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Constipation/laxatives. Don't want to make a really long post about what my 90-year-old mother (with Gastroparesis, IBS, fructose & lactose intolerant) has tried already, but since the closest she has come to something working right is senna, I would like to just ask about that for right now. Regular OTC dosage 8.6 mg. seems not strong enough, but if she takes two she can end up with severe diarrhea and not able to eat next day. (And she is already down to 85 lbs.) Right now she is staying with me, but eventually will be going back home in another state. She has very poor vision and needs a regimen that she can stick to when she is by herself. Since most instructions say to take at night that is what she has been doing. Just read yesterday that someone with functional dyspepsia took their laxative before their biggest meal of the day. Liquid or tea would be easier to tritrate to an exact amount but would be hard for her to measure or make for herself. She usually has someone with her in the mornings and early afternoon if something had to be measured, but I would prefer to find something that doesn't have to be measured out each time. Would like to find the best form of senna that we can figure out an exact dose that would be good for her (at least most of the time). Has anyone had to try to get a really exact dose? A time that is as good as taking it at night? Gentle form, perhaps meant for children?

I hesitate, because you've said clearly that you don't want to go into the full history of everything that's been tried - ! I sympathise - but have you consulted a dietitian about this? It just occurs to me that "titrating" not only the laxative but also the timings and her diet holistically might help to ensure her gut is given a nudge rather than a detonator, if you see what I mean. A dietitian should also be well versed in what dosages, formats and release times the various preparations offer.
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Learn2Cope Dec 15, 2021
Thanks. After disappointing experiences with mom's doctors, dieticians, I've had to figure most things out on my own. Right now Mom's diet is pretty static. Time will tell if she will able to eat more different things in the future. I've figured some things out that we are going to try.
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I had to google Gastroparesis, as I had never heard of it, but I do understand IBS and Lactose intolerance.

But in reading that Gastroparesis causes a slowing of the movement of food through the digestive tract I don't think my idea would help. As a lactose intolerant person, all I have to do to get things moving is have a bowl of pudding, a glass of milk, slice of cheesecake etc.

I hope you have the opportunity to talk with a medical professional about what you could prehaps combine the Senna with to ensure she has daily BMs.

Perhaps a full dose at night and a 1/2 dose in the morning would work? Or combine the Senna with Psyllium.

I understand your concerns and worries. I hope you are able to find a solution that is gentle, but effective for Mum.
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Learn2Cope Dec 15, 2021
Thanks. I probably should not have posted on this forum. She was having a very bad day yesterday and I just thought I would try all avenues since so many elderly have constipation issues. Mother cannot eat anything but very low fiber foods, much less take fiber. Which exacerbates the problems so many elderly already have. (Your suggestion on full dose at night and 1/2 dose in morning perhaps could be one to try).
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My mom was legally blind as too and managed very well on her own for many years. It is your mention of the weight loss that concerns me because at that age a big change like that can lead to weakness and falls, my mom was "fine" until one day when she couldn't get up the two steps into her house after we were out shopping. I eased her fall and called neighbours to help get her up and into the house but when I look back I believe that was the first obvious step down in her decline.
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Learn2Cope Dec 14, 2021
Trust me, her weight loss concerns me as well. After a very long, hard battle with doctors and the health care system, she was recently diagnosed with gastroparesis. We are working hard to deal with that, have managed to stop the weight loss and working on weight gain. She has a medical alert button, family nearby, good neighbors, and a caregiver coming in daily. In the last two months, I have spent more time with her than I have with my husband. I am in daily contact with her and am truly doing the best I can.
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I hesitated to recommend the senna teas because I think precise dosing would be even more problematic, variables like how much water, how hot it is and how long it is left to steep could all change the concentration. And there is also the possibility of not finishing the whole cup...
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Isthisrealyreal Dec 14, 2021
I think that it is pretty easy, use a kettle to heat water, set timer when tea bag put in.

Any laxative is going to create different results daily, so much is a factor. How much fluid, fiber, soluble fiber, protien, fat free foods and....
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You can buy a tea called smooth move, it is senna. Use a bag per cup of hot water and drink nightly to remain regular.

I would have her magnesium levels checked, too low can stove you up.

I'm with everyone else, can she really live by herself in another state with minimal help?
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Learn2Cope Dec 14, 2021
Her magnesium levels are too high.
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Have you looked at different brands, some have different amounts of sennosides. Is she drinking enough fluids with her laxative (and in general) plus are you allowing enough time for the smaller dose to work (older guts can be slower to react)?

My mom was laxative dependent most of her life and polyethylene glycol 3350 (Miralax and others) was a real game changer for us, it helped to greatly reduce her dependence on stronger laxatives.


And I'll address the elephant hidden in your question, are you really certain she is still capable and/or safe living on her own any more?
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JoAnn29 Dec 14, 2021
Miralax did a number on my Mom.
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I can't answer your larger question about the medication, but why on earth do you think someone in her condition with extremely poor vision would be capable of living on her own in another state??
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Learn2Cope Dec 14, 2021
Because she has had low vision for many years and better able to cope navigating in her home. She has excellent hearing, a sharp mind, is fiercely independent, has refused to go anywhere else, and has refused having a caregiver in until just recently.
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