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My father is 86 years old. For a number of months he has been complaining of severe constipation, he says he has to get up 6 or 7 times every night to visit the bathroom. He says his stool is so hard that he has to strain enormously but often with no result. He has been examined a number of times by different doctors who have carried out tests as well and reassured us that he has no constipation. It seems that he has an obsession that he has not emptied his bowels and repeatedly feels the need to sit on the toilet seat. A number of medications treating his constipation have been tried. We have finally concurred with the doctors that there is really no constipation. we have tried explaining this to him but he is convinced otherwise. we are looking for any helpful suggestions to deal with this situation, thank you.

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Well, dementia certainly presents in many different ways...

Before you rule out constipation, I assume he's had a colonoscopy or a virtual one? And then I'd ask if you've observed his stool. Is it, in fact, hard? Is he on stool softeners? If he's not, ask your pharmacist for a suggested dose and run it past your doctor. Is it normally shaped? Ribbon-like stools can be an indication of a tumor blocking the road.

If all is really normal, then ignore it unless he complains of pain.
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With no constipation, a colonoscopy at his age is untoward due to the anesthesia and could lead to more problems. His vagus nerve is over stimulating his brain making him think he is constipated. Have him eat prunes or drink prune juice, eat figs (unless he has diverticulitis due to the tiny seeds), lots of salads and an apple every day. This will keep him regular so he won't have that "urge" feeling. When one reaches 86 yrs. they are entitled to obsess about something with their body and God love him for reaching this age! My husband will be 89 yrs. in Oct. and I allow him whatever time he needs to spend in the bathroom and don't worry about it. It will come out in the end!
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I had a similar case with my father and decided in caring for my mother that I would deal with the situation head on with diet. The daily breakfast is a mixture of whole and quick oats (50 % each) to which I add a pinch of barley bran, wheat germ, flax seed, psyllium husk bran (be creative here). I soak the above in double the amount of water for an hour or so. In the meantime I chop up an apple and a banana and get some peanut or almond butter (1 TBS) and honey (enough to taste just slightly sweet). I cook the oatmeal (porridge) mix in the microwave for 6 minutes (in 3, 2, 2 minute increments, stirring between), add the fruit, peanut butter and finally honey. and serve up, Mum likes a trace of milk on top, but it is delicious just as. I find that if we start the day with this meal the result both short and long term is smooth bowel movement and never a problem with constipation. Mum is 99, Dad died at 80, I wish I had known then what I know now, I could have made him a much happier and healthier time. I meant to add that the soaking and the cooking make sure that the porridge is very smooth. Also, my whole household enjoys this daily ritual and meal and all are doing well. I find that eating for the rest of the day is never a problem once this breakfast has been consumed. Good luck.
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Might try Metamucil.
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Stick with nature's food, not chemical products in a can. We already consume too many chemicals. Try to eat foods without hormones or chemicals - organic as much as possible. Do you realize bees are vanishing? When they go, we go.
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Thanks Ferris for bring up the anesthesia and the bees vanishing. They are very important points.
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Natural products always my choice. We also over medicate. I meant to add that I add the peanut butter to the oatmeal as a source of protein as I have noticed that Mum eats less and less meat, tiny amounts of fish and chicken. It also tastes yummy.
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I forgot to say that my oatmeal recipe is for 1 cup of oatmeal (2 of water)
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Hello, this sounds so much like what I went through once. I felt totally constipated one day,kept using the toilet to no avail. I was straining and still couldn't hav a bowel movement though I felt an extreme need to. I shut down on any solid food intake other than small bites of fiber, apples,oatmeal, etc. I ended up only drinking fluids,no solids at all after it hadn't helped. I tried all the stool softeners, and there is a drink you can get over the counter that guarantees a bowel movement...well nope. It didn't work. Could not sleep much, my legs started their constant twisting and kicking (RLS). Finally one morning I had passed solid blood. That was it; I went in to emergency thinking the worst, ended up wtiha colonoscopy, one polyp,and after that I have never had this problem again. So. I was wondering if this is affecting his eating habits, and if its interferring with his sleep? If he has what I had, then it is a very real sensation of need to have a bm, and pretty much ruins your day, the urge becomes overpowering emotionally, mentally, and physically, you can't ignore it.
My parents are in their early 90's, and they eat prunes when they think things of this nature need help. When you are in a hospital and prepping for a colonoscopy, they have you drink about a gallon or so of this stuff, to help clean you out before th procedure. The nurse came rushing into my room and took away half of that drink, saying the doctor said I didnt need to drink it all because I hadn't been eating solids for days. I had already happily chugged down 50% of the solution though, and it still had no affect on my bowels (nothing there to pass). Anyways someone here mentioned an oatmeal mix that sounds like it'd do the trick, if he really is constipated, if he is still eating solids. Hope this helps, its an all encompassing,dire state of being, when you feel you have to try over and over and over again to have a bm and nothing works.
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Perhaps your father has misdiagnosed his condition. If it isn't constipation, could there be some other disorder causing the symptoms? Has he seen a specialist? Gastroenterologist? This situation sounds frustrating for everyone. Hope a fix is found soon.
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I have to say I have a mum with IBS (among everything else including dementia) she has a pretty healthy diet but according to her suffers from constipation. Now she considers a rock solid stool to be normal which was the first difficulty I had to overcome because she simply call a normal stool diarrhoea.

