Suggest Treatment For Irregular Bowel Movements In A Person With Atrial Fibrillation

Posted on Sat, 28 Mar 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 28 Mar 2015 Answered on

Fri, 24 Apr 2015 Last reviewed on

Question : My father is 81 and has atrial fibrillation. He also has a hypothyroid condition. He underwent a major open heart surgery 5-7 years ago with valve repair and stents (I think stents, but maybe not, he doesn't like to discuss nor do I). He recovered fully as far as I could tell and his follow-up medication and doctors have been great. He was doing really well but last winter he slipped and broke ribs. He’s healed but since then he's had irregular bowel movements to the point that he lost control in a store and now wears a Depends. He continues to have lack of control of his bowels and has to go running to the bathroom. His primary doctor has tried various fixes but to no avail. It's not the bathroom issue he is concerned with it's his loss of mental power. He's now easily flustered, nervous and feels vulnerable (he doesn't say this, I just know) although he's as sharp as ever (as far as I can tell). I'm worried that his bowel issue is affecting his electrolytes and his overall wellness. My brother speculates that when his ribs were healing his digestive and bowel system changed to compensate for the internal repair going on (he was slightly bed ridden). Since the broken ribs he's gone downhill. He's also become very grumpy and I think has some depression. Is there anything his primary doctor or heart doctor can do to get him back and feeling better? I know old age is inevitable but should his doctor be considering anti-depressants and vitamin/electrolyte drips or something we haven’t thought of? Please shed some light if you can!

Answered by Dr. Prakash H Muddegowda (1 hour later)

Brief Answer:
Broken ribs and hospitalization - reduced cognition, possibly depression.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:

1. Bowel control loss appears to be more functional, than pathological.
2. The speculation of your brother about tissues compensating is not correct. It is more at the mental level, rather than physical changes.
3. Any hospitalization or prolonged rest period (at present due to fracture rib) is very stressful in the elderly. This leads to reduced cognition and mentation and affects the elderly at variable levels.
4. This at present is through bowel changes. His being stressful or being wanted - possibly interpreted as grumpiness.
5. He will require evaluation for depression, if he has any of the following: depressed most of the day, reduced activities, no interest, irregular sleep pattern, loss of energy, worthlessness or restlessness.
6. He will require constant care and family support. Psychiatrist management along with counseling will be helpful. Anti-depressants, may be necessary. Family support is most important, to avoid further deterioration.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar