Why is my 73-year-old dad having unexpected bowel movements?

Question

Hello doctor,

My father is a 73-year-old male, currently on prescription medication for shortness of breath, and reports an ongoing issue over the past several years. Despite having normal morning bowel movements and cleaning himself thoroughly afterward, he consistently finds his underwear heavily soiled a few hours later. His digestion appears normal, and recent stool sample results have not indicated any abnormalities. He is concerned and wonders what could be causing this problem.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Unexpected bowel movements (medically termed fecal incontinence) can be related to hemorrhoids, diarrhea, constipation, or certain medications, particularly if he is taking Digoxin or Quinine. This issue may also result from physical or nerve-related problems, some of which could be serious. A physical examination by a doctor is necessary to ensure there is no structural issue in the rectal area.

Additionally, a doctor should examine whether the nerves in the rectum are functioning properly and have not been affected by nerve compression in the back or by circulation problems, such as a stroke or mini-stroke. In my opinion, his symptoms of unexpected bowel movements could stem from nerve issues, medications, or structural abnormalities.

Please let us know:

What medication he is taking for shortness of breath, including the name and dosage. Other medications that may contribute to fecal incontinence include laxatives, heart medications, erectile dysfunction treatments, cancer therapies, and certain weight loss drugs.
Also, kindly let us know if he has a history of smoking, hemorrhoids, diarrhea, or constipation.

Two approaches can be addressed by your provider at the same time:

Treat the manageable factors, such as diarrhea, constipation, medications, smoking, excess weight gain, and reduced physical activity. If he sits for long periods or has memory issues, these could also be contributing to problems with bowel movements.
Evaluate for underlying issues, such as performing a rectal examination in the doctor’s office to assess whether the nerves in that area are functioning properly and visually inspecting the rectal area to check for any obvious abnormalities that can be seen or felt during the exam.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.