Hi all,
My Dad has issues with his bowels, always has. He has been bowel obsessed and constipated most of his life. The reason I know this is because he was bowel obsessed and he had no problem letting his children know he was constipated. Asked us every day if we'd had a bowel movement. If you missed a day, you got an enema or suppository (administered by my mother so we were spared that series of humiliations of my father doing it).
Now, he's quite old and vacillates EVERY DAY between constipation, the runs or both in one day. He does not have the mobility or speed he once had so now these are MAJOR issues surrounding getting to the bathroom in time. I've tried every version of the IBS diet, low fodmap foods, etc. and this just seems to be his system.
The problem is he has made his bowels my responsibility just by virtue of not being able to control these issues himself anymore. And I do not want to clean up that mess every day.
What do I do? A gastroenterologist? His pcp (almost worthless)? Or is this just what happens to old people and their systems?
Help!!!!
Thank you, in advance :)
Definitely consult a GI doctor, though, because yes, a PCP is useless.
she decided at memory care she wanted cheerios for lunch , diarrhea went away … simple diet change
go to a Gastro doc…
You could take your father to a gastro specialist it couldn't hurt. If you've done all the special diets and everything else, there's probably not much they will do for you. I've been an in-home caregiver for a very long time. I had to get out of it because I just couldn't take the piss and sh*t anymore. I've had almost 25 years of it though. This being said, there have been many families over the years who I worked for that had their elderly living with them. For the most part they were wonderful and caring people who really wanted to do right by their elderly and tried their best to. Many of those elders ended up being placed in care because the family just couldn't deal with the incontinence anymore. They couldn't take one more day of living in a house that stank to the high heavens 24 hours a day. Or furniture and carpets stained with piss and crap. Or one more stinking load of bedding or clothing soiled with incontinence. None of these people were bad people. They had to place their elderly loved ones though. It won't make you a bad person if place your father because of the incontinence.
I remember a client from years ago. She lived with her daughter who I became very good friends with and still am. I came into work one day and the stink hit me in the face the minute I walked in. This was a daily thing. There was her elderly mother in the recliner (she slept in the chair). Everything was pissed and crapped through. It was all over her, the chair, the floor. Her daughter had been begging her for two hours to please get up and she'd help her wash up. The mother was stubborn and refused. The choice was clean up or leave in an ambulance. She didn't think we'd do it, but we called. My friend was beside herself.
I helped her find a decent care home for her mother to be placed in. It meant that I lost that job, but it was the right thing to do.
I think it might be the right thing for you to do for your father too.
I just chuckled to myself. She has NEVER changed an adult diaper or wiped an elderly butt. She is someone who GAGs if she has to scoop dog poop out of the yard. Also, for a few months, she and her spouse were discussing moving out of state, which would have left her sister doing all the heavy lifting in taking care of their parents. I told her she could kiss her relationship with her sister goodbye if she did that (they are very close).
Good luck with a difficult problem but one that can be managed, hopefully, better than it is being managed now.
I would recommend, that if you have not already done so, that you get your father medically evaluated so you have some idea of what is really causing his issues. For example, if there is a co-morbidity or underlying disease that can be addressed or whether this is someone who is "wearing out" from age. The course of action might be different depending on the answers to that.
Thanks for all your suggestions, I really appreciate it!!!
If he eats sugarless candies that can cause terrible diarrhea due to the indigestible sugar will accumulate water in the bowel turning into explosive diarrhea.
The chances are that your father has various pills, potions and suppositories hidden away, and is still on the merry-go-round. People don’t give up a life-long obsession easily.
You may or may not know that the US culture was (at least in the past) notorious for this obsession. Long ago my first husband worked in London with a visiting young US couple. Judy’s mother asked about her bowels in every letter. When Judy wrote back saying that she was fine and London chemists didn’t stock suppositories, her mother sent her them in the post! Huge joke at the office!
Also happens in care homes when CGs see daily BM as a sign that they are providing excellent care.
My SIL is a GI doc and he says a lot of older people are bowel obsessed, he doesn't know WHY, my own dad was and I remember distinctly living in a home with 5 kids and ONE bathroom.
There are medications to help make dad more 'regular'--and a GI will do a thorough checkup to see if dad has food issues that are causing this.
At his age he probably will not be subject to a colonoscopy, but a sigmoidoscopy may be in order. I'm not a GI, but helped SIL study enough I sometimes feel I could do a full GI workup.
Personally, I don't know which is worse, constipation or diarrhea. Both are miserable and a mess to deal with.
If you can be the one who controls what dad eats and such--you may find that he's over dosing on laxatives and then diarrhea meds.
and dairy is one of the culprits. Turns out Mom is lactose intolerant
could be gluten too but start with elimination of dairy first.
He has a lifetime of focus on something he thought should happen every - single - day! The less he moves (now) the slower the gut gets. If he takes any kind of pain med (and some others) - those slow the gut even more.
There are natural thing for him to try first. Such as flax in cereals/breads. There is ground flax you can add to foods. Papaya (if he will eat it) is great for causing a BM. Lemon juice in hot water each morning helps many people.
The meds that will probably be described for constipation by a doctor can be very harsh. Linzess is one and Trulance is another. Linzess is a capsule and even the smallest dose can create a blow out. The Trulance is a tablet - you can cut that one into 4 pieces and start off with smaller amount.
I would suggest starting with bran cereals, breads with flax, and the papaya. Those worked quite well for my parent. There is a bread called Ezekiel with flax that is great -- found in the frozen food. Keep in the freezer and take out a few slices at a time for refrigerator to keep it fresh.
crohns, IBS, ulcers and a history of diarrhea, chronic stomach pain.
She only has a third of her stomach from 2 ulcer surgeries in 1960’s & 70’s.
After finding an attentive gastroenterologist, we have her symptoms under control. Align( pro biotic), Budesonide (steroid),
mesalamine (crohns) etc, etc.
Too risky for colonoscopy or endoscopy. besides, what would we do with the information at 99….. ergo the medication that has stabilized the symptoms.
Try to find a highly qualified gastroenterologist.
Sorry he created problems for the rest of the family with his obsession.
Just cannot use it with thickener...as the Miralax and thickeners interfere with each other.
Best to have an MD determine best strategies...and as long as the current med is working and is acceptable to him...don't change a thing.
This was in a previous post by you.
"The problem is he has made his bowels my responsibility just by virtue of not being able to control these issues himself anymore."
So he was responsible for "bowel abuse" when you were a child (didn't your pediatrician or family doctor have any input?), and now he expects you to be his Bowel Master?
I am curious -- do you have siblings? How long have you have you been the elder caregiver? (I see you ended up placing your mother in MC.) WHY are you the elder caregiver? ARE you putting yourself first?
All laxatives, imodium & pepto bismal were removed from my mother's apartment. She was constantly abusing these products and almost got impacted several times.
Now she is in miralax per her primary every morning and her bowels have become regulated and stable.
Make sure he has no access to any bowel regulators and talk to his PCP. A gastro consult might be worth your while.
If none of these things work then yes, that gastrointestinal consult, but do know these problems are worse for those who suffered chronic issues earlier. Good luck.