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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Constipation For A Cirrhosis Patient

My Dad has been diagnosed with HCC. He is also in advanced cirrhosis stage. He is having severe constipation and the dosage prescribed for removing constipation is not working. We have given him Dufolac/Biolac. He cannot be given enema as he has undergone banding for secondary piles. He went into encephalopathy and was treated with Pegmove (Polyethylene Glycol), but that has also not yielded much results. They also gave HepaMerz (L-Ornithine-L-Aspartate) Granules for removing ammonia. This is being given in 8 hourly intervals. He was discharged and brought home, but he is still getting constipation. He is slipping into encephalopathy. Wanted to know if Dulcolax Suppositories can be given as an alternative as enema cannot be given? What are the other things that can be done to remove constipation / induce bowel movement, and remove ammonia? Thanks in advance
Thu, 4 Sep 2014
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Gastroenterologist 's  Response
Hello, Sorry to hear about your dad,
Lactulose( Duphalac) is the best first line drug for treatiing constipation in cirrhosis. I would suggest to increase the dose of duphalac . If he is in encephalopathy the dose of duphalac can be increase and given 2 hrly till he passes stools and then reduced to maintain 2-3 stools per day. Consult your doctor regarding this
Hope this helps,
Do get back in case you have further queries
Regards
Dr Samir Patil
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Suggest Treatment For Constipation For A Cirrhosis Patient

Hello, Sorry to hear about your dad, Lactulose( Duphalac) is the best first line drug for treatiing constipation in cirrhosis. I would suggest to increase the dose of duphalac . If he is in encephalopathy the dose of duphalac can be increase and given 2 hrly till he passes stools and then reduced to maintain 2-3 stools per day. Consult your doctor regarding this Hope this helps, Do get back in case you have further queries Regards Dr Samir Patil