she wasn't speaking a lot, but I know she felt relief and was glad she had a good BM.

I later mentioned this to some of her nurses and they all agreed this is a great method and cannot harm her. They call it a "digital stem". Interesting no one talks about it. I guess because it's a crappy topic.

Ketchupman

[Hidden in reply to ketchupman]

I’m not squeamish talking about any possible helpful information. Thanks for the tip. I knew someone who had dogs he had to do this to when they got plugged up. I had read about it on line as well for people.

[aliciamq in reply to ketchupman]

I had a medicated handicapped child long ago and used your method on him all the time😊My huz suffered through years of constipation and now poops regularily enough. I so hope that constipation issues don't return. 😬

[ketchupman]

She would also sometimes "let go" while in the shower. Her last couple years of life, I would always take a shower with her, as it was a lot easier that way. I guess as the warm water was beading down on her and with natural gravity ... out it would come. Much easier to clean up in there than in other locations.

[aliciamq in reply to ketchupman]

Haven't had that one yet.

[Malattia]

ketchupman,

Thank you for sharing.

[grafixapn]

There is a safe product you can take by the name of Miralax. It's also available under different names at a large savings. Taking many medications come with major bad side effects. Miralax simply adds water to your digestive system, and the only thing you need to be aware of with Miralax is the amount you take. My doctor said to start with a single dose, but not to go higher than 4 dosages. If you take too much, things will start running out when you don't want them to. The product is very safe. I have a condition where even passing gas can be a issue. I need to take 3 scoops every night before bed. Like with any medication, it's always best to talk with your doctor before taking anything.

Andy

[Tippyleaf]

The battles we all have with our loved ones bowels. Thank you so much for sharing this I have picked up new hints/ideas as a result!!

We focus on high fibre diet Poo cake ( bran, figs, dates, prunes, sultanas, ginger and linseed) with custard for breakfast lots of fruit chopped up through the day and root mash with dinner ( pots, swede, carrots, parsnips etc) and a Laxido every night mainly works, if husband misses a day next day x2 Laxido etc. But I still need to resort to giving hubby suppository and enemas every couple of months.

Wishing positive bowel movements all round this week

Love Tippy!!