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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for severe constipation

Hello -

Wife is 65 years old and suffers from extreme constipation. She receives excellent medical care, UNC & Duke graduates, but neither her primary physician or her plethora of specialists seem to be able to offer practical suggestions.

Situation resulted from surgery in 2001 four “flat back” syndrome secondary to scoliosis. Nerve damage occurred during surgery with many negative outcomes, such as, chronic pain, bladder and bowel dysfunction, some paralysis in right leg.

She manages well, in spite of, these difficulties and prior to surgery was high functioning in very responsible position.

She takes heavy narcotics for pain which, of course, contributes to her problem. Also, she takes Miralax and copious fluids.

Bowel movements are unpredictable and can take hours to complete. This part of her disability severely constricts her quality of life.

Are there any suggestions, short of a colostomy, which might alleviate her symptoms of constipation, as well as, relieving the constipation itself.

I understand this is a complicated medical situation, but I am interested only in the bowel management issues.

Any suggestions? Any recommendations? Any solutions?

Thanks very much for your time and attention to this problem.

Regards,
William
Fri, 8 Jun 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

-Use over the counter laxative daily
-take probiotic supplements and probiotic foods
-drink Iiquids
-eat fiber rich diet

Hope I have answered your query. Let me know if I can assist you further.
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Hello -

Wife is 65 years old and suffers from extreme constipation. She receives excellent medical care, UNC & Duke graduates, but neither her primary physician or her plethora of specialists seem to be able to offer practical suggestions.

Situation resulted from surgery in 2001 four “flat back” syndrome secondary to scoliosis. Nerve damage occurred during surgery with many negative outcomes, such as, chronic pain, bladder and bowel dysfunction, some paralysis in right leg.

She manages well, in spite of, these difficulties and prior to surgery was high functioning in very responsible position.

She takes heavy narcotics for pain which, of course, contributes to her problem. Also, she takes Miralax and copious fluids.

Bowel movements are unpredictable and can take hours to complete. This part of her disability severely constricts her quality of life.

Are there any suggestions, short of a colostomy, which might alleviate her symptoms of constipation, as well as, relieving the constipation itself.

I understand this is a complicated medical situation, but I am interested only in the bowel management issues.

Any suggestions? Any recommendations? Any solutions?

Thanks very much for your time and attention to this problem.

Regards,
William

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