Pd drainage

Kind of awkward subject but shortly after starting PD haveing trouble with constipation and low UF. Bulk laxatives and high fiber diet are not effective and may be addding to the problem.{pardon the pun}. Lactulose has been helpful but even this treatment is waneing. When properly evacuated, UF is above adaquate. Any suggestion would be appreciated. Thanks

Dear Guest,
Constipation, as you probably know, causes mechanical problems with the drainage of PD fluid from the abdomen. It is a common problem with many PD patients. It is reassuring to know that when you are not constipated your drainage and UF are good. Laxatives and diet are very important preventions for constipation, but another you may not have tried is more daily activity. Even walking every day can stimulate good bowel function. Also, some people think that if they have one good bowel movement that their constipation is resovled. But you may be so chronically constipated that it would take many days of repeated bowel movements to clear the constipation. Remember also that some drugs are constipating, particularly those with calcium so you may need to discuss alternate drugs that are not so constipating. If these simple remedies do not help, you may need to examine the flow of your drain, perhaps with your PD nurse. If you are on a cycler it is quite easy to see how quickly fluid drains each time. If the drain is brisk at first but stops long before you are completely drained, this may indicate a problem with the position of the catheter. Is the drain flow changed when you change position—from lying on one side or the other or on your back, or sitting or standing? Again this information may help examine some issues with catheter position. Have you had an xray of the abdomen—just a simple xray? If so, did it actually show constipation? Also, a fairly simple catheter dye study can demonstrate if catheter flow is obstructed, and could be done after the xray if that did not answer any questions. Hope this all helps. Very important to have adequate catheter drainage so hang in there until the mystery is solved.