
Suggest Treatment For Chronic Diarrhea

Need more clarification
Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.
Would you please clarify a few things for me?
- how old is your father?
-why is he bedridden? For how long?
- does he have any other medical conditions? Is he on any medications?
-does he talk, respond, converse and recognize everyone in your family?
-is he allergic to anything?
-can he feed himself? What kind of food does he have?
-does he have any other symptoms like fever or abdominal discomfort? Vomiting?
-has he had any surgeries or accidents/falls?
-was he a smoker or an alcoholic?
Please get back to me with the above requested clarifications so that I may help you further.
In the meantime, check to see if you introduced any new food itemnor different in his diet before this started.
Make sure he is adequately hydrated. (urine should be light coloured or if he is on adult diapers (about 6 soiled diapers a day)
An infection will usually result in loose stools rather than regular stools.
Increased frequency of passing stools is suggestive of irritable bowel. Bed ridden people are usually constipated.
However, I need the above information to give you an appropriate answer and advise accordingly.
Regards,
Dr. Shuba Hariprasad


62 years old.
-why is he bedridden? For how long?
Yes he is bedridden for about 1 and half month.
- does he have any other medical conditions? Is he on any medications?
Yes he is on medications.
-does he talk, respond, converse and recognize everyone in your family?
He don't talk because he is a tracheostomy patient but yes he do follow commands and recognizing few of us since he had head injury in the left part of the brain i.e. left basal gangalion.
-is he allergic to anything?
He is diabetic.
-can he feed himself? What kind of food does he have?
He is on RT feed but orally he is taking water.
-does he have any other symptoms like fever or abdominal discomfort? Vomiting?
No
-has he had any surgeries or accidents/falls?
Yes he met with an accident because of which he had multiple rib fractures and infarct in left basal ganglia region.
-was he a smoker or an alcoholic?
No
Some more clarification please
Detailed Answer:
Hello,
Thank you for the follow up.
Your father is a diabetic, on medicationsl.(no not her medical conditions). He had an accident about 6 weeks ago and has been on a tracheostomy and been bed ridden since then.
Is this right?
I would like some more information please:
- can he move both his arms and legs?
-does he have any bed sores?
- does he have a tube to pass urine?
- why hasn't a talking tracheostomy tube valve been placed?
-does he have difficulty eating With the tracheostomy? And weakness in swallowing (as per his doctor's opinion)?
-any change in RT feeds? What RT feeds is he on?
Has he had the diarrhea the whole of six weeks? If not, since when has he had it?
-how often do you give him RT feeds?
- please mention the medications he is on? The dose and frequency as well.
-any frothing, mucus blood or greenish color to the the stools (motion)?
-does he communicate or express any discomfort while passing stools?
-is he able to know when he passes stools?does he have control over it?
I know these are a lot of questions but it is all relevant to his Condition. Please get back to me with detailed replies.
Thanks,
Dr. Shuba Hariprasad


- can he move both his arms and legs?
His Right arm and legs have sensation but movement is not so active currently for that physio is going on since his left part of brain got effected.
-does he have any bed sores?
No bed sores.
- does he have a tube to pass urine?
yes
- why hasn't a talking tracheostomy tube valve been placed?
Tracheostomy had been placed to eject out his cough.Earlier when he was in hospital he had a huge secretion so that was taken out by suction procedure from tracheostomy tube.Now secretion is less and doctors are waiting it to remove when he will start swallowing things properly so that he can swallow cough also
.Swallowing of cough has started now as what we have observed.
-does he have difficulty eating With the tracheostomy? And weakness in swallowing (as per his doctor's opinion)?
Currently we dont see any difficulty when he is drinking water orally.No difficulty as such we have seen so far.
-any change in RT feeds? What RT feeds is he on?
Diet Chart:-
250 ml feed we are giving every 3 hourly :-
6AM:-moong daal ka paani
9AM:-glucerna powder+egg
12PM:-sabzi+roti
3PM:-sabudaana ka paani
6PM:-arhar daal
9 PM:-khichdi
12 PM:-glucerna powder+egg
Earlier we were giving milk along with egg which we have stopped when we observed so frequent motions happening.
Has he had the diarrhea the whole of six weeks? If not, since when has he had it?
He didnt have any diarrhea past 6 weeks.No idea.
-how often do you give him RT feeds?
After every 3 hours in a day
- please mention the medications he is on? The dose and frequency as well.
tab levoflox 750mg OD X 10 days
tab pantocid 40mg OD X 1month
Syp Dyrich 2tsf BDX1 month
Tab Shelcal 500mg BD X 1month
Tab Nicerwin -V BD x 1 month
Tab Dolo 650mg SOS ( in case of fever)
Tab Epsoling 100mg TDS,to contiue
Tab Cerecetam 800mg TDS
Tab Cloba 5mg BD-1/2 tablet morning
Tab Liofen 10mg SOS (in case of hiccups)
Nebulization with levolin TDS,Budecort
Medicine to control Sugar:-
Insuling lantus 6U s/c OD
Tab Istavel 100 10D
CapVibCT DS 10D
CST
-any frothing, mucus blood or greenish color to the the stools (motion)?
No such thing observed.
-does he communicate or express any discomfort while passing stools?
No he didnt show any discomfort so far.
-is he able to know when he passes stools?does he have control over it?
Yes he knows and he gives us indication by moving his legs
Its been 2 days now we have observed frequent motions are happening.Adding to this ,we are also giving him sucraphil o gel syrup.
Please see below
Detailed Answer:
Hello,
Thank you for all the clarifications.
Sudden change in bowel movements is usually due to diet or medications.
In your father's case I am of the opinion that it could be due to the levofloxacin.
-why is he on levofloxacin?
I recommend :
- stool analysis if this Continues even after 3 days after the antibiotic course is over.
- please administer vibact ds twice a day for 3 days (2 hours after or before the antibiotic- levofloxacin). See how this affects his bowel movements.
-if your made any changes to his RT feeds, try to see if reverting that will help.
-add diluted curd (home-made) to his diet twice a day
-avoid milk till this settles
As his stools (motion) is regular but with increased frequency only without any signs of infection or discomfort , I suggest an observant approach. Please consider my recommendations and let me know.
If he has any signs of dehydration (reduced urine - less than 800ml a day or dark urine), or signs of infection (fever, greenish frothy stools, mucus or blood in stools, water stools), please seek medical attention right away.
Hope this helps.
Please let me know if there is anything else I can help you with.
Wish you all good health.
Regards,
Dr. Shuba Hariprasad

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