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My mom is on morphine and hasn't had a bowel movement in a week. She is in pain trying to go. The doctor prescribed Colace on Monday and she's been on it for 2 days. The nurse in the memory care gave her a suppository on Saturday and one today. After about 30 min she was ready to go but only a small amount (I know TMI). She cries out in pain when she is trying to go. Well, long story short and this is where I need your advice/experience - when I went to wipe it feels like a huge ball (like the size of a lemon) is there. How is she going to get that out?? I hate seeing her in pain. What should I do?

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So sorry for your loss. 🤗 hugs
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SWright,
So sorry for your loss.
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Call a nurse. This is going to be uncomfortable for your mother, but a trained experienced nurse will know how to handle it with minimal trauma.

And a thousand thousand curses on any doctor who hands out a px for morphine or codeine without stapling a second px for lactulose to it. May they all poo footballs for a week so that they learn that constipation is no joke.
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swright2 Nov 2018
Sorry to report that my mother passed away on July 16. She stood up and her upper leg snapped. She died in hospice 5 days later.
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I think a stronger laxative
If you can monitor it then 12 hours should help. Maybe also a stool softener
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Opioid medications are known to cause constipation. I am surprised that the doctor didn't state that up front. Yes, I understand that he gave her Colace, but she's in pain. A perfect storm.
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truthbetold Nov 2018
I am not suprised one bit. I have never heard even one regular type MD doctor provide warnings for anything that was prescribed. Or a heads up as to what to look out for with any of their recommendations. As a matter of fact, not even the so called integrative ones. It is only if i am inuiring that small important details are mentioned. And i don't always know what to ask. It is when we get home and apply some things that the questions arise.
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I used Miralax daily for my Husband and he was on Senna twice a day.
(By the way you can not mix Miralax with a food or liquid that has been thickened with one of the food thickeners, the Miralax will thin it out right away.)
We also used Lactulose daily, much easier on the kidneys than some of the other products.
But when we needed to there were a few other remedies we used.
"The Bomb" this was suggested by Hospice. 1/4 Cup milk of Magnesia + 1/4 Cup Prune Juice + 1/4 Cup orange Juice this gets warmed up. Works pretty well.

I also kept pureed pineapple and pureed papaya in the freezer and I would mix the two together and portion it into 1/2 Cup amounts and give that to my Husband when we needed to "loosen things up a bit". This also worked pretty well. Common ingredients in a lot of the commercial "cleanses" available.

Suppository's can work well. But if there is a small impaction you may have to use a gloved hand and some lubrication like Vaseline and try to break it up. Do not do this unless you check with the nurse or doctor first.
(Oh the things we do for the ones we love!!)

Last resort was Magnesium Citrate , pretty inexpensive, under $1.00 a bottle but very high in sodium and tough on the kidneys.
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truthbetold Nov 2018
Doesn't inserting a suppository without making sure that stool has firstly softened? The suppository will cause a stimulus to have a bowel movement and with that comes more stool moving downward jamming into the lower colon and rectum. A TRAFFIC JAM bottle necking jam and a painful one at that. What works to get the stool softened that his not a druf based medicine. i have been using oxy powder which seems to soften the stool so that if i use a suppository, the stool has been softened. So there is a smooth move. If i don't use oxy powder, the stimulus will be there to have a bowel movement but the stool will be too hard to fit through the opening. I use using laxative based products and it cause a lazy bowel. THe bowels stopped working all together.
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Caster oil or cod liver oil take orally.
Enema would work.
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truthbetold Nov 2018
How much of the oils and does any oil work ... What quantity is the amount right before having an explosive and loose stool? I do not want a loose stool for my parent because they can have a BM in the wee hours of the morning in their diaper and that will cause a rash because they sleep through the night. Waking them was ruining my folks mind for the rest of the day. SO now they sleep without interruptions.
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My mom was hospitalized for it also. I was amazed they took their time fixing it with laxatives that didn’t work but at least they were xraying daily for a blockage.
They were holding off giving her constulose but they sent home a rx. That works fast!
Going forward, she was taken off Vicodin, added peri Colace and started Linzess. Also got physical therapy to move around more but I’ll be darned if she doesn’t still get backed up!
or explosive diarrhea.
Also in hospital they quit giving her oral meds because she was throwing up indicating she was full to the brim! FYI
charlotte
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Take her to the ER so they can dig it out. We use miralax daily in my moms protein shake. Has really helped. I hope she goes soon.
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anonymous444729 Oct 2018
Right!!! and I would think that the nurse should be able to do this. I have a CNA who knows how to do this - thank God for her almost every day
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My husband has always had constipation issues and now has Parkinson's, which makes it worse. We, too, have found magnesium supplements to be very helpful. Usually taking 250 mg daily is quite helpful.

