How do you keep bowels on schedule

Teresa39

I have searched the forum and found some ideas, a prune a day or a mixture of applesauce and bran. Lately I have been dealing with no bowel movement for several days and then 3 or  more in one day with my mother. Any help is appreciated. I am thinking to start a prune a day with her.

loveskitties

It might help to keep a food diary and compare it with output frequency.

What you take in impacts what you put out.

Iris L.

Can you give some more information about your mom?  Age? Has she always been irregular? Is she on medication thst causes constipation?  Is she self toileting?

One prune will not be enough.  Can she drink prune juice?  Read about higher fiber foods.  Space them out and make sure she is hydrated.  Regular toileting after breakfast contributes to regularity.  Read about the gastro-colic effect.  Ambulating also helps.  

There is much more that can be done, please post back.

Iris L.

Teresa39

I know she used to take Miralax every day. She stays in bed mostly and has been off the Miralax for a few years because I don't want her body to rely on it. I give her a good diet and include applesauce frequently. I feel that her stomach must hurt in this situation. Her dementia keeps her from remembering anything, even stomach aches or how she felt yesterday. It is also hard for me when she does have bowel movements 3 or 4 times a day. I use disposable pads but I still have to wash the sheets more. She can no longer walk so I am sure lack of exercise contributes to the problem. I will read the info you left and hopefully I can improve the situation.

Iris L.

Teresa, usually it is preferable to work on the diet over medications to ensure regularity.  But at a certain point the body systems weaken, so use of medications is a good idea.  If the Miralax helped her, it is a good idea to resume.  You can work on titrating the dosage, because too much may cause leakage.  Of course, you should consult her doctor on resuming.

Applesauce does not have much fiber, it is mostly water.  Psyllium can be added to add fiber.  Water or other fluid must be given with fiber to help pass things along. 

Since she is bedridden, have you considered asking for a hospice evaluation?  Hospice does not mean that death is imminent,  but can be applied for failure to thrive.  Hospice will give an added level of support.

Another tool is the use of an anal suppository  if your mom becomes impacted.  Ask the doctor about this.  Try to avoid impaction, it can be painful. 

Iris

sunnydove

We have been in poop hell lately so I feel your pain. 

When mom first became incontinent that way I was cleaning up so much poop. She would get it all over the toilet, herself, the floor... then step in it and track it around. When she went in her underwear it was such an ordeal to get all parts of her cleaned up afterward. It was always rather mushy (sorry for that, but this IS a thread on poop) so I thought maybe we should back off some of the softening agents she has always used. She had been taking magnesium daily since before I came to care for her and I never took her off. She also has always used fiber (not psyllium but benefiber type) in her morning drink, again since before I came. After a bout with constipation over a year ago I added stool softener 3 times per week as per her primary care doctor. 

So about 5 weeks ago I took her off the magnesium because that was also a pill that she had a hard time taking (it's sort of chalky). Nothing changed so I reduced the softeners to twice per week. Then everything came to a screeching halt. Oh how I have wished so many times since then I never changed anything and just kept cleaning up poop all day every day. But this is such a depressing gig anyhow and it was so much and in places on her that aren't easy to clean. 

So for the following several weeks we went to having to use an enema every few days, and many times even with that I'd have to help her clean it all out. We were both miserable. I obviously put her back on the magnesium and the softeners, adding in a magnesium gummy in addition. Then we added prunes in the morning (at first 3, but upon reading it should be at least 5 so now 5 every morning). Still stuck in constipation mode with an enema every few days. I was at my wits end, she had hemorrhoids, and it was a horrible predicament we didn't seem able to get out of. She didn't want to push because it the poop was hard despite all the magnesium/softeners/fiber and that just made things worse. 

As I did more research online for ANYTHING that could help, I stumbled upon aloe vera. Apparently it is used for a bevy of digestive issues of every type. After the 2nd day of her taking aloe vera she had a large bowel movement in the morning. Then again the day after. Then again the day after. We are now on day 5 straight of a bowel movement first thing in the morning. She still needs me to tell her to try and I jump up and down and praise her and dance and sing a "mommy did a poop" song when she goes. She loves it and it's not insincere since at this point I do feel like dancing when she goes! Haha! I NOW understand why the poop emoji has a smile. 

At this point I don't know if I should stop any of the other things we are doing but for now, none of them are over normal dosages, none are harmful and things are finally moving. Not to mention poop is a MORNING ONLY thing so no more poop tracks or having to try to clean her up after or dealing with it all day long. 

Goodness gracious, who would have thought that my longest post on this site would be about poop. Sorry! But it's been such an ordeal and we are just getting through it now. For your mom, I'd think maybe increase the prunes (they not only have fiber, they naturally contain sorbitol which can have a laxative effect) and add either psyllium or aloe vera to help it all slip out. (My mom drinks her liquids SOOOOO slowly we can't use psyllium because it turns to gel if you don't drink it fairly quickly.) Good luck! 

Edited to add: Make she she is getting enough to drink. Her pee should be almost clear or pale yellow. 

CanyonGal

We tried everything. My mom takes senna, stool softener, and a probiotic. She still got backed up once that we had to go to the hospital to get a couple of enemas to clear the impacted stool. After that, lactulose is given if my mom hasn’t had a bowel movement in three days. She doesn’t like it, but feels better after her bowels move. I think her lifetime of dehydration and laxatives has come to haunt her.

harshedbuzz

Teresa-

I would discuss this with her doctor.

My dad's doc put him on Miralax. IMO, the risk of "relying on" a stool softener in the context of her being far enough into a terminal disease to be bedridden is less than the risk of a painful impaction and trip to the hospital.

The brain controls everything. If she's no longer walking, her digestive system may not be working as it once did. In the elderly who are losing body fat and muscle, large unpassed stools can cause pain as the press on sensitive nerves. 

Adding fiber is generally a good idea. Metamucil could be a good option. Applesauce isn't a particularly good source of fiber. That's why it's part of the BRAT diet for those with tummy issues-- it's very digestible as opposed to fiber-rich. 

HB

mrl

Hi Teresa,

My DH was on a cheap (walmart) stool softner every day. If it started to get soft, we just stopped for a day or two. Worth a try. Worked very well.

Michele

Iris L.

Sunnydove, how much aloe vera did you give your mom?

Iris

mommyandme (m&m)

We used Mirilax (actually the generic cause it’s $$) every evening for years. It helped a lot! At some point we just did whatever worked. Her body relying on fairly benign things stopped being a concern for us. So sorry!

gampiano

Sunnydove, Id like to try the aloe vera. Can you give a little more info about how much you gave your mom and how often?

Thanks!