try doing a little mini colonic (sold at drug stores); he is likely de-hydrated internally, if there is a good colonic place around it would help. manual extraction might help, but certainly won't cure the problem. i've had to do it on myself, but now i flow freely; it is a brutal thing go through when you can get rid of your waste. the underlying problem is the dehydration and possibly worms or bacteria. there are really good products out there for para/bowel cleanse. lately i have found just a little vinegar with warm water in a syringe up the anus does the trick. i feel for you and the patient and i wish you the best of luck, get me a message back if you don't understand what i'm saying.