How Can Persistent Constipation Be Treated In An Elderly Patient Despite Enemas And Taking Miralax?

Posted on Mon, 17 Sep 2018

Question: My 91 year old great aunt hasn't had a bowel movement since last Sunday. She went to the Emergency room on Wednesday night/ Thursday morning. They did a cat scan and found no blockage. They prescribed Miralax over the counter and some type of prescription. She was given an enema but nothing has worked. She was told to drink plenty of water and take the Miralax until she had a bowel movement. She says she has taken it 4 times and has also taken Milk of Magnesia with no results. I live about 100 miles away from her and was trying to calm her anxiety without going back to the emergency room again. I have called and they are currently on a 4 to 5 hour wait due to flu patients. Any advice?

Answered by Dr. Lekshmi Rita Venugopal (1 hour later)

Brief Answer:

Diagnosis: Fecal impaction

Detailed Answer:

Hello,

The symptoms your grandmother is experiencing is suggestive of faecal impaction. Faecal impaction is common in elderly and is due to faecal matter obstructing lower bowels.

Since she has been on laxatives and has even been given an enema with no result, she will require mechanical (digital) removal of faecal matter.

Digital removal of faecal matter can be done by health professionals in a hospital setting. If the emergency room wait time is long, she can visit the nearest urgent care.

Hope I have answered your query.

Take care

Regards,
Dr Lekshmi Rita Venugopal, General & Family Physician

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Above answer was peer-reviewed by : Dr. Nagamani Ng