enlarged prostate , constipation, and pain

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i am full-time at home caregiver for my dad, age 81, in end stage vascular dementia and alzheimers.....he has quite an elarged prostate, and he is always constipated and/or blocked in his rectum.....i have to give him enema's to keep his bowels clear, as clear as i can get them.....he cannot use the toilet, wears diapers.....he cannot communicate verbally at all......it is hard to evaluate pain levels.......my question is this: with an enlarged prostate, is there pain? where is the pain? when does it occur? .....anything you might want to tell me....it is hard to ask a definitive question, as there are so many....being a woman i have no experience with this area, so i am calling on the boys for help............ps.....he eats very well.....he does not take any pharmaceuticals, at this point......he is taking some magnesium hoping to help with contispation......okay....if you need to know more, please ask....i could use some help.

thanks so much.

kim

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12 Replies

  • Posted

    Enlarged prostate is not likely to be source of pain.

    Did you consider stool softeners and/or mineral oil to alleviate constipation?

     

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  • Posted

    The most common and likely symptom of an enlarged prostate is difficulty unrinating and bladder retention. Given that he can't communicate, you should have his bladder checked (simple ultrasound wand) to make sure he isn't retaining a lot of urine which can be serious. If he's not, then its probably not bothering him much or at all.

    As for the constipation, the stool softener that was recommended might help, as could a strong probiotic.

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  • Posted

    Hi Kim Sorry about your dad, Alzheimer's is such a miserable disease. The only pain I get from the the prostate is when sitting down hard chair or driving a car but everyone is a little different. Maybe it hard for you to tell but how is his urine stream? Decent flow, weak flow dribblle? Do you check him for UTI once in a while? Slow urine stream could cause that.

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    • Posted

      his urnine flow is spotty....it is hard to get started, i usually encourage the flow by massaging his lower abdomen...once started it is not a good flow.....he also seems to be struggling when he urinates....not sure if it is pain...discomfort......he grimaces a lot and grunts and cries out a bit, not alarmingly so.....but because of his inability to communicate verbally it is difficult to tell what is going on......i have checked for uti....nothing so far....but perhaps another just in case...it seems like his scrotum is very sensitive...but again, i am just guessing......thanks for replying......and yes, alzheimers sucks.
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    • Posted

      Sounds like typical BPH symptoms. A full time foley catheter is really uncomfortable and I don't recommend it - but if you're this involved and he's OK with it, you can try learning how to self cath (in this case you would do it) which might be less painful and would empty him completely.

      Does he still understand enough that you could pose this to him as an option and get a yes or no?

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    • Posted

      no. he cannot answer questions....also, it might be hard to get a cath in there....without securing his hands! he grabs and holds on to anything he can.....do you think the enlarged prostate could also be blocking his bowels? the prostate is pretty big.....it makes it tricky to get an enema in there.....

      thanks for talking......i am mostly seeking to understand his pain levels.....just so difficult to determine.....meds are troublesome because of all the side effects building up over time....and any sort of surgery is out of the question....we cannot even get him to the docs.....he is on hospice now....maybe i can ask the nurse to try the catheter.....thanks so much.

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    • Posted

      Constipation is a common side effect of advanced age but its hard to know if the prostate is playing a role - typically with BPH it doesn't, but that doesn't mean it might not be making the "last mile" worse. Fiber laxatives and stool softeners could help. Regardless, any procdure that could help is almost surely not indicated given his condition.

      I will say a prayer for you - I can't imagine how difficult your life must be and how difficult your Dad's is.

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  • Posted

    If he can get a prescription for FloMax and he will take it, you may try it for several weeks to see if it would help.  The worst side effect is that it may complicate cataract surgery later but probable not a concern in his condition.
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  • Posted

    If your dad has "retention" that could cause "pain" and being uncomfortable, as well as, his constipation...In each case, his brain nerves are telling him he "needs to void" , but in both cases he can't control it and void...A REZUM procedure may help him resume normal urinary voiding by reducing the prostate's overgrowth and size, as well as, reducing retention....I'm 73 years old and it helped me..

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    • Posted

      hi...thanks for writing.....we are in a difficult stage, because i am not sure he coudl with stand any type of "procedure".....i am getting the feeling, though, that he may be uncomfortable....and thanks to all you fella's......for your sharing......i don't like to use laxatives often, only in emergency, so i have really been working on getting him super regualr.....juicing, fibers and such.....today he was great....but i did use a laxative yesterday evening and he is all cleaned out, so much more comfortable......and he does seem to be passing urine easier.....or at least no discomfort........i think it may just be a big continuous circle....my main concern is keeping him comfortable...thanks...

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    • Posted

      Constipation can definitely make peeing more difficult and even trigger retention. You may want to consider being less restrictive on laxatives if diet mods aren't working. Retention requiring a trip to the ER and a Foley catheter would probably be much worse for him than anything a laxative could do

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