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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Cause Loose Stool With Gritty Black Specks And Hard Flakes In 90 Yr Old Person?

90 year old male patient, bed bound having loose stool with not much control. Stool is very gritty with black specks and hard flakes present. Not really a specific complaint. Have done enema and milk of magnesia thinking May be an impaction but has not helped. Going on 3 weeks now since stools have been this way
Thu, 21 Feb 2019
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General Surgeon,  's  Response
Hi,

The intestinal system slows down as well as the liver and pancreatic function with advancing age.
Since the patient is bed-ridden and is 90 years old I would advise you the following for the gritty black specks and hard flakes:
Get the X-ray of abdomen to see for the fecolith formation and possible impaction in large bowel.
If fecoliths are present then saline-soap enema can help for complete evacuation and may help regularize the bowel.
Secondly, get the stool tests routine, microscopy and occult blood.
Food adjustments is a necessity to have normal stools.
Addition of pancreatic enzymes an probiotics may help further.
If there is occult blood present in stool, there may be need of a colonoscopy and biopsy to rule out cancer.
Tests of blood: routine and for tumor markers.
CT scan of abdomen if possible and further management as per the cause found.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T Chandrakant, General Surgeon.
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Internal Medicine Specialist,  Dr. Dr. Penchila Prasad Kandikattu's  Response
Hi,

It may be due to impacted stools is coming with in formed stools. Shows incomplete evacuation of bowels. Also possible with upper GI bleeding or intake of dark green leafy vegetables.

Give her plenty of fiber with liquids intake. If symptoms not improved please consult your doctor he will examine and treat you accordingly.

Hope I have answered your query. Let me know if I can assist you further.
     
Regards,
Dr. Penchila Prasad Kandikattu,
Internal Medicine Specialist

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What Could Cause Loose Stool With Gritty Black Specks And Hard Flakes In 90 Yr Old Person?

Hi, The intestinal system slows down as well as the liver and pancreatic function with advancing age. Since the patient is bed-ridden and is 90 years old I would advise you the following for the gritty black specks and hard flakes: Get the X-ray of abdomen to see for the fecolith formation and possible impaction in large bowel. If fecoliths are present then saline-soap enema can help for complete evacuation and may help regularize the bowel. Secondly, get the stool tests routine, microscopy and occult blood. Food adjustments is a necessity to have normal stools. Addition of pancreatic enzymes an probiotics may help further. If there is occult blood present in stool, there may be need of a colonoscopy and biopsy to rule out cancer. Tests of blood: routine and for tumor markers. CT scan of abdomen if possible and further management as per the cause found. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon.