This subject doesn't quite fit the incontinence thread, so I will start a new one. My DW has been plagued with loose stools that primarily soil her underpants (with a pad) but not a great deal of volume. For some time now and I have been treating her with anti diarrhea medicine, but long story short, a friend mentioned she may have a rectal blockage. I looked it up on the net and the description was exactly what she is going through. Watery stool passing around a blockage with the appearance of loose diarrhea. Here all along I have been treating her for diarrhea instead of constipation! I started her on Miralax and so far so good, but I'd like input if anyone else has experienced a similar situation. Any long term solutions....Marsh are you out there? DickS
The question is - what is causing the blockage? It might just be a hard, constipated stool. In which case the treatment would be an enema. Laxatives might do harm if the blockage can't be moved. Most of these blockages are close enough to the anus to be felt with an examining finger (not by you, but by a doctor or nurse). Another possibility would be a tumor (cancer) of the rectum. The way to check on this would be with sigmoidoscopy or colonoscopy. Before trying anything yourself you should check with her doctor.
I agree with marsh. This is no time to guess about the problem which could become even more uncomfortable. I would see the doctor of the visiting nurse should address this if you have that. My mom developed this problem during her final stage and it was so sad. I would suspect somehow that "signal" that says I need to visit the bathroom doesn't quite work right now. If this goes on too long, your wife could endure some extremely painful cramps. Pleas contact your doctor soonest thing.
I have been told by the Hospice Nurse that when our AD spice do no walking and just sit or lie all of the time, that they get constipated from no movement and that their bowels should be watched closely to prevent blockages. My husband's are working fine....and I refuse divvi's crown...she gets to keep it!
Thank's everyone for your comments. I am working with a specialist (Gastroenterology) and he is the one who suggested the Miralax. We discussed a colonoscopy, but he ruled it out for the present......no pain or bloddy stools. He has ordered a CAT scan, of her stomach and bowels, which will take place in the near future. Mary, that's a great comment on the lack of movement causing constipation....never thought of that!! She has always been very regular. Would like to hear from anyone else with similar problems. DickS
Dick, Miralax worked great here as long as it was taken on a daily basis. It was stressed to me by our Doctor to continue with daily basis was very important, so it was a regular morning med here for dh and my Mother.
Imohr, Did you give a full dosage daily? Did this result in normal BM's ? Any concerns about dependency on a laxitive? (Not that it should matter......what is worst than AZ) DickS
I gave the almost cup full daily - mornings. I was not worried about dependency. When occasionally, loose stools appeared I would reduce or omit that days then pick it up again soon. Good product.
Phranque: when I was growing up harvesting Cascara bark aka chittum bark was a way my brother and I made some summer money. Once the swamp dried out we would go harvest it (the trees grew in the swamp). We would spread it out on the metal roof over the woodshed then sell it to the feed store. When we chewed on it we knew we got diarrhea, but it wasn't until years later I realized what it was used for. The native plant nursery I do bookkeeping for sells it.
'Commercially called cascara sagrada which means sacred bark in Spanish. The much more pertinent name chitticum, which means shit come, but old timers call it chittum bark.'
We are now in the Palliative program and the nurse recognized the symptoms of blockage right away. My dh was having bm after every meal and some watery. I was giving him more fiber which helped make the stool more solid but found we did not get out the stuck stool. Dh is now on a stool softner (very, very bitter) and Miralax. The nurse has given him two Fleets and still nothing seems to get rid of that sucker. Other stool seems to go around it and come out. Not being able to put him on the pot does make a difference. He can't push to help either.
not a fun subject but necessary one. and of course i have had alot of input in this dept ... :) in my experience, fleet enemas and or 'manipulation' in the lower colon area are essential to help release the blockage. we have had a couple as well and omg you wont believe what they can store in there once the blockage opens. in my opinion it can grow toxic as well left over time but thats my own opinion. if you suspect blockage with the bm occuring as indicated above with small bm after meals and or watery, it should be reported to dr and if possible have a nurse out to get them 'going; again. it may take time to get this working but if its not high up in the colon or something other than blockage, usually they can manipulate it into release. a bit uncomfortable to the patient but worth it after. my DH sleeps so much better and you can see the relief immediately in their demeanor. we use the enemas as needed and Senokot S every other day to keep stools soften so they dont dry out. alot of this is caused by dehydration as well. get them on a regime of as much fluid as possible to help divvi
While we are on the topic, I have noticed a couple of times our toilet wants to overflow and I am suspicious that DH is having a bit of problems in this area as well..My Dad, God love him, used to clog up the system with a supply that I could hardly imagine! I am wondering if this is what might be going on..DH says he is not corked up but there are days I do wonder.. I am tempted to start to slip a little Metamucil in his food like I have to do for the cat...any thoughts?
metamucil and or miralax type products need to be followed by lots of water. they tend to swell and need plenty of liquids following doseage. i really like the ones with stool softeners built in. much easier and works nicely.
Brindle, you should check with your doctor. The "blockage" could be due to a rectal or low colon cancer. But you also have to decide what you would do about it if that is what it is.
Thanks. The nurse has done the Fleets a couple of times now and lots came out. You wonder how so much can be stored. He used to have such large bm's that I could not flush and had to take them out of the toilet and put into the trash! Recently began giving stool softner liquid and wow is that bitter tasting. Also is on Miralax. The nurse will check every week to make sure he is clear. No wonder he was grimacing. The redness on the rectim is also gone. It was so sore! The nurse returns on Monday. I remembered that last yr I took dh in twice because of no bm's and they did the xray and showed that it just was not moving and he ended up drinking this hugh container of liquid to get it out. Now that dh is bedridden, I think this is going to be something to watch.
My husband has a lot of trouble with constipation (sometimes swinging to diarrhea) from the Parkinson's symptoms that go with Lewy Body Dementia. Taking Metamucil, stool softener and a half dose of Miralax every day has helped a lot (and doesn't contribute to diarrhea). It is safe to take Miralax long term. If he gets blocked up he has found the Magnesium Citrate sold for people doing colonoscopy prep works better for him than an enema. But he did once have to go to the urgent care center for manual extraction (something which some caregivers learn to do themselves). When we renovated our house I made sure to put in toilets with maximum flux capacity--they have improved toilets dramatically in that respect in recent years, particularly compared to the first low flow ones.
Problem is my dh now bedridden cannot push to get out the bm. Luckily, this nurse goes in and gets as much out as possible (by hand). Did not know about the max. flux capacity toilets. Good thing to know. I wonder how expensive they are. Do you have to do anything different to the pipes in the house? Miralax is good as it disolves so well in water or other liquid.