Suggest Treatment For Severe Abdominal Pain And Fever In An Elderly Perosn

Posted on Sun, 25 Dec 2016

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

Sun, 25 Dec 2016 Answered on

Wed, 18 Jan 2017 Last reviewed on

Question : Two weeks ago, my 93-year-old mother was taken to the ER and admitted for six days. Her symptoms were chills and low-grade fever on and off, and pain in the lower abdomen. Diagnosis UTI. While in the hospital the doctor ordered an x-ray, ultrasound of the abdomen, a sonogram and urogram. Also urinalysis and blood CS.
Three days later, she was taken to the ER again because she had not had a bowel movement for almost one week. She was admitted, given an enema which was mildly successful. The next day she was given Castoro oil which did the job.
Now, four days later, she is complaining of abdominal pain and has a fever of 100.8.
Her current medications are Namenda for dementia, levothyroxine, and simvastatin 10mg. She also takes a multivitamin pill daily. She is not hypertensive or diabetic.
Prior to the last two hospitalizations, her last hospital stay was three years ago for a fall. Other than the dementia, she is otherwise in fairly good health for a 93-year-old.

Answered by Dr. Abhijit Deshmukh (14 hours later)

Brief Answer:
Hi

Detailed Answer:
Hello,
Welcome to the HCM.
Thank you for your query.
I can understand your concern.

Well possibly her UTI has not got cured completely.

Need to repeat her blood count urine routine and culture examination and creatinine levels too.

Also need to evaluate the cause of UTI possible improper voiding of urine meaning she is unable to evacuate the urine completely. Which might possibly have been ascertained by previous ultrasound.

Also it'll be worthwhile getting an digital rectal examination to look for any impacted stools in rectum which can cause Constipation and UTI both.

Also keep her well hydrated and ensure that she is compliant with full course of medications too.

Hope this answers your questions. Feel free to ask further.
Wish her a speedy recovery.
Happy to help.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Abhijit Deshmukh (3 days later)

Hello, Dr. deshmukh,

Thank you for your response.

My mother has fever on and off, the latest was 38.1 (100.5), about 12 hrs ago.She was given Tempra again for the fever which seemed to help. Also, she was given antibiotics, Cefuroxime 2x/day after meals.

We are still trying to collect urine for the urinalysis, which is difficult because she has been going in her adult diapers since the hospitalization Dec. 9 (6 days for UTI) and Dec 18th (3 days for constipation). I'm guessing that could also be a contributing factor to the UTI and the difficulty in clearing it up.

She has an appetite but now is on soft foods only.

My other concern is her energy level. Since her hospitalization, she has not been walking (previously walked using a walker) but her arms and legs are massaged 2x/ day. This is why she goes in her diaper all the time.

What can be done to increase her energy level, Dr. Deshmukh?

Thank you.

Answered by Dr. Abhijit Deshmukh (6 minutes later)

Brief Answer:
Hi

Detailed Answer:
Hello
Thank you for your query.
Well need to get her diet well to gain strength by ensuring adequate fluid electrolytes and energy.
Can try frequent juiced and protein supplements if OK with your doctor.
Also aggressive treatment of urinary infection is important for her to gain strength too.
Try to ambulate her out of bed say in a chair as much as possible.
Wish her a speedy recovery.

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Above answer was peer-reviewed by : Dr. Prasad