Plus, magnesium is good for so many things!
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Riverdale Nov 2018
Amother poster said it was high in sodium and tough on kidneys. Is magnesium different than magnesium citrate? What is the time frame for it to work?
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The name of the medicine for opioid inducedconstipation is Linzess I believe. It worked wonders for Mom at first, actually we were overdoing it, but now not so well. We have had to resort to the constulose often but not until she’s missed 3 days. It is very harsh.
I suppose what worked well at first was due to her hospital diet. I think the inactivity is responsible as she no longer takes any opioids.
When she ever gets her teeth working we plan to invest in a prune spree. Hope it won’t affect her sugar.
It seems to me that all daily fixes have a short period of promoting bowel activity. Her body seems to need a regular change.
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My friend with end stage renal disease was fluid restricted had the same problem with her bowels until she started taking Miralax powder in her coffee every other morning. I also think the Preparation H is a good idea too. Also, the Hospice people have a lot of experience I'm sure.
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Magnesium, without fail, will give regular bowel movements. Make sure you get the gel caps.
Two at dinner or bed time will give the results you need.
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So glad you had success!
My mom was recently hospitalized for constipation. it’s possible she was backed up for 3 weeks! We tried to treat her at home for ten days and who knows how long before that she’d last gone.
They sent her home the first day but we took her back 2 days later and she was admitted.
I was amazed how many enemas and suppositorys they tried! They kept her 6 days and withheld the constalose All that time. They were taking cat scans regularly but I guess there can be a blockage that can’t easily be detected. She finally went in the hospital without taking the constulose.
I personally had a bowel resection and had an ostomy bag for ten months. Let me tell you, it is not something my mother could handle at this age.
Since she came home we’ve been trying different medications and Linzess has helped a lot. She now has a “poop” calendar that she places “poop” stickers on each time she goes. We are watching it closely!
Charlotte
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hospice recommended the dulcolax suppositories for us.
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anonymous444729 Oct 2018
also, the senokot every other day keeps things moving along if the over the counter remedies aren't enough
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Smooth tea with some honey or whatever type of sweetner she uses. Make sure to have her have a cup or so a couple of times a week.
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Why aren't her doctors and nurses aware of OIC??? Opiod Induced Constipation. There is a medication on the market specifically for this condition.
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I'm so sorry to hear about your mom. Can't suggest anything more than above with respect to the impacted feces. However, I have been giving my mom about 8oz of coconut water every other day as a maintenance schedule and it seems to assist in regular bm almost daily. Everyday shouldn't hurt if that's what is necessary. I rely on the Colace or senna if there is a problem. Not fun but I ask about her bm daily to prevent an impactation. Good luck
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definitely enema. mom got that way. (from personal experience I can tell sendflower or something, that yes, wiggling back and forth does help if you hit the pressure points against the inside edge of the toilet seat right.) as for the current situation, yes, fleet enema is cheapest way to go, and maybe before that a bottle of magnesium citrate. once this round is done, a concoction i came up with to help keep loose in future is simmered prunes, apple juice, apple sauce, prune juice, coconut oil, butter, whatever else you think of as a loosener. simmer all that together for a while, it will get a little thicker, let it cool and you can container and refrigerate it to portion out. it's quite tasty and can mix with yogurt, spread on toast, by itself, whatever. also a couple of senokot or some other natural pills a day as well. that colace stuff doesn't seem to work too good.
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Fleet glycerin suppositories - if she hasn't gone for that long, she might need another after the first movement. They work.
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Watermelon
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Get Magnesium capsules from drug store or health food store and give her enough to start her up (after the Fleet's) then adjust the dose . Magnesium is extremely scarce these days and an important electrolyte. Many people's deficiencies have lead to heart attack symptoms or actual attacks. Good luck PS Let her eat what she wants. Let the Mag. do the rest.
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#1 Coffee
#2 Prunes
#3 Prune juice
#4 Activia
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Some people swear by Castor Oil. Google it and find the benefit. It has been known to help greatly with constipation. Good Luck!
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I have heard that Castor Oil works wonders and it's natural. If you try it, let me know how it works out for you. Good luck...
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More regular,
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My Moms Dr recommended Mira Lax in the morning, and 2 tablespoons of Mineral Oil (plain) by mouth. It helped her be more their her last year's with me.
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Miralax works naturally. Not addictive or stimulating. My G.I. doctor put me on it daily. It works with water in your colon to soften feces and pass easily. Been a miracle fir me. Just something for you to ask her doctor or gastroenterologist about.
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FYI....if anyone is using a product like Thick It the Mirilax will thin it right out. The Mirilax would have to be given in a product that does not need to be thickened like pudding, oatmeal, or other thick food (Ice cream)
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I would try warm juice daily
You may have to sit her on  the potty soon after
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