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Per the dr., I gave her a stool softener and two hours later had her go to the bathroom, but.....still no bowel movement. I'm concerned. Next move??? cadams

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One cup of hot water, 1/2 lime juice squeezed into the cup.
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Daughter 2 contributes:

"have they tried worn peas? But that might be quite a large volume."
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Cwillie- what about whirled peas? 😝
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Yeah, Rainmom: all we are saying, is give peas a chance.
😁
Sorry about that. I did honestly see it graffitied on a highway gantry once and giggled all the way home.
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Who would have thought that peas had more fiber than veggies like broccoli or cauliflower? The poor pea doesn't get the respect it deserves!

Rainman loves peas as well but they can be a challenge for him to eat as he has dexterity issues. The pea salad I give him has a nice, light dressing that holds them together - so easier to eat. Probably a plus for an elderly person suffering from arthritis or has a tremor.

Anyhoo - good luck with it all. And remember that old saying "An apple a day..."
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Again thanks to you all. Who would've known there would be so much to know about such a topic....... To thenerd.....I got the beans and vegetables you mentioned to make that soup. It sounds terrific. You are an amazing caregiver that goes to extraordinary lengths to learn what foods work for your mom. She is blessed to have you! To Cwillie.....that is exactly my problem and confusion with this whole thing. Absolutely no changes in mom's life-no new meds, no different foods, no change in activity level. All is the same.....which leads me to believe her body itself is somehow going downhill in a new way and I think is causing much of the anxiety in me. To rainmom----I love the idea of the pea salad. Mom loves peas. I will definitely check that out.
If any of you get to St. Petersburg, Fl.....look me up and we'll all go out to lunch and have a howlin' good time talking about .....anything but poop!!! cadams
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Mmmm, I love bean soup :)

And yes, fiber supplements like Metamucil need to be taken with plenty of fluids so they often aren't the best choice for our elders, especially as their intake of food and fluids decreases.
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Hi cadams,

Glad it worked out in the end :-) pun intended. It is good to see the humor in things I think as well. As you mentioned it is amazing what a relief it is when they finally get a BM. Who ever would have thought we would cheer such an event, lol? I am sure many caregivers here have done the same. Yes, I'm so happy! :-) seriously, if she is ok and not in pain and doc says it's Ok, it will be easier for you if she has only one well formed, easy to clean BM every three days vs tiny messes several times a day.

I think the trick now is keeping her BMs regular as her body continues to change. It's different for everyone and requires some experimentation. Even their tastes change.

For me the pressure cooker now has been the workhorse cooking tool rather than crock pot or other stuff. Although a good one like instapot (about $70 to 150 on amazon) can do slow cooking, pressure cooking and even yogurt making and other stuff.

When I make the bean soup, I also put carrots, onions, garlic, potatoes, celery, tomatoes and sometimes other veggies I have around. For myself and sometimes mom afterwards I'll add sliced chicken breast and some cheese (or sometimes sliced salami to it.

Sometimes if she has trouble chewing or doesn't like an ingredient I'll put the meal in a blender and serve it like a paste. Sounds gross but if the flavor is good she loves it and eats more. I was surprised she like it even more when I put vanilla whey protein in the mush.

The pressure cooker works not surprisingly by increasing the pressure in the closed pot which raises the boiling of the water. So the water doesn't boil until a much higher temp. The higher temp speeds up the cooking process remarkably and you can make great meals in no time at all. The fact that you dump stuff in and walk away is a great time saver and allows you to multitask.

The instapot comes with a little recipe book but googling "instapot and any dish" gives a lot of great recipes.

I think you can keep the mac and cheese and ALL those other foods in her diet, at your mom's age she sure deserves some simple pleasures like that! I haven't cut out any of my Mom's fav foods for her. I have found that even some constipating foods are OK in her diet so long as on that day or no later than the next day she is getting 14 grams of fiber/1000 calories consumed from natural food sources like veggies and fruits....and plenty of liquid (without fluids the fiber will be a problem). So try and have a rough idea of about how many calories she eats on a given day and make sure she gets that 14g fiber per 1000 calories.

My trick is when my mom is the most hungry I give her the healthy stuff to eat with veggies for fiber to make sure we get that in for the day. Then later meals might be the more delicious favorites.

