Relative unable to move bowels for over two weeks. Has taken dulcolax, citric magnesium, and prune juice. Given prescription suppositories by urgent care center, still now movement. No stomach pain, just pain in rear and urgency to go. What should be d
Go to ER now.. Digital rectal exam? Occult blood? A KUB? Acute bowel series? Time to go to a real ER. He needs a CT+contrast. Critical: is he even passing gas? If not & you have no imaging, *stop* giving any treatment from above. NPO with IV fluids. Nothing by mouth except sips of ginger ale until docs know what is going on. He may just be impacted, or have something worse like a mass, torsion or infarct.
I. I recommned MiraLAX as a first step. Amitiza (lubiprostone) is also good choice, but requires a prescription. Clearly, if a colonoscopy has never been performed, then it should per formed to exclude significant pathology.
Constipation. Constipation is a common condition that affects most people from time to time, and some individuals have chronic problems moving their bowels. Constipation occurs more often in sedentary individuals and people with diabetes, muscular or neurologic disorders, thyroid disease, irritable bowel syndrome and certain psychiatric diseases. Medications are a frequent cause of constipation, as well, and it always pays to review a person's medications when constipation occurs. General management of constipation includes laxatives (milk-of-magnesia, senna, magnesium citrate, etc.), stool softeners (dulcolax), fiber (prunes, psyllium, methylcellulose, etc.), exercise, suppositories, and enemas (such as fleets). If these conservative measures don't help, sometimes the use of "industrial strength" enemas at an urgent care center or er will get things moving again. Severe constipation that doesn't respond to the above measures may require manual disimpaction and referral to a gastroenterologist. Sometimes a search for an obstruction, such as a polyp or tumor, must be conducted. Since you posted your question nearly a month ago, your relative's problem may have already been addressed. If so, maintaining adequate fluid and fiber intake, along with daily activity, will usually prevent a recurrence. Good luck!