constipation and pd catheter

[Charli]

I just had my pd catheter put in 10 days ago.  Surgery went well. I have had some abdominal pain when urinating and I don't know what it is. It's a very very full feeling with pressure and when I go to urinate the abdominal pressure and pain is pretty bad. I sit there for anywhere from 10-20 minutes trying to force urine out and it just slowly dribble out as I'm just holding my breath from the pain.  I've heard constipation can do this, but I don't feel constipated (I don't think). I've had small (hard) bowel movements like every other day.  Can anyone tell me what does constipation pain with a pd catheter feel like?   Also, I had my first flush and it didn't hurt at all when I filled and she said tube worked great, but draining I had a little cramping (like little nagging sharp pains).  I'm nervous, cause that was just a flush and if it did that then, is the actual full fill and drain going to hurt also and will it be worse than that???  I have a very low pain tolerance.   Any suggestions?  Should I take a pain pill before I go, is full or empty stomach (food) better or worse?

Thanks,

Charli 

[Red from Canada]

Charli,  It could very well be constipation.  I learned the hard way to take my docusate sodium (stool softeners) every day twice a day.  Constipation, can ruin a perfectly good catheter.  Please make sure your bowels move every day at least once, maybe more.  Constipation can push your catheter out of position.  Your drain pain and pinching is normal and will eventually disappear.  Hang in there.  You will grow to love PD.
                                      Dennise

[KICKSTART]

Yes sometimes you think you are not constipated when you are ! A dose of laxatives wont do you any harm even if you are not , but constipation is very common! When you start to do your exchanges you will find you get that pinching pain , its usually an indicator that you're nearly empty or empty when you drain. For some people it does go away, for others it doesnt! There are 2 ways to deal with this ,if you do manual drain CAPD just shut your line off when it starts tugging , you have probably drained everything out anyway and then do your normal fill (fills never hurt). If you go on to APD (overnight machine) ask the nurse to set it to TIDAL as this leaves some fluid in at every drain so you dont get that nipping feeling. Eating before or after an exchange wont really make any difference , a lot of people actually dont feel like eating much for a while because the PD fluid makes them feel full to bursting till they get used to it , so just eat little and often 

[peleroja]

Is "going every other day" normal for you?  If you usually go every day, then you are constipated.  Also, I have found that when I have what I call rabbit pellet bowel movements I'm constipated.  Remember, just cuz you go every day doesn't mean you are not constipated.  It's the amount you are getting rid of that counts.  As Red said, make sure you take your stool softeners every day.

As for the draining, I often feel a slight ache as I near the end of the draining, but nothing painful. 

Hope you get it all worked out soon.

[george40]

I was thinking about creating a post on this but instead I will just reply. Recently, while having some draining issues the drs. kept saying that I could be constipated. Well, since I was going regulalry I felt I was not. So, I humored them and took the lactoluse as prescribed and to my surprise yes, I was constipated. This was not the ultimate reason for drainage issue but it was not helping. I would get some colace (over the counter) or talk to your nurse about something stronger if you think its needed. The over the counter stuff did nothing for me, but that lactulose (spelling?) worked in a few days.

[rookiegirl]

Is it also possible you may have a UTI (Urinary Tract Infection)?  You mentioned about forcing urine & all you get is drip drip.

As for constipation, this was one I had to closely watch while I was on PD.  I took Colace everyday and if I miss a day or my BM is not soft, I took Dulcolax or eat fruits, prunes, etc.. to keep me regular.  Even though I had a BM everyday, I was still constipated which cause my first & only Peritonitis. 

The only pain I had is during the end of my drain.  But I was doing CAPD (manual) & once I start to fill the pinch, I turned off the line.  The pain at the end of the drain for me never went away, but it didn't get worst either.  I just tolerated it.

[MiSSis]

As Rookiegirl mentioned, constipation is nothing to mess with.  I take two stool softeners before bed each evening and usually have a bowel movement sometime the next morning.  I too had a pretty bad bout of peritonitis almost 3 years ago now and based on the bug that was identified from cultures they'd taken of my fluid, constipation appeared to be the cause.  So now I don't take any chances and take my stool softeners every night.  You mentioned that you had your catheter put in just 10 days ago.  Have you been on any type of prescription pain medication?  I've found that drugs used for pain will cause constipation in some patients (I know it does for me).  So if I ever have to take a pain pill, and I'm talking something fairly strong like Percocet, etc. not aspirin or Tylenol, then I always make sure I'm taking something to keep me regular at the same time. 

I don't think doctors always think about these types of side effects and especially how critical constipation can be for a PD patient. 

As far as the pinching is concerned, I use a cycler at night and don't have any problems but if I ever have to switch and do any manual exchanges, I notice a tendency toward the ache and pinch during the end of my drain. 

I'd also probably mention to your PD nurse or the doctor about the pain your having when peeing.  It's not a big deal really for them to check for a UTI infection and if you do have one, you need to start receiving treatment soon.   

[george40]

hi again, when I first got my catheter I thought I was having some sort of infection because of the pain I felt when urinating. Sure enough as the catheter settled, so did the pain. I would definitely tell the nurse or dr. But it could be where that catheter is sitting right now. Early on mine was sitting on a sack or nerves and all I had was pain especially on drains. The silver lining is that if it is this sort of thing, the pain will subside as things shift and settle. Hang in there.