bowel incontnence and anal plug (yes really) and confusion

Discussion in 'I care for a person with dementia' started by spuddle, Jan 12, 2015.

  1. spuddle

    spuddle Registered User

    Mar 13, 2014
    Here i am talking about poo again.
    I recently posted about mums bowel incontinence and im still busy searching for ways to manage this.
    with the power of the internet ive become aware of 'anal plugs' for bowel incontinence. they basically seem to be similar to tampons but obviously put up your bum. They can be worn for up to 12 hours and are removed like tampons with a string (i wonder what happens when it is removed). sounds pretty scary but im willing to try anything to help mum. has anyone had any experience with these.
    im also still puzzled about the reasons for the problem. when mam was in hospital she was thoroughly checked out and we were told that she had an unidentified infection and was treated with anti biotics. we were also told that she probably had compaction/overflow. after reading about this it seems that the bowel can become stretched causing the incontinence. weve since been to her gp but are not really getting much advice other than wearing her 'big girls pants'. trying to find out if this can be corrected in anyway. any advice on this be gratefully apreciated.
    . she has stopped wanting to go out in public as she is so embaressed about things. i have already been given some great advice here on my previous posts but im still searching for ways of helping her cope with this.
  2. penga

    penga Registered User

    Jun 4, 2012

    Just my thoughts
    As your mother has dementia, do not think anal plugs would be a good idea, cannot tell you if they hurt, are causing irritation etc. and there is alway fiddling.
    Have you tried other things (hard with dementia I know), pro-biotics (you can get good ones in liquid form), bananas, rice, boiled eggs, apple (stewed), cutting back on dairy and fats. The above would need to be eaten for a couple of days to see if there is any improvement. Restricted diet might upset your mother:( but if it does help she will be able to go out again).

    Hang in there

  3. Beate

    Beate Registered User

    May 21, 2014
    You've got to be joking. How would someone with dementia understand these? Get yourself referred to the Continence Service who will explain all the pads etc available.
    Constipation overflow can be helped with gentle laxatives like Fybogel.
  4. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    Oh dear, I wish I knew the answer to this. Mum is in a similar position. I've never heard of anal plugs but I agree with Beate and penga, I'd be surprised if they helped. Could actually cause more problems.....:(

    Incidentally, my problem is that mum simply won't wear pads, so it's a case of permanently being on watch to clear you, spuddle, I am pretty much at my wits' end......:(

    Good luck with whatever you try. I do hope something works for you and your mum xx
  5. Leswi

    Leswi Registered User

    Jul 13, 2014
    If your mum had compaction with overflow she was probably constipated and those plugs would only exacerbate constipation. My mum had the overflow with constipation and was initially given a pessary to help clear her bowel. She has since taken
    one sachet of laxido daily which kept her regular. Ideally a healthy diet with plenty of fibre, fruit and veg would do the same thing. Previously I have read comments that laxido caused diarrhoea but it was marvellous for us, think we were lucky to find the right dose. If your mum is aware enough to be embarrassed it probably isn't dementia related incontinence as such. My poor mum now entering another stage with accidents but is not aware of what happens.
  6. Benrese

    Benrese Registered User

    Apr 12, 2014
    I had never heard of this, so being the google-fool I am, I found this:

    I now better understand what they are and what they do. However, I also agree, since we are looking at someone with Dementia, this may cause more distress than relief. Always good to check with an expert in any case.

    Good luck x
  7. CJinUSA

    CJinUSA Registered User

    Jan 20, 2014
    eastern USA
    Hello. Have you considered that your mother might have an allergy to some of the foods she is being given? We develop allergies across time, and things that were easily digested earlier in life can become indigestible later on.

    Key examples in our family are pork and milk products containing lactose.

    My mother can no longer process pork well. It makes her feel a bit sick. It is harder to chew than other meats, so I think she doesn't chew sufficiently.

    Milk solids, which have lactose) are in many foods you might not think of - canned and homemade soups (as a thickener), gravies (thickener, bulk-maker), and of course milk and ice cream. If your mother has tea in the afternoon with milk in it, you need to shift her to a non-dairy substitute. We typically buy lactose-free milk - it has the quality of milk, but the lactose has been removed. Watch the labels for milk or dairy products, take her off anything with the potential for lactose, and see what happens.

