Constipation: Help, I’m stuck

Fecal impaction is when a large amount of poop is stuck inside the rectum. The poop can be soft or hard. Chronic constipation is the most common cause of impaction. Constipation is due to 1) the inability to push stool out 2) the persistent habit of holding bowel movement inside or 3) small stools that pile up. Impaction is often, but not always, uncomfortable. Frail seniors are at higher risk. Sometimes caregivers are surprised to hear that a patient has an impaction. What are signs of impaction? Impaction is likely when a patient feels full […]

Constipation Relief … What’s the Scoop?

Constipation can have an awful impact on quality of life among frail seniors. First of all, it increases urinary tract infections. Then, at its worse, it results in fecal impaction and incontinence. This increases caregiver burden and stress. Ultimately, the person ends up being unable to live at home. What a disaster. That’s why I think it’s so important to avoid constipation. The goal should be a solid, medium-sized, bowel movement with complete evacuation. In addition, at a regular time every day. That’s constipation relief!! Now, what’s the scoop? Step 1: Are medicines causing the […]

Constipation? I Have Two Questions

“There’s Nothing Like a good Bowel Movement” made the point that chronic constipation is all too common and distressing among seniors. In the past, doctors defined constipation as having fewer than 3 bowel movements a week. Anything else was considered “normal”…hmmm…really?? Obviously, the patient was much more uncomfortable than the physician. We now evaluate constipation more broadly, starting with the patient’s perspective. Here are two important questions: Question 1: What bothers the patient the most? Different answers mean different problems. A. It’s very painful to have a bowel movement. Sometimes only small pieces of stool […]

There’s Nothing Like a Good Bowel Movement

There are 3 questions that I always ask my patients. They are about “E, S, B&M”: How well are you eating? How well are you sleeping? How are your bowel movements? These are questions that patients are glad I ask. They show that I care about life’s most basic needs. It’s a doctor’s more specific way of asking “how are you doing?” ESBM are important in childhood, adult life and as people get older. The answers to these questions are “life” vital signs. Just like heart rate or respiratory rate, they give me clues about […]