Constipation and Diarrhea

Symptoms:

Constipation - stomach cramps which makes the whole body go stiff

Plug is hard and high up making enema's and ducalax ineffective

Moaning followed by screaming

Stomach stops emptying

Management:

Colace is given as a stool softener (10ml 2xday)

Lactulose is given to encourage the bowels to work (10ml 2x day)

Bowel log is kept with dates and relative sizes of movements

Regularly massage rectum on second day after no movement

Glycerin Suppositories, Ducolax, or Pediatric Fleet Enema

Complications:

Medications such as her anti-convulsants may not be absorbed effectively when bowels are backed up

Misses G-tube feedings or on continuous slow feeds until bowels relieved

With increased spastisity small seizures may occur

Position changes are increased as sitting is uncomfortable due to the pressure of her abdomen being bent. This in itself reduces the normal flow of bodily functions if she can’t or won’t go into a sitting position -  hence the loss of gravity as a factor.

Often, long after giving a treatment, Katie will have a bowel movement on her own that has a hard plug follwed by very loose stool. Katie is incontinent and therefore wears diapers. The loose stool gets into the vaginal area leading to UTI's and vaginal infections. Again, one problem leads into another and if not understood or diagnosed the treatment may be inappropriate.

Opportunity to go to school is greatly reduced as is the overall quality of life. The delicate balance found in good health is hard to maintain when one aspect or more gets out of control.