anal leakage and constipation

[Jojoteacher]

my husband has aggressive metastatic prostate cancer Gleason 8 with mets to lymph nodes, bladder, and pelvic bones and hips. He is scheduled to start triplet therapy in the next 2 weeks. Last week he underwent a TURP procedure in hopes to get rid of the catheter which he had for over 2 months. Unfortunately, the bladder was blocked by the cancer so he had to get nephrostomy tubes to eliminate the urine and did get rid of the catheter. Since 3 days after the turp, he has been experiencing constipation and anal leakage. He tried stool softeners, but these have not helped. Anyone experienced something similar?

[spencoid2]

constipation and anal leakage sound mutually exclusive. please clarify.

[HikerWife in reply to spencoid2]

Actually, it is possible - many years ago, my 4 year old son suffered serious constipation AND anal leakage - pediatrician explained that even with a hard feces sitting in the rectum, more liquidy stool can dribble past.

[spencoid2 in reply to HikerWife]

sounds awful, i guess i am just lucky to have leakage alone

[Chipnick]

Hi, this is called encoparesis. He will likely need to use a laxative short term to clear the blockage. Stool softeners are rarely effective enough to clear the large stool accumulation that he is leaking around. Basically a colonoscopy bowel prep such as this: my.clevelandclinic.org/heal... up with a daily capful or 2 of miralax for at least several weeks to keep stools soft.

Be near a bathroom for 2 days for this. If he doesn't expel the hardened stool completely the leakage will continue. It may be worth asking for kub abdominal xray to verify the "moderate " or "large" stool volume before doing this. The goal is to get clear bowel effluent. Then you know he is cleaned out.

Sorry if tmi!

[Graham49]

I had a similar problem and used a low tech solution, which is not very pleasant, but worked.Put a finger up the bottom and dig out as much of the stool as the finger will reach. You then wait some time (it can take hours so no néed to sit continuously on the toilet) until the bowel pushes the remaining stool further into the rectum and repeat the process. After several times I was able to blow out the last part of the stool.

[CAMPSOUPS in reply to Graham49]

Yep. Along with a stool softener this is about the only solution for me. The first time it happened I could see in my minds eye the page from my Navy Hospital Corpsman from the 1970's medical book explaining to use digital removal. I thought no way I am going to let a random Emergency room tech. do that to me since its painful and sensitive down there so I used sterile surgical gloves and did as you. It can take hours an be exhausting requiring resting on ones side in bed to try and relax the cramps and discomfort in between sessions on the toilet. Leakage is common.

Do not use a laxative unless you see a doctor. Forcing expulsion of the compacted fecal material which is like clay could damage the intestine, rectum etc.

[pjd55d in reply to Graham49]

a solution

caveats:

make sure your nails are trimmed - pretty short and sanded down with an emery board

a little lube - could help. Using anything one would use for penetration sex should be fine

sometimes - the the hard stool ( the plug ) comes out ...but then what is left in the colon is not formed and when that comes out you can experience a LOT. Stay close to a toilet - and putting on a depends is not a bad idea

[spencoid2]

sounds like a very practical solution. might help to add some lubricant with an enema, maybe a little very mild soap but i would check onlline first to see if a little soap might be irritating or ??? i don't know if the magnesium stuff used for colonoscopies works as well on already hardened masses? get the shit out !!!

[CAMPSOUPS]

Please dont use a laxative unless approved by Dr. Forcing out the compaction can damage intestine or rectum.

[gpa_dave]

Something that can increase anal leaking is intestinal gas. If that seems like a factor, dietary changes could help. Possibly eliminating beans, cruciferous vegetables, dairy and/or gluten might assist, depending on his system. Also fizzy drinks.

[Seebs9]

I have one nephrostomy tube and a suprapubic catheter. ended up with a total penectomy.

On OXY but take 2 capfuls of miralax for the constipation works like a dream...