Hi doctor,
My mom is 83 years old. She had a bad fall 1.5 years ago and suffered with a head injury with little internal bleeding and a broken arm. While in hospital, she contracted C. diff and has had several recurring bouts with it. She has had a transplant and so far she is doing well with no recurrence. She also has a fistula near the rectum from an abscess. They put in a tube to keep it open and flowing. She has always had bouts of constipation and diarrhea for years before the accident. Her cognitive functions have been diminishing. One of my brothers is living with her and care taking her for full time. She is very weak, but can walk with the aid of a walker. Before the accident, she was fine. But, she may have shown a few signs of slight memory issues and balance prior to the accident as well. Our main issue right now is loose stools with some fecal incontinence.The doctor said that the fecal incontinence is because of a weak rectum that will not hold back fecal matter. Also, the fistula is always draining. When her stools are normal, she has good energy and cognitive function. When she has loose stools, she is very weak and can hardly stand or walk. Her cognitive function is a lot worse. She gets very confused about daily items and memory issues. We are looking for supplements to keep her regular and avoid the loose stool episodes. These are recurring every other week. Being so weak at the time of an episode, the toilet and the surrounding area get very filthy. She has little control and not able to clean herself properly. Her diet is pretty good. We are trying to keep dairy items away, limiting sugar and some carbohydrates as best as we can. We are giving her Metamucil when she has loose stools as well as some ammonium. This seems to have very limited success. She is on a blood pressure medicine as well as on Coumadin. So, we have to watch for interactions between everything. Regarding supplements, right now she is taking Alpha-GPC, Prevagen and multivitamins B for cognitive help, Fish oil, turmeric and Centrum multivitamins. Any help or suggestions to prevent the loose stools without creating constipation would be appreciated. I would also like to increase her core energy, so she will feel more like moving around. We have a physical therapist at once a week.
Hi,
Welcome to icliniq.com.
I appreciate you seeking help for your mother. Well, after having gone through the case history as described, it seems her fecal incontinence is mostly of neurological origin. In the given context, I would advise that she would be clinically examined by a neuro physician first and treatment recommended appropriately. Also, self-administration of any supplementation should be avoided. For her cognitive, memory, weakness issues and health balance you can include a BRAT (banana, rice, apple, toast) diet, which will likely help improve her present diarrhea or fecal incontinence issue. Make sure that she stays well hydrated too. WHO (World Health Organization) recommended electrolyte drinks can be of help. Supplementation with probiotics (especially lactic acid bacillus) is advisable for optimum gut health. Intake of fibrous vegetables and fruits too will help. Please ensure that the food is cooked well before consumption and you can use fresh turmeric freely while preparing the dishes. You can try giving her two teaspoons of psyllium husk or fiber, mixed thoroughly in a glass of clean drinking water, preferably warm, once daily, in the morning and see if it helps improve her loose motion issue. Try avoiding laxatives as this may worsen the loose motion or diarrhea. You can give her a good supplementation of vitamin B containing vitamin B12 and alpha-lipoic acid subject to her neurologist's concurrence.
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