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What Causes Severe Diarrhea?
Question: Hi! I have some questions about my mother in law digestive system problems. I can't describe it just in a few words. Can somebody help me with that?
Brief Answer:
Needs surgery
Detailed Answer:
Hi.
Thanks for your query.
Read the whole history and about Crohn's also.
This is a case of Symptomatic diverticulitis with infection. May not be a problem due to
This is the reason for all her symptoms and problems particularly diarrhea.
Now the findings are confirmed and she may need another surgery to get the infected segment of the bowel to be removed.
This is the only best way for a cure. Otherwise her problems will become recurrent.
Hiatus Hernia can not be operated at the same time as this is a clean operation and the intestinal operation is going to be with infection.
Discuss with the Surgeon who operated or is going to operate and follow his advise.
I think for the best outcome try to follow this::
First of all let me enumerate the factors which will help you to get the best results.
*Correction of Anemia, you need a normal hemoglobin
*Correction of hypoproteinemia. The serum Proteins should be within the normal range.
*Proper bowel preparation, mechanical cleansing with the preparation you will be given and the oral antibiotics.
*Good hydration
* Good normal mental status , the positive attitude ( please do not laugh- this helps a lot).
And go ahead as per the advise of your Surgeon.
Needs surgery
Detailed Answer:
Hi.
Thanks for your query.
Read the whole history and about Crohn's also.
This is a case of Symptomatic diverticulitis with infection. May not be a problem due to
This is the reason for all her symptoms and problems particularly diarrhea.
Now the findings are confirmed and she may need another surgery to get the infected segment of the bowel to be removed.
This is the only best way for a cure. Otherwise her problems will become recurrent.
Hiatus Hernia can not be operated at the same time as this is a clean operation and the intestinal operation is going to be with infection.
Discuss with the Surgeon who operated or is going to operate and follow his advise.
I think for the best outcome try to follow this::
First of all let me enumerate the factors which will help you to get the best results.
*Correction of Anemia, you need a normal hemoglobin
*Correction of hypoproteinemia. The serum Proteins should be within the normal range.
*Proper bowel preparation, mechanical cleansing with the preparation you will be given and the oral antibiotics.
*Good hydration
* Good normal mental status , the positive attitude ( please do not laugh- this helps a lot).
And go ahead as per the advise of your Surgeon.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your answer. Unfortunately surgery is not an option. She is 83 and 2 years ago she hardly survived the surgery where they removed part of her intestines, gall bladder and appendix. We still regret that we let it happen. Before the operation she had slight symptoms but after she rapidly went downhill. Is it anything else can help to improve her condition( reduce bloating, pain)? Is the surgery only treatment for diverticulitis?
Thank you.
Thank you.
Brief Answer:
Can try medical management
Detailed Answer:
Thanks for your feedback.
I do agree with you. Our approach has to be really humble in such elderly persons.
Yes, I do.
We do get incidental findings of diverticulosis in some CT scans where there are no symptoms.
If She gets symptom-free with the help of antibiotics and other medications, you can wait and watch.
I would advise::
If this is possible
* Admission to the hospital
*Intra-venous antibiotics, TPN (total parenteral nutrition), IV fluids, Oral locally acting antibiotics on intestines ( for diverticuitis), I would like to keep her nil orally otherwise ( this helps to give rest to the intestines). May be added probiotics and multivitamins through IV lines.
This to be continued till she gets free of the symptoms and signs.
Well you say she has come home.
This can have a very positive response. Then she can be started on oral water only and slowly to progress further with liquid diet with strained juices. This is possible in hospital only, and can avoid the surgery.
Till then continue on the oral antibiotics, probiotics, water and liquids orally ( which the patient and you all know suits her) do not try fancy market preparations at all.
WATER- best is the one which is boiled for minimum 20 minutes and cooled.
Juices and water of boiled rice/ lentils has to be strained to make it as a clear soup at home.
Well, please keep me posted and feel free to ask anything to clear the doubts. Let us all try to help Her the most.
Can try medical management
Detailed Answer:
Thanks for your feedback.
I do agree with you. Our approach has to be really humble in such elderly persons.
Yes, I do.
We do get incidental findings of diverticulosis in some CT scans where there are no symptoms.
If She gets symptom-free with the help of antibiotics and other medications, you can wait and watch.
I would advise::
If this is possible
* Admission to the hospital
*Intra-venous antibiotics, TPN (total parenteral nutrition), IV fluids, Oral locally acting antibiotics on intestines ( for diverticuitis), I would like to keep her nil orally otherwise ( this helps to give rest to the intestines). May be added probiotics and multivitamins through IV lines.
This to be continued till she gets free of the symptoms and signs.
Well you say she has come home.
This can have a very positive response. Then she can be started on oral water only and slowly to progress further with liquid diet with strained juices. This is possible in hospital only, and can avoid the surgery.
Till then continue on the oral antibiotics, probiotics, water and liquids orally ( which the patient and you all know suits her) do not try fancy market preparations at all.
WATER- best is the one which is boiled for minimum 20 minutes and cooled.
Juices and water of boiled rice/ lentils has to be strained to make it as a clear soup at home.
Well, please keep me posted and feel free to ask anything to clear the doubts. Let us all try to help Her the most.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I was thinking about her condition a lot. I am a nurse and understand some things going on. Here is my opinion. I don't think the diverticulitis is the only problem causing her symptoms. I believe she might have partial intestinal obstruction. That is why she has horrible bloating, sharp pain all the way from anus and up and not able to pass gas and stool. And she has all reasons for that: Chron's, Diverticulitis, Hernia and maybe scar tussue developed after surgery. By the way the surgery was performed because she had a kink in her small intestines. While stayed in the hospital she was treated for diverticulitis( antibiotics, lots of fluids vua IV) plus she continued antibiotics at home for 10 days and it is not getting better. My question is: if she does have a blockage how can it be treated?
Thank you.
Thank you.
Brief Answer:
Good conservative management.
Detailed Answer:
**My question is: if she does have a blockage how can it be treated?
It is good to know you are a nurse and you must have got the plan of management as detailed above can help even if she has a blockage.
The catch is > if this is a temporary blockage due to swelling/ edema, fecoliths, effects of the tablets- Welchol, the conservative management will help to overcome the problem, and the surgery may not be needed as an immediate procedure.
We can buy time to improvise her on nutrition and can undergo some investigation to see for the need of surgery. Are her electrolytes normal? These are the ones which can create more problems. Low potassium can give pseudo-blockage. Get all the blood work done again, have an X-ray in the standing position..
Good conservative management.
Detailed Answer:
**My question is: if she does have a blockage how can it be treated?
It is good to know you are a nurse and you must have got the plan of management as detailed above can help even if she has a blockage.
The catch is > if this is a temporary blockage due to swelling/ edema, fecoliths, effects of the tablets- Welchol, the conservative management will help to overcome the problem, and the surgery may not be needed as an immediate procedure.
We can buy time to improvise her on nutrition and can undergo some investigation to see for the need of surgery. Are her electrolytes normal? These are the ones which can create more problems. Low potassium can give pseudo-blockage. Get all the blood work done again, have an X-ray in the standing position..
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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