Question:
Female, 22 years-old, Unknown subtype
I’m concerned about gastroparesis. I give my daughter one stool softener a day. Ok with her doc. She does not empty her stomach without picking at her bottom to stimulate. How do I address this issue?
Nurse Lynn’s Response:
This is actually very common for our individuals to rectal pick/dug when they feel that they need to have a BM and it doesn’t easily come out. Clearly there is a danger that this can result in rectal ulcers or other infections.
- -Keep a log of daily BM’s (post it in the bathroom) and use the Bristol stool chart also.
- -Exercise will help promote peristalsis.
- -Perhaps a different or increased dose of stool softener? I’m not sure what she is currently taking. Some people also include a daily probiotic.
- -Try to encourage a schedule even if she doesn’t feel the need to go, just sitting on the toilet.
- -Is she getting an adequate fluid intake along with a well-balanced diet?
A colonoscopy may tell us if there is any structural abnormalities in the colon. You mentioned that she “does not empty” are you referring to gastroparesis? Was a diagnosis made through testing? There are Motility clinics that may also be able to help before a colonoscopy or upper GI is performed. I think that you may be on the right track in stating that the problem is not with the colon structure rather complications of decreased intestinal motility and delayed gastric emptying. A colonoscopy may be needed in the end as part of the process of a full understanding of what the problem is.
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Jennifer Bolander has been serving as a Special Education Specialist for PWSA (USA) since October of 2015. She is a graduate of John Carroll University and lives in Ohio with her husband Brad and daughters Kate (17), and Sophia (13) who was born with PWS.
Perry A. Zirkel has written more than 1,500 publications on various aspects of school law, with an emphasis on legal issues in special education. He writes a regular column for NAESP’s Principal magazine and NASP’s Communiqué newsletter, and he did so previously for Phi Delta Kappan and Teaching Exceptional Children.
Evan has worked with the Prader-Willi Syndrome Association (USA) since 2007 primarily as a Crisis Intervention and Family Support Counselor. Evans works with parents and schools to foster strong collaborative relationships and appropriate educational environments for students with PWS.
Dr. Amy McTighe is the PWS Program Manager and Inpatient Teacher at the Center for Prader-Willi Syndrome at the Children’s Institute of Pittsburgh. She graduated from Duquesne University receiving her Bachelor’s and Master’s degree in Education with a focus on elementary education, special education, and language arts.
Staci Zimmerman works for Prader-Willi Syndrome Association of Colorado as an Individualized Education Program (IEP) consultant. Staci collaborates with the PWS multi-disciplinary clinic at the Children’s Hospital in Denver supporting families and school districts around the United States with their child’s Individual Educational Plan.
Founded in 2001, SDLC is a non-profit legal services organization dedicated to protecting and advancing the legal rights of people with disabilities throughout the South. It partners with the Southern Poverty Law Center, Protection and Advocacy (P&A) programs, Legal Services Corporations (LSC) and disability organizations on major, systemic disability rights issues involving the Individuals with Disabilities Education Act (IDEA), Americans with Disabilities Act (ADA), and the federal Medicaid Act. Recently in November 2014, Jim retired.