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Suggest treatment for IBS

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Posted on Sat, 14 May 2016
Question: How to control irritate bowl movement in older age?
My grandfather is 82 years old and since last few months he doesn't feel about when bowl has been moved? So, he has lackness of feeling as well as frequency of bowl movement is also more (~5 times). Type of bowl: little loose but not much loose.

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My grandfather is 80 years old. His He is suffering with BPH and using Upper catheter (direct in bladder) due to unable to urinate since last 4 months.

Since last 2 months he is facing problems of constipation, loss of appetite, indigestion, gas.

Doctors did Enema to clear his stomach in December 2015 but even after problem continued.

Again doctor tried to make the colonical test but his stomach was not empty, they did the Enema process on 15th January 2016. After 2 days of Enema he became too weak to doctor deny for the test. His weight is just 39Kg.

The major problem he is facing - frequency of bowel movement is very high (6-8 times daily) and he never feel about it. He lost his control on bowel movement. Everytime with passing of gas, small amount of bowel also pass.

He is using below medicines currently:

1. Eslo AT (for BP. 1 Tab daily)

2. Geriflo D (for BPH - at bed time only)

3. Rifagut 400 (2 tablets per day. For 10 days only).

4. Zinetac 150

5. Gnorm (2 tablets per day for 10 days. ended after 15 days on 20th Feb)

6. Actigut (Using since 21st February for 15 days).

doctor
Answered by Dr. Ratnakar Kini (4 hours later)
Brief Answer:
CT scan with rectal contrast / Colonoscopy

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

The altered bowel habits is recent in onset and it is unlikely to be irritable bowel syndrome.

In old age individuals with these symptoms, malignancy has to be ruled out.

You discuss with his gastroenterologist whether he is fit for a colonoscopy now.

Or else he can have a CT scan with rectal contrast done and if it shows any lesion, a colonoscopy may be planned.

I would like to reiterate that taking his age and recent onset of symptoms in to consideration I discussed about the possibility of malignancy.
He need not necessarily have malignancy, but it has to be ruled out.

Let me know if you have any more questions.
Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ratnakar Kini (2 hours later)
Thank you doctor. Have you gone through my previous question thread where I have uploaded all recent documents or should I upload it again?
Still he is too weak for colposcopy.


I have uploaded his whole report of recent treatment and medicines he is using.
He is not in a condition for colonoscopy. He has not been recovered after recent Anema Therapy.
My current gastroenterologist advised for colonoscopy but after 3 days of Anema he denied due to my grandfather health condition.
His food item:
Rice
Rice+pulse (Khichri)
Few Green vegetables cooked without gravy.
Problems in digest bread, Milk or any fruit.
So, there is no extra source of getting energy. In normal days
He has very less

1. I didn't understand your medical terms - possibility of malignancy. Can you described it little more?
2. What do we mean by irritate bowl syndrome?
3. He has some improvement in less frequency of bowl movement (4-5 times now while it was 10-12 times earlier) and better appetite than earlier. But, still same level of weakness.
4. We just want to know the way about how this weakness can be reduce and get control over his bowl movement.
5. What food supplement he should take which he can digest to get some energy.
6. In first Anema Therapy in December, the doctor's assistant used his hand in his rectum. Is this a cause of loosing control of bowl movement?

Many Thanks...
XXXXX
doctor
Answered by Dr. Ratnakar Kini (30 hours later)
Brief Answer:
Answer given below

Detailed Answer:
Hi,
The answer for your questions.
1. I said in old age individuals with recent onset of these symptoms malignancy ( cancer) should be ruled out.

2. You have discussed about the possibility of irritable bowel in the first line of your first post. Irritable bowel syndrome is a condition characterized by abdominal pain/discomfort associated with either change in frequency or consistency of stool..

6. Rectal examination will not cause these symptoms.

For questions, 3,4 & 5, treatment can be planned after diagnosis. Colonoscopy may be done.
If it is not possible stool occult blood test and CT scan with rectal contrast may be done.

Regards,
Dr.R.K
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ratnakar Kini

Gastroenterologist

Practicing since :1994

Answered : 2122 Questions

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Suggest treatment for IBS

Brief Answer: CT scan with rectal contrast / Colonoscopy Detailed Answer: Hi, Thanks for posting your query. I am Dr.R.K and I am pleased to assist you. The altered bowel habits is recent in onset and it is unlikely to be irritable bowel syndrome. In old age individuals with these symptoms, malignancy has to be ruled out. You discuss with his gastroenterologist whether he is fit for a colonoscopy now. Or else he can have a CT scan with rectal contrast done and if it shows any lesion, a colonoscopy may be planned. I would like to reiterate that taking his age and recent onset of symptoms in to consideration I discussed about the possibility of malignancy. He need not necessarily have malignancy, but it has to be ruled out. Let me know if you have any more questions. Regards, Dr.R.K.