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Old 06-05-2004, 10:25 PM   #1
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Loose, mushy stools

I'm an lpn who's been taking care of the same patient for 12 years. We've been able to work through every bowel change she's had, until now...She has frequent motility problems d/t a seizure disorder, and is on a sse schedule of 3x's a week. About a year ago, she began with increased incontinence, of loose, mushy stool between normal, soft-formed enema results, and has progressed to where all her stools, enema + inc, are all loose, and mushy. (except when we added too much fiber to her diet and she got constipated) Over the last few months, We've tried: adding benefiber, d/c'ing colace, d/c'ing the miralax she was on, adding oatmeal w/ friut/applesauce, adding wheat/bran flakes, banana, limiting dairy, etc.,etc...(not all at the same time, of course). She was also placed on a new anti-seizure medication, Lamictal...which didn't help her stool problems much either. We have been trying everything we can think of to get her back to normal (her normal), without much success. I've suggested getting a specialist's opinion, but it hasn't happened yet. Any ideas out there? Metamucil would probably not work with her and her motility issues, and we can't get any more h20 in her than we are already (she's primarily gt fluid fed with 2 small po, pureed, regular food meals a day).
Any ideas would be much appreciated.

 
Old 06-06-2004, 08:06 AM   #2
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Harry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB UserHarry HB User
Re: Loose, mushy stools

It appears you have covered alot of her your patient's problems.

The only suggestion I have is that all the food that you are feeding her except for oatmeal is insoluble type of fiber or no fiber. To bulk up her stool you need more fiber that absorbs fluid. I certainly would try psyllium, grains other than wheat --like rice and grits, root veggies.

Bananas, applesauce, wheat bran, Benefiber, Mirilax, Colace all just pass through the intestines or produce the kind of stool you describe and dairy products contain no fiber. Oatmeal is the only item that is a water absorbable fiber --- I think you need more balance. If someone posted that is what they were intaking--- you don't need to tell me what kind of stool they are having --- I would tell you exactly what you descibe but very much looser.

To get a firmer stool you need just need more water soluble fiber.

Harry

 
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