Serving Skagit, Island, San Juan, and Snohomish Counties
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Palliative Pearl:

Palliative Pearls – “Be a hero: Make S**t Happen”

July 2020 – Deliver a one-two punch:  increase gut motility and stool moisture with scheduled meds.

Constipation is predictable.  Think hospitalization, immobility, newly prescribed opioids, traveling, hot weather.

Constipation is miserable.  Be a hero.  Prevent it.

Simple advice may be all that’s needed: “Take 1-2 prunes and an extra glass of water with every dose of pain meds.”

For higher risk patients (prior constipation or hospitalized), we

use twice daily senna (up to 8 tabs per day) AND daily miralax or lactulose.   In the hospital, prn is not good enough.

For already constipated patients, consider how quickly you need to get results and whether there is a need for rectal disimpaction.  Fast acting meds include methylnaltrexone (for opioid induced constipation), bisacodyl suppositories, enemas and oral magnesium citrate.

For more information contact Dr. Leslie Estep or Dr. Anita Meyer at Hospice of the Northwest, 360-814-5550, or  or

About Hospice of the Northwest

Hospice of the Northwest is a skilled, caring and compassionate team of nursing, medical, social and spiritual professionals, volunteers and generous donors. Together, we provide comprehensive care and comfort for patients facing serious illness and the loved ones who care for them. We’ve been serving the residents of Skagit, Island, San Juan and Snohomish Counties since 1989.

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