Yes, it used to be such a hassle to make bean soup, soak, then cook and stir for hours. With the instapot I open the bag of beans, rinse them and throw them in the pot with all the other ingredients, walk away come back in an hour and it's ready! Unbelievable. I cook for 2 hours only because my mom needs the beans and skins very soft or she'll just spit out the skins.

Even Metamucil was constipating for my mom and shouldn't be. Maybe it's too much fiber in one shot and it formed more of a plug, not sure but nothing has worked as reliably as vegetables and beans of all kinds and so on on a regular basis now.

Instantpot is a brand name for an all-in-one pressure cooker, steam cooker, crock pot etc. there are other brands but I have only tried instantpot. I had bought the 6 quart Bluetooth one ( not necessary) and recently just bought an 8 quart one (non Bluetooth one) for $129 on amazon.

This one is $99 on amazon.
Instant-Pot-IP-DUO60-Multi-Functional-Pressure

Here are some vegan recipes for instapot: the web is full of them, from making ribs to vegan stuff

buzzfeed/whitneyjefferson/vegetarian-instant-pot-recipes?utm_term=.qhO5ng510#.miaRa8RDm


Enjoy! You're doing great! And your sincere concern for your mom and running to urgent care and worrying so much after only two days :-) speaks to your good character and how loving you are! Don't forget to take care of yourself too! Best wishes to you and your loved ones and all!
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Since this is her first experience with constipation I'd spend some time contemplating what the cause might have been. Any new meds? Different foods? A change in her activity levels?
A diet rich in fruits, veggies and whole grains is best for all of us of course, and the advice to get enough fluids is bang on too. Hope this was just one of those things and doesn't become a pattern for her, but if it does there are many threads full of advice and lots of experts here!
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Unfortunatly this is a subject I know way more than I'd like to. But I'm gonna stick towards fiber rather than pooping remedies - although fiber is probably the best pooping remedy.

A woman over age 50 needs roughly 21-30 grams of fiber a day. It depends on total calorie intake and activity level. Keep in mind that too much fiber can cause constipation as well as too little.

Easiest rule to remember- stay away from food that is white. This includes things made with white flour and dairy.

The most surprising high fiber food I've found is the pea. Yep - one cup of cooked green peas has nearly 9 grams of fiber - more than almost any vegetable besides some beans and the artichoke. Find a good recipe for a pea salad on line. My deli sells a pea salad that is amazing - check around at your local grocery stores that have a deli.

A good whole wheat bread has 3 grams of fiber a slice. If you can get your mom to eat a whole sandwich and an apple - 4g - for lunch, you're almost half way to goal in one meal.

Salads can be good for sneaking in high fiber and/or high protein goodies but if you're gonna use iceberg lettuce- forget it. You'd get more fiber and nutrition eating the wrapper the lettuce came in.

While yogurt is dairy and dairy constipates - find a good yogurt with active probiotics to help keep the gut balanced. I put a tablespoon of Benefiber in Rainmans nightly yogurt to help lessen the dairy evil.

