Thursday, July 3, 2014

Constipation

I'm not sure if this is practicing good medicine or not, but coworkers and I were sitting around the other night discussing the various alternatives to patient care (read: ways to avoid actually completing the order) when a doctor orders an enema on a young and otherwise healthy patient. Really, we'll do anything to get out an enema administration. They're not fun. Trust me.

In this conversation, I mentioned the best constipation remedy I've ever heard of - it was a comment from Hood Nurse, and I still laugh about it and wish I could tell my patients this:

If you are young, healthy, and just suffer from an unfortunate lack of fiber in your diet and subsequently think "should I go to the ER because I haven't pooped in four days?" then the answer is no. Go home, drink one cup of black coffee, eat one taco bell taco or burrito with hot sauce, and then go for a jog around the block. If you don't run the risk of shitting your pants before making it back to your house, then you may come to the ER and we will give you a bottle of mag citrate.

Pretty sure that's not an exact science though, so take it with a grain of salt. And don't sue me if it doesn't work, because this is the internet and contrary to popular opinion not everything on here is true.

12 comments:

Aesop said...

This is also purely anecdotal, but I'm pretty sure, based on personal experiences, that ToxicHell puts mag citrate in their sauce.

I can only pity the folks east of the Mississippi for whom there is no other option for trying to find something that approaches Mexican food, but much like my first sergeant's counsel about beer, you aren't actually buying it, you're just renting it for a while.

girlvet said...

Isn't mag citrate OTC?

ER docs who order enemas should be taken to the ER break room and beat with a TWE bag until they agree never to do it again.

Shash said...

Sometimes the problem isn't diet in itself. I had horrible, painful constipation when my GP insisted I go on a statin. I normally eat more than recommended amounts of fiber but after three days, I switched to what was practically a fiber and water diet. After a week of pain, I went to the urgent care because of the pain and was treated with great derision because I "wasn't eating enough fiber." What is oatmeal for breakfast, green salad for lunch and bean or wild rice casserole for dinner if not enough fiber? He gave me no other suggestions but eat more fiber.

Sorry but this was about the fifth time I was appalled by the assumptions made by the medical practitioners. I went to my local co-op and explained the problem. They handed me a bottle of magnesium and suggested I talk to my doc again about the statin. It worked. I don't take statins and I don't get constipated. And I steer clear of going to an unknown doc until I have done my own research even if I'm in great pain over something.

jill said...

For crying out loud, people go to the ER for constipation? There's an entire AISLE at the goddamned RiteAid for that. Go get some Miralax. It's cheap, OTC, non habit-forming, and doesn't cause cramps. And it WORKS. Christ.

Cartoon Characters said...

If you want to make taking a laxative/clearing the bowels fun, all you have to do is buy a 5 lb bag of gummy bears and eat them all in one setting. THAT would do the trick and you wouldn't have to hold your nose to ingest it! ;)

Shash said...

Jill, I was worried I had an obstruction because none of the usually-effective tools I tried in the past helped. And I went to the Urgent Care, not the emergency room. My GP was not available. I have not had the problem since stopping the statin.

Barb said...

The Gummi Bears need to be the sugar-free variety. I don't know if regular Gummis will work ("regular" - see what I did there?) but for sure the artificial sweetener in the sugar free bears will clean you out like a colonoscopy prep.

TheUglyTruthMom said...

The things you can learn on a nurse's blog! :)

Badambo said...

I always remind my docs that there's only one indication for an enema in the ER - the anus is literally on fire. 9 times outta 10 I get my enema to go wish!

Axce Dant said...

I left a comment on your earlier post but it would be just as applicable here. Two very strong posts - thanks!

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Jeanne Foster said...

Thank you for great post! I often face with constipation and have some experience in curing it. If you also want to know more about quick home remedies for constipation I recommend you to read this article:
http://homeremedieshelper.com/colon-cleansing-home-remedies/home-remedies-get-rid-constipation

Javier Parrales said...

The worst I've experienced is a bodybuilding cut diet that required 12 weeks of egg whites and oats. After about 8 weeks, I could have used an enema, but switching to brown rice did the trick. But it's good to know enemas are as traumatic for practitioners as they are for patients. What people will endure just because of pooping...sheesh!

Javier Parrales @ U.S. HealthWorks Tukwila