6 Compassionate Ways to Help Your Loved One with Bowel Movements in the Hospital

“ I won’t eat until I can get up to go to the bathroom alone…. The nurses work too hard here already.” Malcolm* had been admitted to the hospital 7 days ago and was not eating. He continued to express that he didn’t want to be a burden. Since he was unable to walk to the bathroom by himself, he was determined to avoid pooping.

Going poop in the hospital is a topic many patients dread. Especially if they are stuck in bed. Some people may stop eating to avoid the need to go or hold it in, sometimes they end up hurting themselves to avoid embarrassment. Nobody wants to be known as the guy who stunk up their room. Being cared for in a hospital can already be humiliating for some, and the added stress of bowel habits can strip away any sense of dignity. If you have a loved one embarrassed by bowel movements, you may be key to helping them keep their bowels healthy. So, what can you do to help if your loved one is struggling with constipation or the very idea of bowel movements while hospitalized?

Understanding Constipation

Constipation can be defined in various ways. It is normal to have bowel movements anywhere from three times a day to once every three days. Constipation includes having less than three bowel movements in a week, having hard stools, or feeling like their bowels didn’t empty (1).

There are many reasons someone might become constipated in the hospital. People might not eat enough or eat few fiber rich foods or fluids. Medications like pain meds (opioids), iron or calcium supplements, or antidepressants can cause constipation. Less physical activity than normal, certain medical conditions, psychological stress, or hormonal changes slow down the digestive system. Whatever the reason, not having regular bowel movements will affect your loved one’s health and comfort if it’s not addressed (1).

Why Bowel Movements Matter

Constipation can lead to serious, and even life-threatening, complications if not addressed. The side effects of constipation can vary per person. The consequences can worsen over time, making it essential to help your loved one manage this issue before it becomes severe.

Commonly Seen Stages of Constipation:

Stage 1: Loss of appetite, abdominal discomfort, nausea, and vomiting

Stage 2: Development of hemorrhoids and anal fissures

Stage 3: Rectal prolapse (where the rectum protrudes through the anus)

Stage 4: Fistula (an abnormal connection between parts of the body. Ex: think a hole in your organs where there should not be one) or bowel death

Practical Tips for Support Bowel Movements in the Hospital

Your role may depend upon the relationship you have. Your loved one might need you to do a variety of tasks. This may include communicating, advocating, brainstorming, or providing distant moral support. Here are a few ways you can encourage and assist your loved one in having healthy bowel movements in the hospital:

1. Order High-Fiber Foods

Help them request double servings of vegetables or fruits with meals. Encourage them to choose whole grain breads and cereals (like oatmeal or raisin bran). Remind them it’s important to eat enough to recover.

2. Encourage Hydration

Remind them to drink enough water. Increasing fiber without enough liquid can worsen constipation. Ask for water refills and consider bringing their favorite drinks. (Remember to check with the nurse about any fluid limits though.)

3. Notify Staff About Constipation

If they are constipated, inform the medical staff. Staff typically have protocols for treating constipation.

4. Alert Staff at the First Urge to Poop

When your loved one feels the need to go, notify staff immediately so they can prepare the agreed upon room setup. It may take several minutes to position your loved one comfortably in the correct location.

5. Discuss Ways to Make Them Comfortable

Talk about what would make them feel more comfortable when needing to have a bowel movement. Some options include whether the door is open, the type of commode, your presence or absence, or even air fresheners they want available.

6. Normalize the Experience

Don’t make a big deal out of it, but mention or ask about if they’ve pooped. You might share a recent poop experience you had. You get extra points if it’s a comical story. Hospital staff are experienced and will help maintain their dignity. Avoid making a big deal about any smells or sounds; your loved one may already feel exposed and sensitive.

Common Treatment Options

- Prune juice or a mix of prune juice with soda or melted butter (it's magic)

- Physical therapy to encourage movement

- Changing medications that may be worsening the constipation

- Adding medications like stool softeners and laxatives

- Using a suppository or enema

Timing Matters: How Long for Constipation Treatments to Work?

A common concern is the unpredictability of when constipation relief will come. There is nothing like the feeling of panic and your heart racing when you need to reach the bathroom, but might not make it. No one wants to be stuck in bed when they need the toilet. Unfortunately, there is some unpredictability involved in treating constipation.

But here are general timeframes for common treatments:

The Key to healthy bowels: Communication and Compromise

Communication with staff is crucial. Often, your loved one may not track their bowel movements or food intake. Their last bowel movement may not be on the top of their mind. Encouraging your loved one to eat, drink, poop, rest, and take necessary medications is essential for their well-being. You can play a significant role in helping meet these needs by communicating well. It takes all of us working together to improve recovery.

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*I draw inspiration from real people and events for my stories, but I fictionalize them to protect privacy.

References

1.       Diaz S, Bittar K, Hashmi MF, et al. Constipation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513291/

2.     Prune juice: A nutritional elixir for Digestive Health. California Prunes. (2024, September 10). https://californiaprunes.org/articles/health/prune-juice-a-nutritional-elixir-for-digestive-health/#:~:text=How%20long%20after%20prune%20juice,4%2D8%20ounces%20of%20juice

3.       Colace [package insert]. Stamford, CT : Purdue Products L.P.; 2016

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