Frequent Bowel Movements in Elderly Patients: Causes and Care

Frequent urination in the elderly?

Hello Dr.
Liang, I would like to inquire about an elderly person (80 years old) who has a very low food intake, averaging about ten bowel movements a day, but actually has very little stool.
They often feel bloated in the lower abdomen, but the frequency of bowel movements is high, causing physical and mental fatigue for both the caregiver and the elderly person.
The elderly individual has a history of hypertension, diabetes, liver cancer (only known to have a tumor), and has previously suffered a stroke.
Should this condition warrant a visit to the hospital for examination? What tests should be conducted? What symptoms could this indicate? If no examination is needed, how can we assist them? Thank you for your response.

Ting, 20~29 year old female. Ask Date: 2016/03/04

Dr. Liang Yinpan reply Geriatrics

Hello, regarding elderly patients in their eighties with multiple chronic diseases, they are prone to complications such as dyspepsia, which may present as abdominal bloating or abnormal bowel movements.
If there is excessive accumulation of fecal matter in the colon, it can lead to frequent urges to defecate, resulting in multiple bowel movements in a day.
However, due to constipation or poor peristalsis, they may be unable to pass stool, leading to a sensation of bloating in the lower abdomen.
It is also important to consider whether there are rectal or gastrointestinal lesions contributing to these symptoms.
Therefore, a thorough examination and diagnosis by a gastroenterologist is essential to identify the underlying cause and provide appropriate treatment.
Changhua Hospital cares about you.
Geriatrics Department, Liang Yin-Pan, March 8, 2016.

Reply Date: 2016/03/04

More Info

Frequent bowel movements in elderly patients can be a complex issue, especially when accompanied by other health conditions such as hypertension, diabetes, and liver cancer. In your case, the patient is experiencing a high frequency of bowel movements (approximately ten times a day) with minimal actual stool output, which can lead to significant discomfort and fatigue for both the patient and the caregiver.

Potential Causes
1. Gastrointestinal Disorders: Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even infections can lead to increased bowel frequency. In elderly patients, the gastrointestinal tract may become more sensitive, leading to symptoms like bloating and frequent urges to defecate without significant stool production.

2. Medication Side Effects: Many elderly patients are on multiple medications for chronic conditions. Some medications can cause gastrointestinal side effects, including increased bowel movements or diarrhea. It’s important to review any recent changes in medication that could contribute to these symptoms.

3. Dietary Factors: A diet low in fiber can lead to constipation, which paradoxically may cause frequent trips to the bathroom as the body attempts to expel stool. Additionally, if the patient is consuming more liquids or certain foods that irritate the bowel, this could also lead to increased bowel activity.

4. Neurological Issues: Given the patient's history of stroke, there may be neurological factors at play that affect bowel control and sensation. This can lead to a feeling of urgency without the ability to produce stool effectively.

5. Psychological Factors: Anxiety or stress can exacerbate gastrointestinal symptoms, leading to increased bowel frequency. This is particularly relevant in elderly patients who may be experiencing changes in their living situation or health status.

Recommended Actions
Given the complexity of the situation, it is advisable to consult a healthcare professional for a thorough evaluation. Here are some steps to consider:
1. Medical Evaluation: Schedule an appointment with a gastroenterologist or the patient’s primary care physician. A comprehensive evaluation is necessary to rule out any serious underlying conditions.
2. Diagnostic Tests: The physician may recommend several tests, including:
- Blood Tests: To check for signs of infection, inflammation, or metabolic imbalances.

- Stool Tests: To rule out infections or malabsorption issues.

- Imaging Studies: Such as an abdominal ultrasound or CT scan to assess the gastrointestinal tract and liver.

- Colonoscopy: If indicated, to visualize the colon and rule out any structural abnormalities.

3. Medication Review: A thorough review of all medications the patient is taking should be conducted to identify any potential side effects that could be contributing to the symptoms.

4. Dietary Adjustments: Encourage a balanced diet rich in fiber, unless contraindicated due to the patient’s medical conditions. Adequate hydration is also essential, but this should be balanced to avoid excessive fluid intake that could lead to increased bowel movements.

5. Symptom Management: Depending on the findings, the healthcare provider may recommend medications to manage symptoms, such as antidiarrheals or medications to regulate bowel movements.

6. Supportive Care: Caregivers should be educated on how to manage the patient’s symptoms effectively. This includes understanding the importance of regular toileting schedules, maintaining hydration, and recognizing signs that may require immediate medical attention.

Conclusion
In summary, frequent bowel movements in elderly patients can stem from a variety of causes, and it is crucial to conduct a thorough medical evaluation to determine the underlying issues. Given the patient’s complex medical history, it is advisable to seek medical attention promptly. This will not only help in diagnosing any potential issues but also in providing appropriate management strategies to improve the quality of life for both the patient and the caregiver.

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