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Uncontrollable diarrhea?
Posted: Sunday, May 12, 2019 8:33 AM
Joined: 2/19/2019
Posts: 8

My dad is completely unable to pass solid stools in any form.  So it backs up and comes out all at once after several days.  It’s AWFUL.  He cannot control himself at all, he just tried to use his urinal and had an accident on the floor.   Does anyone else have this problem? Does anyone have any recommendations?  My mom is in MAJOR denial about dad’s condition and I’m trying to get him into a nursing home because his condition has deteriorated so badly it’s become impossible for her to be his caregiver.  She even refuses to take him to the neurologist.   He has hospice come in to do his care a few days a week but he really needs a higher level of care.  I’m at my wits end.

He has been eating 2 Activia everyday and he has seen a digestive specialist.  I think he is too weak to pass his solid stools.  He had an episode last summer and I took him to the emergency room.  They had to give him 3 enemas he was so backed up.  I am afraid he´s going to get an intestinal blockage 

Posted: Sunday, May 12, 2019 8:53 AM
Joined: 9/8/2017
Posts: 2042

I recommend taking a look at his diet. What is he eating and how much fluid intake. I ensure my father consumes over 6 cups of flavored water with a bit of honey or juice (he’s probably ~135 lbs), I give him fruits daily, and pitted prunes daily (~4 prunes). We stop the prunes when his stool is too loose. Overall my father is quite healthy though.

Do you think your father might be getting not enough fiber or too much?

Posted: Sunday, May 12, 2019 9:18 AM
Joined: 2/20/2017
Posts: 17

Your dad may have an intestinal parasite, or some type of digestive condition. He needs to be evaluated by a doctor. I'm sorry that your mom is so hesitant to find alternative care for him. Regardless, he needs to see a doctor. I hope the situation improves...
Posted: Sunday, May 12, 2019 12:06 PM
Joined: 12/15/2011
Posts: 3908

Your dad needs to see a gastroenterologist.  He may have C-diff or it could be something else.  That said, there is prescription medication that can help with this problem greatly.  There are several different drugs that come in both pill and powder form which the gastroenterologist can prescribe.  Incidentally, things with caffeine, such as coffee can trigger diarrhea in elderly patients.  These drugs take about 3 days to work and then diarrhea will be a thing of the past.
Posted: Sunday, May 12, 2019 12:40 PM
Joined: 6/3/2013
Posts: 682

If your dad were continent with his bowels, would you still feel that he needs a higher level of care?

Get him to his primary to help distinguish whether the incontinence is a bowel issue or due to dementia. 

Dreamer Lost
Posted: Sunday, May 12, 2019 6:12 PM
Joined: 3/7/2019
Posts: 219

You mentioned your dad has seen a digestive specialist so am assuming they've ruled out any serious problems.  You may ask if a daily stool softener or something like Miralax would be appropriate for your dad in order to prevent the backing up.  Diarrhea is a whole different problem, if frequent and persistent, check if you can use Immodium with your dad. After that I agree with Ruthmendez in that you should watch his diet for adequate fluid and fiber intake. I also agree with MacyRose in that coffee can often stimulate the colon, at which time you may try scheduling a long bathroom visit and trying to develop a routine.
Posted: Monday, May 13, 2019 6:04 AM
Joined: 3/6/2017
Posts: 1593

It sounds like your father should revisit the GI specialist.

I wonder if he has developed encopresis. Sometimes a person can be very constipated but have liquid stool slip around the blockage. For some people, the blockage stretches the area and damages the nerves that would signal a need to go so they not longer experience the sensation that would send them to the bathroom. Dealing with the blockage won't necessarily fix the issue of incontinence depending on where his is in his progression of dementia and whether his GI track is impacted by the disease.

I agree that a SNF could be a good option. What is her objection to that?

Posted: Monday, May 13, 2019 8:07 AM
Joined: 12/15/2011
Posts: 3908

One of the drugs used to treat chronic diarrhea is cholestramine (prescription, powder form - it tends to stick to the teeth and can cause dental issues if teeth are not brushed after administration) this drug can be given dissolved in juice up to 4 times per day.  Another drug used to treat chronic diarrhea is called colestipol (prescription, pill form.)  My suggestion is that you talk to his doctor about putting your father on one of these medications.  Once you have the medicine, it should take up to 3 days to get full effect, but once the drug is working your father should not have diarrhea anymore.  I also meant to mention that eggs, in particular, can trigger chronic diarrhea in some patients, so if he is eating eggs, remove them from his diet, except when used as a binding agent in a casserole, bread or dessert.
Posted: Monday, May 13, 2019 9:46 AM
Joined: 2/16/2019
Posts: 66

It is confusing to read about stool backing up but also coming out in the form of diarrhea. Usually stool is too hard when it backs up but as someone else said, sometimes loose stool makes its way around the hard stool. That is easy to diagnose with imaging. Has he had imaging or colonoscopy or endoscopy or barium tests?

My mother had fecal incontinence. She had diverticulitis, and was on stool softeners to make sure the stool got past the narrow place in the colon, that resulted from the diverticulitis. She tended to "go" in small amounts all day- kind of the opposite of your Dad! There was poop in her clothing, bed and bathroom.

She did get a bowel obstruction and was in the hospital for a few weeks, then had a colostomy and went to rehab. The colostomy was done in a minimally invasive way with a "bandaid" incision. She is 92 and made it through fine.

If your father had diahhrea it would be a priority to check for C Diff or other infections, including parasites.  But it sounds like that isn't the issue-?  Did the GI doc think it was neurological? (I know spinal issues can cause trouble moving bowels.)

With the colostomy, my mother returned to assisted living and did not need a nursing home. These days the bags are disposable and click on so it is pretty easy.

If he does end up having an obstruction or if the GI doc finds a cause that would suggest a colostomy, just want to give you a positive view of them and let you know a nursing home is not needed solely for fecal incontinences, most likely.

If the GI doctor wasn't helpful find a better one!  Sometimes a teaching hospital is best. We switched GI docs and it made a HUGE difference. We found one who had an interest in geriatrics and palliative approaches and not only was the correct diagnosis made, but this doc minimized my  mother's suffering while addressing the problem.


Johns baby girl
Posted: Tuesday, May 14, 2019 10:49 AM
Joined: 2/26/2019
Posts: 56

Aricept is known to cause GI upset.  Is he taking it?  If so, does it or any other med correspond to onset last summer?
Posted: Thursday, May 23, 2019 4:02 PM
Joined: 5/23/2019
Posts: 99

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