She DOES take chemical intervention because her muscles are no longer working properly. That said I make sure she also drinks enough water - essential for a softer stool. I record her stools daily and describe then - normal soft hard (and you should note any change in colour too) Then when she says she is constipated I check ....most times she has just forgotten she has been. She often tells me it is loose when it is normal. So a whole host of little things that might be an indicator - Mum did have a scope done but it was very very painful for her - in the UK they usually do it under local anaesthesia to minimise risk.

Mum takes movicol daily and I have to say if she refuses it we are in for a bumpy ride - it almost ALWAYS results in constipation followed by an explosion so I do urge her to take it every day to avoid the above issue
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I'm wondering about his prostate. Just a thought, but pressure from the bladder can feel a lot like pressure for a bowel movement as well as the other way around. I agree that at his age intervention should be limited to what he can withstand. However, a blocked bladder due to an enlarged prostate could send him to the hospital in agony.
Carol
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It's because he is old. My mom is in ALF the biggest thing with every old person is their BM. Because they don't eat as well or drink near enough water they deal with constipation for the rest of their life. And the best part of every day is being able to poop. Plain and simple.
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My mom is obsessed with her bowels, too. But it is not constipation. It's embarrassing to discuss, but she digs her stool out even if it is loose (soft). She has an internal hemorrhoid which could cause a problem. She has scratched it and made it bleed. We try to stop her immediately, but that is the first thing she does when she sits down. She will use her finger with toilet paper. We have talked to her PCP, and a colon doctor. It's just O/C
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Am sole caregiver for Wife--moderate to severe Alzheimer's patient 74 yrs--Have had excellent results to combat her constipation with our Dr's prescription for 290 MCG of "Linzess"; best taken ½ hour before breakfast. This in concert with prune juice, prunes, high fiber cereal, and exercise. The exercise normally needs coaxing and firm walking assistance.
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A apple a day
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Ground Flax seed can be put in cereals, meatloafs & casseroles. Takes a couple of tablespoons daily if severe constipation Has very high fiber!
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I also find when they have enough to do, they forget to obsess about it. Also could be mis-self-diagnosis. M-I-L thinks that if she is not DAILY regular, that she needs chemical intervention and tries to get people to buy her laxatives, which she then forgets she has taken, and indeed forgets that they have WORKED so takes more. We had to put a stop to that real quick. Now we just make sure she drinks plenty of water and eats apples and prunes, it's not enough to take them to her, we have to make sure she eats them. And stays busy.
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my mom is very obsessed with her bowel movements. We have tried bran cereal, prunes etc. and telling her she doesn't need to go every day, as long as she is not uncomfortable. (which she isn't) But she does go on and on if she hasn't had a BM each day. She is 96--my father in law who is 89 is the same way. Does it have something to do with aging? I don't recall them being this way when they were younger.
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bettyb, I think it does have to do with aging, with one's world shrinking, and with losing one's "filters." When they were younger, they wouldn't dream of bringing up this subject, even if they were thinking it. Now I find that M-I-L can't appreciate the difference between thinking something and blurting it out.
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Linzess has helped greatly my 92 year old hubby who also has prostate problems.. When he doesn't have a bowel movement for 3 days, then I give him double dosage the following morning. Just a one time shot! Then we are back to one a day.
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My mothers nurse told her to cut down on coffee, its a diuretic and causes constipation
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The question is whether or not he is in fact moving his bowels. Has anyone seen him do this, and if so, how often and how much? A lot of us who have an "obsession" with moving our bowels have real undiagnosed bowel issues. He may have an obstruction or pseudo-instruction that has not been picked up during colonoscopy, because it is not prominent or visible while laying down with an empty stomach. You may want to have a Sitz-Marker Study, where he swallows a capsule containing radioactive markers to see where they get stuck or a pill-capsule or barium enema. Mayo Clinic has more extensive bowel follow-through tests. I found out I have a hernia that is "kinking my bowel" but it has not shown up on any tests until I sent a CT Scan to Dr. Shirin Towfigh in Beverly Hills. She found it. If nothing works you may want to try prescription Linzess for constipation. It will produce a bowel movement each day for relief but it will probably be diarrhea. Feeling bound up is very uncomfortable... I feel bad for your dad. I was called crazy for 2 years by numerous doctors who could not see any problem. Best of luck.
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Just have to say :-) that bananas bind and if u have kidney problems not good because of the pottasium. Would loveto give them to Mom but the doctor said no.