Lastly is the advice that always annoyed me the most - water. And more water. Then after that - serve some water. It's tough to get a lot of water in - I think even the average person struggles with it - but it is true. Staying properly hydrated is essential for avoiding constipation.
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My aunt (90) was given a fleet enema after x-rays showed she was full of poop. Told not to take softeners but to take Polyethylene Glycol each day. Need a prescription from her doctor/less expensive than Miralax. Her problem was too much thyroid medication. Now that the meds are better adjusted she does not have a problem. She lost 10 lbs in a few days. It took awhile for her to get it cleared out. Since it is unusual for your mom to be constipated, you might want to have her blood work checked. Glad things are better.
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Thanks to TheNerd, though I can't figure why you have that name.....your suggestions are superb. "Impacted".....that might be just the word for what was going on with mom. It sure wasn't constipation. I have found beans are terrific for digestion, though mom has said she doesn't like beans. I gave her some tonight though mixed in with broccoli and rice and some broth and she ate it, so that's a clue that she might be ok with it after all. I was hoping the Nature Valley granola bars would be ok, but seems they have to go. I have been getting fresh spinach, broccoli, sometimes zuchinni and squash. I'm not that creative a cook, so if you have a site to go to for good, simple vegetable recipes, please send. I'm having to comb through our cupboards and refrigerator to re-think what to get rid of. Mom loves macaroni and cheese---probably a no huh? Maybe she can have that occasionally? She also loves chicken noodle soup. I like to make that in the crock pot to cut down on the salt. The broth is great for her, but are the noodles and chicken ok? I made a pot roast with vegetables in the crock pot that was super. I hope that is ok. I also get the best sliced corned beef for sandwiches, chicken salad, seafood salad from the deli. Are those not good ideas? One of our helpers made a Waldorf salad that was yummy with chicken, grapes, walnuts, celery and apple as well as a red cabbage salad with apples. Mom ate all. Do those sound ok?
I don't know what an instapot is. With beans, I used to get them and just soak them overnight to soften them. Lately I have just been getting cans of beans and using those........
Thanks again for sharing. It certainly makes life easier all the way round when you find what works......as well as what doesn't. cadams
I have to say I agree about the constant, regular use of OTC meds. Seems to me this would fight against the natural body functions and weaken them.
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Of course, listen to your doctors and do what they say. You don’t want your loved one to get ‘impacted’ that can be a dangerous condition. I’ll share what worked well for my Mom and this has been a long journey of trying many things.

First two days is not bad. I have heard anywhere from three times per day to three times per week is in the normal range. Frankly it’s easier to manage if your loved goes regularly every two days vs 3x a day.

I personally don’t like the over the counter meds or other stuff especially on a long term basis because the bowels can lose their normal function and then its gets to be a bigger problem.

I found a diet high in natural fiber about 75% insoluble and 25% soluble worked very well. Here is the trick though – it has to be from real unprocessed food (veggies) – no cheerios, fiber bars, fiber one cereal or anything else – use veggies! Get a Bean soup recipe off the web and use that (consider a pressure cooker like instapot to make it very easy to make and store enough for a week at a time; if your loved one has dentures you can blender it after you make it so it’s a paste and easier to eat). I also cook it for two hours (longer than the 45 min most recipes call for) in my instapot so the bean skins get very soft. Sometimes I add a spoonful of a whey protein powder supplement and stir that in to her bowl; she likes it and she gets a good dose of extra protein too. It worked better than any meds or anything else and has worked well on a regular basis now. My mom has a bowl or more a day and so long as we stick to that things go very well. Soups are great too because they consume water along with it. Sometimes it’s hard to get her to drink a glass of water but you sneak in the liquid with the soup easily. You have to have the fiber and the water for things to work well.

Some guidelines:
You need about 14 grams of total fiber (sol and insol) per 1000 calories consumed a day. Because women generally need about 2000 calories and men 3000 per day. You typically see recommendations of 28g fiber/day for women and 42g/day for men. However, an elderly Alzheimer’s patient that sits around all day (exercise/walking helps bowel movements too by the way) may only eat 1000 calories per day sometimes and so should only get 14 grams… more fiber might constipate them! Also, you need water or the fiber will constipate them. A lot of caregivers seem reluctant to give water because then they have to take them to the bathroom more regularly but drinking about 2 liters a day is vital for many reasons.

Why not use fiber bars etc? Because in 2007 the FDA starting allowing companies to claim their food products have fiber in them if they add synthetic polydextrose or inulin. Polydextrose does add bulk to stool so the FDA allows it to be listed on a food label as fiber (but it’s not real fiber- its glucose, a sugar alcohol and citric acid combined in a lab). To my knowledge it lacks evidence of all the other benefits of natural fiber from fruits and veggies and in my experience doesn’t work and rather causes constipation. Inulin although natural and concentrated from chicory root also seemed to cause constipation. Skip the fiber bars, and cereals etc. is what we do. I was wondering why these specialty fiber cereals and fiber bars were actually causing my mom constipation whereas if she ate real veggies and bean soups everything started flowing again perfectly. I suspect this is why.

Lastly, eat some bean soup yourself too! It’s good for healthy young people as well. So as we take care of our elderly loved ones maybe we can learn to be healthier too instead of the typical caregiver decline in health!

