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Hello-constipation is a common complaint, especially among the elderly. As we get older, the normal motility and functioning of the intestines is altered. Additionally, chronic medical conditions and regular use of prescription medications can affect the bowels. Of course, intestinal conditions can also develop that affect bowel habits. In Anna's case, Diabetes is likely contributing to the obstipation, as it can cause a sort of intestinal neuropathy. You mentioned using "standard laxatives" and Metamucil, as well as miralax. Some therapies, such as colace, have very little effect. Miralax is an excellent choice for chronic constipation because it is gentle and safe. However, in cases of severe constipation more is needed. In your wife's case, she will need to get "flushed out" and then begin a regular regimen of aggressive constipation control to prevent the problem from happening again. I would suggest a bowel prep or half a bowel prep (like she would take for a colonoscopy) to begin with (she should be considered have an x-ray taken first to ensure he does not have an obstruction). Once she's cleaned out, she could try Miralax 2-3 times daily titrated to effect. Dulcolax could be added every few days of this is not enough. She consult with her doctor prior to beginning a new medicine regimen to ensure it is safe with her other medications and medical conditions. If she's not had a colonoscopy, this should be arranged. Any symptoms like blood in the stool, weight loss, black stools, change in stool caliber, abdominal pain or distendion, nausea/vomiting or fever should prompt evaluation. If her symptoms do not improve despite conservative measures, she may need a more tailored evaluation of the functioning of her colon.
