Constipation
Constipation is taken very seriously because although in most people it only causes intermittent discomfort, it can lead to severe pain and discomfort if not managed proactively. Therefore, it’s important to track the frequency of your bowel movements.
Common causes of constipation include:
- Decreased mobility.
- Decreased fluid intake.
- Decreased intake of fiber in the diet.
- Use of opioid pain medication such as morphine, oxycodone, or hydrocodone. Although opioid analgesics are generally considered the most effective medications for severe pain, they have a constipating side-effect. For this reason, taking a laxative concurrently with opioid pain medication is generally recommended.
- The disease process itself (e.g., colon cancer or ALS impact the motility of the gastrointestinal tract).
Your hospice team has extensive experience in managing constipation and will collaborate with your physician to find the right medication(s) for your specific needs (including various types of bowel medications). Timely updates from you will impact the success of your bowel regimen. Please notify Hospice anytime you have not had a bowel movement in three days.
Non-Pharmacological Methods for Relieving Constipation
- Warm prune juice.
- Increase fiber from natural sources in your diet such as vegetables and fruits.
- Fruit paste.
- Attempt a bowel movement at a consistent time every day.
- Decrease high calcium-content foods because calcium is constipating.
- Gentle abdominal massage (consult your hospice nurse first).
Pharmacological Methods for Relieving Constipation
Your hospice nurse will be proactive in implementing bowel medication(s) in order to prevent severe constipation. These medications may include pills, oral liquids, suppositories and/or enemas. A common medication for treatment is Bisacodyl suppositories; a Bisacodyl suppository is indicated when a patient has not had a bowel movement in three days and should only be used if directed by a Hospice nurse.
How to Give a Suppository
- It’s easiest to administer a suppository when the person is in a side-lying position.
- Remove the suppository from the foil packet and with a gloved hand, coat the suppository with a little lubricant from a small packet if included (other lubricants can be used such as KY Jelly).
- With your opposite hand, gently part the buttocks to view the rectal opening.
- Place the pointed end of the suppository into the rectal opening and push straight in with your index finger.
- If stool is present in the rectum, the suppository should be inserted against the rectum wall (not into the stool) because the medication is absorbed through the rectal tissue.