Thank you for sharing your expertise here. My Q is re my mom: 81YO, 115#, 5'6", unexplained weight loss 15# in past 5 mos. She can stand with help, doesn't walk, comlains 2-3 X/wk of pain, primarily of back and hip. Diagnoses of PD, mid-stage Lewy Body Dementia, osteoarthritis, and severe chronic constipation, which has been progressive for years. Slow colon transit time, no bowel obstruction noted on CT, labs WNL, no other significant health issues. Meds are 8 mg Razadyne bid, 81 mg aspirin daily, 200 mg Provigil daily, 17 gm Miralax tid, and tylenol PRN (averages 3 tabs/week). 1200 - 1500 cal intake daily, adequate hydration. We rely on Ensure and soy milk for sufficient calories and nutrition. Constipation and related painful gas cramps no longer respond to any standard treatment, only to enemas. The constipation/enema cycle is very fatiguing, which affects her quality of life.
My former personal physician was a DO, but he has retired. While she has dementia, her cognitive skills are sufficiently intact that she refuses to see anyone but her own long-term MD. He is open to discussion of care options.
My primary concern is the debilitating constipation.While I know you cannot diagnose or prescribe for mom, I would appreciate your thoughts on cases such as this. Again, many thanks.
Lin
Answer Hi Lin, I'm very sorry to hear that your mom is not doing very well. As I'm sure you know, it is possible the Razadyne could be contributing to the constipation (often causes diarrhea but constipation is a possibility). But if her dementia is adequately controlled one has to weigh benefits vs risk. One possibility is atonic colon where the large intestine gives up and doesn't squeeze anymore. Without knowing your mom I can't give specific recommendations, but usually walking is helpful (which she can't do), in some people abdominal massage around in a clockwise manner can help, eating some fiber filled or bulking agents could help, probiotics (good bacteria eg yogurt etc) could be of assistance. But as you know, without knowing your mom I can't make any recommendations for her particular case. I wish you both the best health possible. Tom