Good luck!
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Thanks. I sooo appreciate the humor you guys. You gotta laugh at some of this stuff, right? And thanks Barbbrooklyn once again for insight, sharing about the "intestinal blockage" site. I did look that up. I want to read it over again. Sorry if I came off as sooo hyper, but I really was as mom wasn't getting better and was sooo off and it seems I kept running into people telling me "it was no big deal", "common in the elderly", "happens alot".........but that didn't solve the situation. It was just "all talk and no action"....(where have I heard that before?). I shudder to think what would have happened to mom if I just left the whole BM situation alone.....
Sometimes, as caregivers, we know in our gut something is seriously wrong and needs to be dealt with. This was one of those times. I'm still monitoring mom as she is slowly recovering from this, slowly building her back up starting with broth, soups, oatmeal...... Again.....thanks lots. I appreciate much!!!cadams
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I think the "silly" and "over the top" comments weren't meant to be a slam, rather an admonition to take a deep breath and s l o w d o w n and let nature (and laxatives) take their course. Which it has, yay!
Poop dysfunction has it's own little circle of h*ll, you worry when they don't and then have to clean up when they do... you can't win for losing!
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Not sure whether to say "whoops" or "whoopee!"

It's never silly to be worried, and I'm just glad she's feeling better. Hugs to you both.
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Ask the doctor for a prescription of Lactulose; this will soften the stool. Google this to read about it before you contact the doctor. It's not expensive. You get it through your local pharmacy. My mother has had chronic constipation since childhood and is worsened due to medical complications. She can go four weeks - yes, you read right! - without a bowel movement - if I don't give her the Lactulose; with this, she blows in 1.5 weeks. She has diverticulitis on top of a difficult bowel digestion history since birth. It's awful. I get so stressed out whenever Mom can't poop! Malabsorption of nutrients and low stomach acid, both of which can cause constipation, are not uncommon in the aging population.
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NatuRE-CALM. Its a powder... Sour. Magnesium... It's supposed to help balance potassium, but it is wonderful for this situation.

Lemons sliced and soak indrinking water is goo.......Slide 1.2 of lemon and put i n glass. The other half squeeze it, and ifyou want add that to your glass. After awahile you don't taste the sour....
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I've never been sooo happy to see a BM as I was this morning! Finally.....mom had a bowel movement......very, very messy but I was sooo happy, I didn't care. This was exactly what she needed. The color in her face is back and I feel like I got my mom back. She is much more like her old self after a week of very off behavior.
One thing about mom----she never complains and always says she is "fine", so I can't go by any of that. I have to do lots of observation of her nonverbal actions, reactions.
I'm sorry if this is "silly" to some or "over the top" to others, but this is a new spot for me, dealing with something I haven't and I reached out to you all for some advice, comfort, compassion as it appeared to me that it had the potential of being very serious. I thought that is what this site was for....... Sometimes I just need feedback or someone to listen. Thanks. cadams
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Cadams, go to the Mayo Clinic website and search "intestinal blockage". It gives a nice overview.

If your mom is not having abdominal pain, I'd just wait it out.
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When you took her to urgent care, they did an abdominal examination and asked her how she was feeling, yes? And they didn't find any problems at all? I'm not quite sure what you'll want the ER to do with her, or what you're expecting them to find. As you will know only too well, a colonoscopy is not something you wish lightly on anyone, let alone a tiny little elderly lady.

Has she taken any codeine? Has she eaten a lot of the notorious bunger-uppers recently, like eggs or white pasta or anything like that?

I just wonder if your own recent difficulties are making you fear the worst. It isn't likely that a lady of your mother's age would suddenly develop diverticulitis, is it? Stop freaking out about what might be going on in your mother's gut and concentrate on how she's feeling. As soon as *she* seems worried and/or uncomfortable, that's the time to get her seen. Have you noticed any other problems besides this?

