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Dr. Andrew Rynne

Family Physician

Exp 50 years

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My 99 year old mother, who lives with my sister,

Answered by
Dr. Anders Mark Christensen

General Surgeon

Practicing since :2016

Answered : 872 Questions

Posted on Wed, 23 Jan 2019 in Elderly Problems
Question: My 99 year old mother, who lives with my sister, is confined to a walker and wheelchair. She is incontinent and has also had big problems controlling her bowels, which coupled with her lack of mobility, has resulted in “accidents” before she can reach the toilet. Because of very painful constipation, she had occasionally taken Miralax. That has contributed to her “accidents,” but until last week those problems had occurred in the home. But Christmas Eve day, while at the hairdresser, she had a very public accident in the bathroom there — soiled clothes and underwear, with a half hour needed to help clean up her and the bathroom. Very humiliating for her, very embarrassing for me (no son should have to see his mother with her drawers down). So we immediately took her off Miralax and substituted more high fiber foods in her diet. Then she had another accident at home yesterday. Exercise is out of the question due to her age and immobility. More liquids are problematic because of her incontinence and because of the high fall risk when she goes to the bathroom at night; one time in the middle of the night she fell and gashed her head open, and Christmas night she fell and raised a large hemotoma on the back of her head/neck, which necessitated a trip to the ER.
Has her GI tract/digestive system deteriorated or regressed to the point where she will alternate between constipation and explosive bowel movements? Should we take her to a GI specialist? Given her immobility, can anything really help?
Answered by Dr. Anders Mark Christensen 55 minutes later
Brief Answer:
There may still be remedies

Detailed Answer:
Hi Goodbywlf,

I am sorry to hear about your mother's troubles. Being completely immobilized carries many issues as you point out, and alternating diarrhea and constipation is not uncommon. I suggest a high fibre diet as you mention, as this tends to solidify the stools without causing or exacerbating constipation. Furthermore, I advise you to see a gastroenterologist or a colorectal surgeon, as surgery with a permanent stomach may be a solution, unless your mother is very ill and fragile.

Hope this helps. Please let me know if you have further questions.
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