Wednesday, 3 October 2012

Constipation, a Kidnapped Diplomat and an Enema

My husband is a retired diplomat.  A colleague from the service, Bob Fowler, had the terrible misfortune of being kidnapped in Mali and wrote a book about his awful experience called "A Season in Hell".  Bob tells a story in his book (and one recounted in even more vivid detail at our dinner table one night last year) about the constipation he suffered in the desert while in the hands of terrorist captors.  Bob actually thought he was going to die on account of his bowels because he could no longer take in water without vomiting.  He was dangerously dehydrated.  Bob described Louis Guay, a fellow Canadian diplomat and fellow captive as a magpie who collected bits of rubbish on their long treks through the desert wasteland.   When Bob's constipation became so advanced that it constituted a full-blown emergency, Louis' little collection of discarded items became life-saving equipment.  Louis filled an old plastic shopping bag with warm, soapy water.   An empty plastic 'bic' pen casing attached to the plastic bag full of warm, soapy water became the vehicle for an enema that served to save Bob's life.


Last week, our doctor gave an order for a 'soap suds enema' and I discovered that Louis and Bob pretty much had it right, except that most shops that carry home medical supplies sell a kit for the purpose.  If you want to try this, you won't need to use a bin liner and pen casing.

If you are a caregiver who is new to helping someone with constipation, here are my top tips.

1) Don't be afraid to talk about constipation.  If a person has not moved their bowels for three days or more, they will feel nauseated.  If days continue to pass without any bowel movement, the symptoms of bowel obstruction can occur and this very dangerous for your charge.  Anything taken by mouth, including water, will just come back up and the person will quickly become dehydrated.

2)  To treat chronic constipation, the rule is 'push from the top' and 'pull from the bottom'.  Pushing from the top means what you are ingesting - it should be lots of fluids and fibre.  Here's a great article called "Ten Foods to Make You Go".    If you still feel bunged up, try oral medications to promote better bowel function.  Ask your doctor or pharmacist which one is best for you.

3)  'Pull from the bottom' refers to suppositories and enemas.  Don't be afraid of these, they can be your best friend, because if your charge is unwell, you will be unwell too (with worry!).  Glycerine suppositories are easy to administer (always remember to use rubber gloves) and they often work with very little discomfort on the part of you or your charge.  Otherwise, try a fleet enema (they come packaged in easy little bottles with applicator tube attached and are available at all drugstores).  Never use these products on a regular basis without telling your doctor, though, because constant use of enemas can contribute to a 'lazy bowel' and a dependency on the procedures.

Bowel health and digestion are just like any other health concern, but it's one area that we sometimes don't like to talk about.  And if we stay silent, it could have nasty consequences for someone we love who is under our care.
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