Mind you, if she's meekly swallowed her Miralax and her magnesium citrate I hope it's not far for her to get to the bathroom... :/ Keeping my fingers crossed that all will be well, and that she'll be fine by tonight.
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Again......thanks for all your suggestions. This thing isn't over yet I can see. I DID take mom to Urgent Care, but all they did was give her a "prescription" for Miralax and Magnesium Citrate. No imaging.(Thanks BarbBrooklyn for that insight.) I wish they had done that. That makes sense now as to why the dr. would recommend Urgent care. Still no bowel movement tonight even after taking this combo. (It's 4-6 days now.)
It mind sound over the top to be so concerned, but mom has never....in the 8 1/2 yrs. I've been here, had anything remotely close to constipation. She is very regular. It is also my thought this "blockage" could be pretty serious as she is only 96 lbs. and almost 98 yrs. I am shocked at such a sudden change.
I am hoping and praying tomorrow will be different. Otherwise.....I think an emergency room is in order....cadams
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Excellent answers so far, but just to make something else clear, stool softeners are not designed to work immediately so taking her to the bathroom two hours after giving her one was kind of silly. Or were you referring to suppositories?
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My Mom was always having a BM, in fact she used to complain to the Dr. that she was going too much but the Dr. told her that she should be thankful, elderly people often complain of constipation.

When she had a gallbladder attack they did a cat scan that showed that she had BM too high. I was surprised with this as she was always going. Doctor said even though she was having a bowel movement that didn't mean she was getting cleaned out.

Well, that day her digestive system went almost to a stand still. He ordered her Osmoprep which consists of 4 pills every 10 minutes with an 8 ounce glass of water for 5 doses (20 pills in an hour). Then 2 hours later give her 3 more does which was 12 more pills. It was a good thing she had dementia because she would never of taken all those pills with water that close together. : p

Ever since that gallbladder attack and trouble with her bm she won't go without her 2 glasses of Metamucil and 2 Colace tabs a day. Plus, her diet is now lots of fresh salads, fresh fruit, very little starch and zero fried foods. I have always had her to drink lots of fluid, but diet soda was out and she hates just water so I give her watered down Gatorade. Mornings I give her prune juice/orange juice in an eight ounce glass mixed with her Metamucil along with Gatorade.

Her problem was so abrupt that I thought she had a stroke in her digestive track, that was how fast things slowed down but I was told that that was not the case. Her system just decided to slow down. Things that used to work, don't work anymore or they slow down. Her body is ever changing.

It's funny sometimes when I place her on the toilet I tell her to grunt like you do a child. Not sure if she just makes the sound or she is really trying.
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I'm very much in agreement that you are not at the urgent care step yet, unless your mom is in pain. You asked, re:urgent care " what could they do?", and the answer is imaging. Just wanted to clarify.

If she seems to be getting into a pattern of a huge BM every couple of days, you might want to consider an every day fiber add in. Might keep things more manageable.
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I'm with CM. I've gone as long as a week without a bowel movement. My Mom used to say you should have a bm in the pm and a bm in the am. I think if you ate an ideal diet every day and drank the tank of water that they recommend maybe that might happen. But honestly, unless you are in a lot of discomfort I think as long as you are having one most of the time I wouldn't worry. Try the raisins. I snack on them occasionally and they do help.
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Two days is *nothing*.

What is normal for your mother? Is she uncomfortable?

Unless she's opened her bowels once a day regular as clockwork for ever and is complaining of feeling bunged up or colicky, you're getting waaaaaay ahead of yourself.

Just keep an eye on her, and she isn't fine today or tomorrow give her some lactulose. Or an extra handful of raisins.
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She may need imaging to diagnose a bowel obstruction. That's why the doctor is suggesting urgent care. Hope the laxative route works.
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Thanks much for the suggestions. What is odd is that her appetite is great! Sometimes she eats more than me! My thought and concern is that the food is going into pockets in her intestines like I just went through recently. I got a colonoscopy to confirm that that indeed was the problem as I too wasn't having any bowel movements but it wasn't constipation at all. So diverticulitis could actually be the culprit here. I even thought she may have a UTI as her behavior soo off this week, but it doesn't appear that is the case here. Another odd thing is that she had a whopper of a BM on 3/06.....and then......nothing (though I only just now noticed no BM the last two days. There may have actually been a BM on 3/07. Even still......not good. I have called the Dr. who suggested Miralax, Colace or going to Urgent Care. Any more ideas? I am thinking Urgent Care tomorrow.......but what can they do? cadams
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I find that a gentle laxative, e.g. Miralax, and a big meal work best. Older people often don't want a big meal. Maybe you can think of something she really likes and will eat a lot of. This can stimulate the bowels to move.
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