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    Suggest treatment for constant diarrhea

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Posted on Tue, 11 Jul 2017 in Digestion and Bowels
Question: Hi, I am searching for answers for my 83 year old father. He is a cancer survivor, bladder cancer. He had an urostomy done 2 years ago. His last check was 10/16 lungs and kidneys clear. One month ago he began experiencing leaking bowels. A colonoscopy was done and was clear. No treatment was recommended. He was active in all ways. Now last week he is week, constant bowel leakage, no normal bowel movement, loss of appetite for several days, alkphos off the charts, swollen ankles which he has never had before, short of breath, slightyly anemic. Doc put him on mild heart med and diuretic or lisinopril. He does not have high blood pressure. Prior to his urostomy he was diabetic and hypertensive but with weight loss of 60 lbs he has not required treatment in 2 years. Anyhow a chest ct scan is pending and nothing has been prescribe for the diarrhea. Doctor said not to take immodium. An appointment has been made for a gastro doc at the end of August. Hes 5ft 10 in and 130 lbs. He cannot wait until the end of August. Two weeks ago he was doing yard work and was very active. Now he just sleeps and is unsteady.

He did not take any medication for 2 years. Now he is on 2.5mg Lisinopril and something like biophosphate I think, not sure, but its for the heart I believe. There has been little improvement after being on these meds for 1 week. He has not had any heart trouble before but did have years of hypertension before losing weight and having cancer 2 years ago. He is not a smoker, but did smoke up until 1980. He does not use alcohol or any drugs.
doctor
Answered by Dr. Sunil 3 hours later
Brief Answer:
Depleted gut flora may be recurrent gastroenteritis.

Detailed Answer:
Hi,

As per your query regarding gastroenterology problem his over all digestion is poor.Digestion is the process in the alimentary canal by which food is broken up physically, as by the action of the teeth, and chemically, as by the action of enzymes, and converted into a substance suitable for absorption and assimilation into the body.
This digestion or catabolism is divided into two types –
1)the mechanical digestion of food that occurs in the mouth when it is physically broken up into smaller pieces.
2)chemical digestion that occurs in the gastrointestinal tract when the food is broken down into small molecules by digestive enzymes.This part is severely hampered in your case.

From swallowing to excretion every thing is a part of normal digestive process.

Now lets come to your problem one by one-

Our gut consists of communities of good bacteria responsible for proper fermentation and food digestion. However, when these good bacterias are destroyed, food is partially fermented causing the release of gases. Take a probiotic like vizylac daily.The pathophysiology of gas and bloating flatulence is complicated. Understanding gut microflora, gas production, intestinal transit, intestinal propulsion of gas, and sensory function within the GI tract are essential for understanding symptom generation.The term gut microflora or microbiota means hundeds of species of bacteria which lives in our intestinal tractintestinal tract.These bacterias and yeast are responsible for proper digestion and fermentation of food. Hundereds of species of bacteria and yeast re found in colon of human intestine.In the same way thousands of these species florishes in our gut these bacteria play a vital role in digestuion and absorption of food.Even minor disturbances in gut microflora can lead to significant changes in gut function, including gas production.
There are various mechanism that can be related to recurrent loose stools

As told above If this microbiota is disturbed food is improperly fermented causing production of large amount of gases in gut leading to severe flatulence indigestion and diarrhea.Hence most common cause in most of the cases is disturbed microbiota.

Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestines causing improper and disturbed food digestion.


Medication suggested-( you will get all of them on prescription)
Tab norflox TZ(antibiotic) 1 tablet twice daily for 3 days.(Some time patient is suffering from chronis recurrrent gastroenteritis it would help eradicate bacterial or protozoal infection).
Cap Vizylac twice daily for 14 days(probiotic)
Tab Spamindon(dicyclomine0 twice daily for 5 days (for spasmodic pain).
Syrup aristozyme(external digestive enzymes) 2tsf three times a day(to improve digestion).

Follow up after 7 days.

Test suggested are -
Stool routine and microscopy
Ultrasound of abdomen
Stool culture
Taking medicines with life style modification will help you a lot.As overall digestion would improve things would be better from gastroenterology side.
Hope i answered your query well.

For any other suggestions kindly message me his ekg 2d echo and other investigation reports.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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