Trying to solve a mystery here - stomach issue since hospital.

Olly_Bake

Dad has been back in his home for a week now and we have been dealing with an all-day-long upset stomach issue. The next day after getting from the hospital, I came in to find dad in a dirty diaper and stressed to sister that we have to try and keep him changed although I know the nursing home and hospitals were not doing a good job of that either. She has been helping now.

Then scratch head, I thought maybe I fed him dinner too late the day we brought him home from the hospital. So moved that up to four or five instead of six and asked aid to do the same. Still a stomach issue which is not his norm, which use to be occasional constipation.

Then I went to thinking, maybe it was something like the Senna that the hospital was giving that needed to run its course. No change. We just made our first week and I’m trying to figure out what to try this week starting today because before morning was over, we were two diapers in. Gave imodium this time but don't want that to be the norm when things that need to come out, should be coming out.

He is on a total of 6 meds now. Three are meds he has been on a very long time (januvia, tamsulosin, spiriva) with no issue. However, the hospital with last admittance removed the ecitalopram and lorazepam and added folic acid (once daily), ferrous sulfate (3 times daily) and carvedilol (low dose - twice daily).

Mentioned the meds because with research it suggests the iron and BP pill. So I dropped the iron down to once daily - no change. Then once daily on BP pill - no change. Today I changed the iron to a store bought brand that is said to be slow release and still plan to try twice a day.

If this still does not change, do you think the broken hip, even after surgery, messed something up and that all food will just run through him now? I worry about this because of trying to prevent bed sores as much as possible until we try to see if we can get him back mobile. The therapy part starts this week. He has gotten so stiff now.

I didn’t know that my family home was so dead. All my sister wants to do is sleep and not fix herself something to eat even which now explains the extreme weight loss. Now dad wants to sleep whereas he was very active even in the hospital. During the day he would be watching TV and don’t put a food plate in front of him. But now? 

But at the same time, I see at night through video that she has a bright lamp in his face that I thinks means he’s not resting as much. Once we get his hospital bed and I can put him in one of the rooms, I hope to test that theory. As for sister, if I don’t offer her some of dad’s food, she will just eat a bowl of cereal day and night or a piece of melon and then it is back to sleep.

Thanks for reading and for advice.

zauberflote

Olly, yuk, the poor man! Not to mention you as mess-cleaner-upper. Re iron, I know that when my kids were babies, one tolerated formula with iron and one got similar digestive issues to your dad. And re carvedilol, I've been taking it for decades and don't think it affects my digestion one way or the other. 

Do you think he might have brought a bug home with him? Would a probiotic or some yogurt be appropriate?

I hope you get this under control ASAP!

Stuck in the middle

Not a doctor, but he had surgery so he had antibiotics, which probably killed the beneficial and necessary gut bacteria.  I second the motion for probiotics, such as yogurt, beans, and sauerkraut.

May flowers

If he has diarrhea, I agree with stuck - probiotics, and kefir is a good source too ( for me it is easier on my digestion than pills… and maybe have them check for c-diff if it doesn’t get better). If it is his stomach mainly, you might want to ask the doc about giving him something like Pepcid AC. I know some of the meds my FIL was on did a number on his stomach.

M1

If diarrhea is the main issue:  yes, like Stuck said, it's very common to get a colon overgrowth from antibiotics with a bacterium called C. Difficile (C. Diff for short).  You need to have him checked for this--it's treatable but can be lethal and won't go away on its own.  Call the docs asap.  You can check for this is a stool sample--collect some from his diaper and put it in a clean container with a lid.  You can refrigerate of put on ice--best to collect a sample on the day it's to be tested if you can. 

If you google C. difficile or C. Diff diarrhea you'll find it.

Quilting brings calm

I agree call the doctor.  Several days of this can make a person dehydrated too. 

Also-try ferrous gluconate  rather when the  sulfate.  It’s said to be easier on the stomach and should be given on an empty stomach.   The internet says to not give the daily allotment all at one time.  I looked yesterday because my spouse just got upped from 1 to 2 a day. 

Olly_Bake

You all are so wonderful and awesome! Narrowed things down to two suspects (the iron pills and cdifficile).

At first I swear if he ate corn for example, we saw the pieces of corn in his bowel movement that was green. Now we are moving toward watery but still green. His iron pills are green so that's also why that was suspect right off.

Going to try and get some sleep now. This hour drive to and from is kicking my butt already lol. Will start with all the suggestions tomorrow as I'm back at my home now.

ImMaggieMae

M1 mentioned CDiff. This is very common in hospitals and with people on antibiotics. There is a test for it. I had it a number of years ago and it’s very difficult to get rid of.

mommyandme (m&m)

I haven’t needed to use it yet, but our hospice CNA gave us a bed pan to use in case of diarrhea.  Don’t even know what that’d “look like” if I was to try to use it.  Just a thought.

Marta

Your concern is about frequent stools or diarrhea?

This would be a bowel issue rather than a stomach issue. 

Questions to ask:  how often are stools (or diaper checks for same occurring?)

Is there any solid matter in the stool?  If yes, labs will not accept a stool for C. difficile testing unless the stool is liquid only. Of course, tests for other pathogens may be performed. 

Is there any blood or mucus in the stool?  Any fever?  These point to an infectious agent.  

For any patient with frequent stools/diarrhea it is recommended to try the BRAT diet:

Nothing but electrolyte solution for 24 hours (e.g. Gatorade or Pedialyte)

Then, add in bananas, rice products, apple sauce, and light toast. Most non-serious causes of diarrhea will get better with this regimen  

Best,

Marta, NP

Jo C.

Based on what you have written, it would be best to  call the doctor and get lab order for stool tests.   Doctor will want to rule out the cause of what is happening and may want to order several different labs to check for multiple infectious agents and also to check for C. difficile.  C.diff  can be dangerous; it is easily picked up in hospitals and NHs and also when having received antibiotics.   Someone can go to the lab and get the stool sample containers if doctor orders labs; there will be only several small vials for the stool sample that can be taken out of the diaper.  Some stool labs will require special agents in the vial.  It will not take much stool.  You will get written directions along with the vials.

NOTE:  It is far best not to give Immodium or Kaopectate to stop the stools without the doctor permission to do so.  Reason is, there is some thought that if the stooling is stopped when tere is a bacterial infection, depending on what it is, it can cause the infection to become far worse.

Good to keep him well hydrated.  Please do contact the doctor, it is vitally important to do so.

J.

Olly_Bake

Well I tried to use stomach issue Marta as a way not to make anyone queasy lol. But thanks for clarification. Right now, I’m thinking it was the 325 ferrous sulfate. I switched it out Sunday to SlowFe Iron Supplement from the store. He had no bowel movement yesterday but had one this morning and it was not an explosive one and still not seeing any blood thankfully.

The bowel movements were solid but explosive on the days I was at his home last week. Then the two days I was off, the aid that came in said it was very watery or green or black looking. I took the green or dark looking color to be that of the iron pill, which I was seeing that myself. I have not seen any blood in the stool and not sure I would know if I see mucus.

No fever. I did start the Gatorade treatment as well.

I am going to go back to the old iron, in a few days and see if the same thing starts. Going to ask the doctor today about the stool sample just to be on the safe side.

Thanks everyone.

Edited to add: We just did a diaper change and it still looks green although we switched to a red iron pill. I was able to collect the sample and praying the doctor will let me bring it for testing today. This was so hard not to barf.