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My my dad was complaining of stomach pain for a few weeks and it kept getting worse so we took him to the doctor and she told him that he has a fecal impaction which is common with his opioid medication and she suggested getting an enema. He refuses to believe the diagnosis he will not go to the hospital nor let me give him an enema. He symptoms are getting worse and this can be very dangerous I have read about it online and he's showing all the symptoms of it becoming a significant risk to his health and life. He's very stubborn and will not budge on going to get help. Can I force him to go or will he be able to leave the emergency room without treatment? I don't want him to get worse and die over something that could be remedied? If they ask him questions like what year it is and what the president is he'll answer this correctly but that doesn't mean that he is cognitive enough to make his own decisions about his care. Please help.

My aunts breath was smelling like poop she was that impacted. Aunt (90 at the time) wasn’t eating but wasn’t losing weight. She wanted to stay in bed. She was nauseous. Her blood pressure was stroke level. She was very sick. An X-ray showed she was impacted. This was on a Friday night. She was given a prescription for an enema. I called her home health nurse who came the next day and gave her the enema. She felt better for about 20 hours then back to bed, etc. I took her to a better ER on Sunday where they repeated the X-ray, told me it would take time and referred her to a Gastro. He recommended a geriatric primary as her thyroid medication was off and had caused the constipation.
Started her on daily polyethylene glycol 3350 (Miralax). Took her off stool softener.
She has not had a problem in over two years.
The fleet enema got it going. The first ER didn’t administer the enema. They were more concerned about her bp. If I had not had home health on board, I would have insisted they do it.
Your dad has a lot going on. He’s more vulnerable than my aunt and she was in a bad way. In less than 30 min he could be feeling much better.
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Reply to 97yroldmom
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Your profile says that your father has Alzheimers dementia and that he lives with you. In that case, I'd be quite focused on getting him help, because, it might be considered that you are responsible for his welfare. I'm no expert, but, I'd consult with an attorney to find out what your legal responsibility is. I'd hate for him to end up in the ER by ambulance and social services get called due to his lack of medical attention. He has the right to refuse, but, if he is incompetent.....I'd either get legal authority to make his decisions or get out from the responsibility of ensuring that he he's receiving proper medical care. What he is doing puts you a very difficult and stressful situation, but, with him having dementia, he may not realize this.

I might also tell his doctor that he's refusing medical treatment and your hands are tied. Perhaps, his doctor doesn't think that he's making proper medical decisions.
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Reply to Sunnygirl1
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This is common in older folks--they can become obsessed with their bowels, for some reason, and I get it, since constipation is miserable,

Yes, it is entirely possible for your dad to have an impaction AND diarrhea. The impaction simply stays hard and firmly in place, the fecal matter that DOES get out is runny and often is not accompanies by the "urge" to defecate.

Could you draw a little pic for your dad to demonstrate what is going on in his colon? I had a nephew who really struggled with this--and once I was tending him (he was about 6-7) and I drew him a picture of why he was having problems. Once he understood that we had to move that impacted stuff, he was on board with an enema and some glycerin suppositories. (he's 40 years old now and I bet he'd just LOVE that I am sharing that story). However--problem solved.

Mother gets backed up as she is chronically dehydrated. Keep the fluids going...way past what he may want.

Hoping you can stay out of the ER, but honestly? ER docs see this EVERY SINGLE DAY!!
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Reply to Midkid58
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SvidaO - it’s been a few days since your original post and I’m wondering if there has been any action - one way or another?

One point that is important to keep in mind in situations involving an intestinal blockage of one type or another - is that the colon and yards of intestines are flexible. This means that the intestine/colon can stretch, allowing a certain amount of “matter” to pass around the blockage.

This is does not mean that the situation has improved. In fact, this can be very dangerous as it puts the internal organs more at risk for tears and even rupture. As well - continuing to take laxitives which cause diarrhea only aid in creating this passing of some stool, fooling people into thinking the situation has improved or even resolved.

Impacted stool and other intestinal blockages are nothing to fool around with - allowing too much time to pass before treatment can become deadly.

To be honest, I’m a bit surprised that the doctor that diagnosed the condition didn’t insist that your father immediately go to the ER for treatment.
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Reply to Rainmom
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A big glass of warm PRUNE juice followed by a glass of water.
He should see results withing a couple of hours.
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Reply to XenaJada
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Svida0, two things I have found work for constipation- Juicy Juice CHERRY juice, & cooking with onions. My m.i.l was taking something for constipation everyday & still had hard little "peanuts" come out (she takes meds). I started cooking 4 years ago when f.i.l. passed. She no longer takes ANYTHING for constipation. Hubby & I were gone 1 week & she had to start taking something again. G-sons did fast food,,, A couple days of onions in her food & back to normal. JUICY JUICE CHERRY JUICE : always gave my children the runs. My sis called saying she hadn't gone for 5 days & was hurting. I told her to get THAT juice. She called back hours later relieved. Same w/anyone else. I recently had pan surgery, that juice helped me after I hadn't gone for 6 days. Hope this helps !
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Reply to Sidesaddle
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Call his doctor and ask for a referral for a Hospice evaluation.

If nothing else, it might make him understand that this is a life threatening condition, easily remedied, but fatal if not managed.
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Reply to BarbBrooklyn
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My my father is very stubborn man and does not like to go to the doctor especially the emergency room cuz he goes to dialysis 3 times a week what he hates doing as well. He doesn't want all the fuss of the emergency room and all the poking and prodding and invasive procedures he just wants to stay at home and watch TV and being his own little world he is still having bowel movements mostly diarrhea and so that's why he does not believe that he has an impaction because he doesn't understand how he can have both. I don't mind taking him there kicking and screaming but will they treat him if he is adamant about not wanting to be there and getting what he needs. if he refuses will I be able to force him basically to stay
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Reply to Svida0
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It is very serious and could develop into a sepsis infection very soon if it hasn't already. I know of a much younger person who died from this. If a regular doctor who treats him is not possible then I do think he should go to an emergency room. I suppose you could try a laxative and stool softener and monitor the situation closely. I think time is of great importance in this situation.
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Reply to Riverdale
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Svida0 Nov 20, 2018
Thank thank you for taking the time to reply I understand what you're saying and I appreciate the severity of the situation and his condition that is why I am just frustrated at what to do because he's so difficult he doesn't like being told what to do for one he struggling with loss of his independence and I don't want to make him do what he doesn't want to do but I can't stand by and let him get worse
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Do you have any idea why he is being so difficult? Is he shy about the idea of anyone getting up his bum? Or is he actually thinking that this is cancer and he doesn’t want to know? Is he still having bowel movements? The serious health risk is if they stop completely. If it is a partial blockage, he may well be having diarrhoea (liquid enough to pass the blockage). If so, he is suffering from both constipation and diarrhoea, and is probably very uncomfortable. If he has tried to remove the blockage himself, he may have caused some bleeding, which will probably make him even more worried about cancer.

Perhaps you could at least get him back to the doctor for a more detailed discussion. If the diagnosis was quick, and the cancer option wasn’t covered, some more information might help.
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Reply to MargaretMcKen
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