    My mother is off lactose products entirely. We give her Lactaid with any meal where we are unsure what's in it. She went from being very incontinent (and weak and dehydrated as a result) to being mostly normal for her age. We also discovered that her incontinence was linked to one of her pills - only because she is no longer on that pill: she is now on Plavix rather than Aggrenox and is doing ever so much better.

    Please don't consider an anal plug. Try testing out dietary causes for incontinence, as these are *very* likely to be the causes behind her issues.

    The "unidentified infection" would worry me. How can they not know what infection it is and where it might be?
  8. spuddle

    spuddle Registered User

    Mar 13, 2014
    thanks so much for your replies. I think really you have said what i already thought about these plugs. I guess the fact that i had never heard of them before tells a story in itself.
    I have vaguely tried to work out if there is any food intolerances or anything making the problem worse and i try and make sure she has a healthy diet, as she always previously had. its a bit difficult as whenever takes her fancy she trots off to the shops to buy it, the latest fad is scones and its usually cakes or biscuits.... leaving all the healthy stuff i put in the fridge and not being hungry when i make her a nice meal (maybe my cooking isnt as good as i think it is).
    and yes the 'unidentified infection' is a mystery. apparently her blood count (not sure what this is) was very high which is why they say she had an infection, and it came down after anti-biotic treatment.
    Thanks again for all your input and suggestions. I'll keep trying with the food/diet changes and in the mean time thank heavens for her 'big girls pants'.
  9. CJinUSA

    CJinUSA Registered User

    Jan 20, 2014
    eastern USA
    Hello again. If she is having scones and pastries with filling, then she is definitely getting lactose in her system. Lactose created such a havoc for my mother until we identified it. The issue with incontinence is that once it occurs, the person is dehydrated. If you could find a way to make sure she understands that what she eats from the shops is probably causing her the problem, this might do the trick. We don't give my mother anything that I have not carefully scrutinized. I'm tired of the bland diet but not at all tired of not having to deal with her incontinence.
  10. susy

    susy Registered User

    Jul 29, 2013
    North East
    Did the hospital "clear her out"
    If she is having overflow then she needs to have her constipation dealt with. It would probably lead to her having a messy couple of days but would probably help long term as long as she then manages her diet better and drinks plenty. Fibogel and latulose have both been mentioned and would help her maintain a good bowel movement once cleared out.

    Overflow is where the bowel is literally full of poo that is dried out (like rabbit poo but bigger). The bowel then gets more poo coming down behind it and can't get past. The bowel is quite elastic, a bit like a balloon so eventually the liquid poo behind the blockage makes it's way past the blockage that remains and hey presto we think that this person has diarrhoea or they become incontinent.

    Sorry for the graphic detail but I hope it helps to explain to people who don't realise just how important making sure that constipation is kept on top of.
  11. Beate

    Beate Registered User

    May 21, 2014
    I completely agree. You won't be able to completely eradicate bowel incontinence but it will help hugely in maintaining regular bowel movements. People with dementia often need help as they can't strain themselves anymore so something that makes it easier to poo is a good thing. Our doctor put OH on a whenever we need it repeat prescription of Fybogel which has helped enormously.
  12. spuddle

    spuddle Registered User

    Mar 13, 2014
    great description of overflow susy. far better than the hospital vague attempt at explaining it. As far as 'clearing her out' I think mum cleared herself out after what i found on her bed the day she went into hospital. She seemed to have been 'leaking' at night for some time which i had just taken to be one of those things and now realize it was probably 'overflow', but since then there seems to be no holding back in the poo department.
    ill definately give Fibogel a try and i have already got dioralyte from docs to keep her hydrated... though getting mum to drink the stuff is another issue.
  13. nitram

    nitram Registered User

    Apr 6, 2011
    North Manchester
    "...ill definately give Fibogel a try and i have already got dioralyte from docs to keep her hydrated... though getting mum to drink the stuff is another issue..."

    If Fybogel is not drunk quickly after mixing it turns into something akin to wallpaper paste in consistency.
    One solution is to mix it into jellies. Fybogel comes in orange and lemon flavours.
  14. Beate

    Beate Registered User

    May 21, 2014
    Yes but you can always stir it again. The orange one tastes nice.
  15. percot

    percot Registered User

    Jan 4, 2015
    This is a common problem with children too. The usual treatment is Movicol, multiple sachets for a few days until cleared out, and then the maintenance dose of one or two sachets per day, often for months. It takes a long time for the bowel to shrink back and regularity to return. In my experience with childhood constipation and leakage GPs are useless. Ask for a referral to continence care.

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