Colonic interposition, impaction, laxative choices

Posted by minajo @minajo, Aug 1 6:22pm

My daughter is a 48 yr old nonverbal, autistic, epileptic who had a chest x-ray many yrs ago with elevated right hemi diaphragm ,colonic interposition noted.. pcp said not to worry..
After several months on a seizure drug, Zonisamide, noted she gained 2# monthly for 14 months,.. got her off it but during that she ended up hospitalized with severe impaction, treated with enemas, laxatives in hospital until she 4 days later did empty huge amount but dr said she developed megacolon over that time as she tried to " stool" around impaction
Now she is on Colace 100 mg2x day, Lactulose( for ammonia elevation also) and Miralax.. she can't undergo testing now as she was very traumatized in hospital and her autism makes her very unmanageable
But wondering what is best laxative to keep her having good size bms daily?
She still doesn't go daily.. eats many veggies, fruits, drinks prune juice etc
Since she's nonverbal it is sooo hard trying to figure best laxatives for long term use
Thank you to everyone!!

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@minajo

Thank you, as another person wrote it might be making her nauseous, she gets several meds in morning for epilepsy and autism, daily vitamins,etc .and also the Colace and Lactulose 2x day..
Trying to figure all this out us hard but getting help from " normal" people not dealing with epilepsy/ autism too,just g.i.issues helps so much!!

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God bless you for all that you do. I’m sure it’s a lot for you. Sounds like you’re doing an amazing job for your daughter!!!!!

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Thank you for your kind words . it's been a long journey for a sweet daughter, has some good supportive people in her life.. as a senior mom now i just try to stay healthy and hope the ole brain stays sharp for her!!

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@minajo

Great suggestions!! She is in a 2:1 staff ratio philipino carehome which gives her fresh made ginger tea, not sure if warm.. kiwi, lots of veggies, steamed, Etc she gets magnesium, zinc, calcium supplements , has been on Seroquel for years and never had issue till the Zonisamide added two years ago( off now, on lamictal for seizures)
Her sleep never good with autism and takes Melatonin for that
She is getting more complicated as she ages, close to menopause, but the megacolon happened over time as the Zonisamide seems to have started the constipation.. being nonverbal i know it's hard for her to handle her physical issues, then the epilepsy recently was a 911 trip due to status epilepticus..
So a lot for her..
I so appreciate everyone reaching out to help me qith their experiences!
Thank you!!

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Minajo --

Melatonin gave me severe constipation a few years ago (think cement). The worst I have ever experienced.

I now take 1/2 tablet of a 300 mcg Melatonin product --"Carlyle Low Dose Melatonin 300 MCG."

150 mcg is .15 mg, so quite a low dose, but it does the trick.

It is likely most people think that Melatonin is a freebie, side effects-wise. However, it is a hormone.

This webpage reflects my understanding:
https://www.singlecare.com/blog/melatonin-side-effects/#:~:text=Melatonin%20and%20the%20digestive%20system,or%20cramps%20in%20some%20people.
Google further yourself.

If you are lucky, your daughter's constipation could be resolved by simply resetting the colon back to zero with a stimulant laxative of any sort and reducing her Melatonin dose.

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I may have replied at the wrong place. I think having 💩💩💩💩 has made me stupid (haha) So hard, seems like an understatement. I thought my CIC was horrible, but now I feel like I'm a whimp. I have been under the same GI for 17 years. I thought finally a Dr. who would help me 💩💩💩normal. Short answer is NOPE. He did say that miralax was totally safe in higher doses and long term. I don't know if he is correct... but I have no choice. I am 65, age seems to affect everything. I take 3 capfuls of miralax every day and 3-5 Metamucil gummies daily(I find the gummies to be better for me) and drink tons of water. This is what I have to do as to reduce most fecal impactions, reduce, not eliminate, constant moderate to severe fecal load throughout large colon. Prevent partial small bowel obstructions forming and prevent rock hard obstructions in anus, which required the digital removal of enough poop, to let the rest come out. The removal was done by me, 3x in 4 months. OMG!!! It hurt as bad and almost as long as one of my births. So, I keep my poop mush-diarrhea, out of fear. I know that I am taking large doses, and I have to live with the consequences. These doses may not be right for your daughter.
Has she had a colonoscopy? If yes, did it show a redundant flexure anywhere in her colon? The doctor would not necessarily have told you if she did. You would have to get bitchy and demand a full report. Most people that have this, are born with them. I didn't know I had one until I was 64, and it was the radiologist who read a CT scan, that documented it. Sending you all the strength you need and the best wishes for least pain for your daughter. Shelley

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