The hospital has Mom on all kinds of stuff because she didn't go everyday. When I was given the discharge papers I questioned it. Later found out her med was causing the constipation so was taken off. Stopped the Senna and when she went the other way, the colace. Dr. said Phillips if haven't gone in two days. There muscles are not the same anymore. If they have a hemroid that could be what they r feeling.
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STOOL SOFTENERS & MALOX... Can't hurt him...
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I think people of a certain age grew up thinking they had to go everyday. Yes, it does feel better but not necessary. My dad also has had trouble thinking he needs to go everyday and taken natural stool softeners (senekot). Now he's on probiotic pills instead and that seemed to help. He is almost 93 but this started about 3 or 4 years ago with him saying he was constipated after 1 day of not going. You might try probiotic pills or miralax since that can be put in coffee or anything. Good Luck.....
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I wish more people would raise bees.
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my dad has this obsession also. he has enlarged prostate and a catheter, because his bladder no longer functions. He also has advanced kidney disease among other issues too numerous to list. He is 83 I am his caregiver. He will insist on Fleet enemas and do them himself! I put miralax in his cup of coffee in the morning and it keeps him regular. Its tasteless and odorless. We get the equivalent in Publix brand and save a few dollars.
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It's frustrating that people think these people are obsessed, bored or imagining things. I am 52 and suffered 2 years with similar problems; I could not work or do much of anything. I learned there are many "hidden" causes that most doctors know nothing about. It seems if it's not on the Top 10 List of "obvious problems" then it's all in your head. If you can afford to spend a week at the Mayo Clinic in Rochester, Minnesota they will run a series of tests which no one else has. It could be any number of the following:
Rectal Dyssynergia- The rectal muscles are "confused" from too much straining and don't work. There is pelvic physical therapy for this.
Hernia - A nerve, piece of fat, or intestine is trapped by a weakness in the abdominal wall. Send scans to Dr. Shirin Towfigh in Beverly Hills. She's the only one who gets it.
Pseudo-Obstruction - Kinks or muscle weakness in the large or small intestine prevent proper flow. (Mayo Clinic)
Scar Tissue - Scar tissue from prior surgery can press against or wrap around intestines and restrict flow.
Chocolate Tumors - Dark tumors that do not show up on Scans.
Parasites - Clusters of worms that block flow; particularly if traveled out of country to poor countries.
SIBO- Small Intestine Bacterial Overgrowth
Food Allergies - Dairy, Soy and Gluten are common. There are many more.
Note: I personally think Irritable Bowel Syndrome is code for "We don't know what's wrong with you and we wont keep looking." Symptoms are always the result of an underlying problem. You just need to find it.
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Buy a 3-QUART ENEMA (most likely online) to fill the colon SLOWLY. Use lubricant. Hold it for a few minutes of possible. It will take several trips to the toilet before its all out. It's a "pain in the butt" but the only way to clean out the colon immediately. It will also answer if there's stool stuck in there. Don't use the little Fleets Squirt bottles... they're useless.
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