Hey gang, I went to my doc the other day to talk to him about some bowel issues I have been having. (Note, I might get descriptive here, so dont read further if poo poo talk bothers you)

I have PN in my feet and hands from Diabetes, as well as Gastroparesis (a form of neuropathy that effects the stomach)

In the last few months I have had increasing symptoms of messy bowel problems. At first I thought maybe I had eaten something that disagreed with me or perhaps the bacteria in my system were causing me to have excessive gas and loose stool. Its not really diarrhea but its messy.

It has continued to get worse to the point I am having to change my underpants twice a day. I dont always feel it when it leaks out but I have gas all the time. I have had a few occasions when I have soiled myself during the night in bed.

This is obviously an issue, and can make teaching middle school a little tricky. There have been a couple days when I spent a good part of the morning on the toilet before I felt I could even walk out the door.

My doc thinks that maybe the Acid reflux medicine I am on might be causing the symptoms he wonders if I am digesting my food fully. He has taken me off it for now, to see. Its been over a week with no change.

Has anyone experienced this with neuropathy. I undstand that diabetics can get constipated from neuropathy or from medications but this is hardly constipation.

Other meds I am on include

3600 mg Gabapentin
30 Mg Cymbalta
20 units of lantus insulin.

if you have any suggestions of things I might try to alleviate symptoms short of wearing depends I am all ears.

Sounds very, very distressing for you!

I have been diagnosed with idiopathic Neuropathy (2007) and now Gastroparesis (2009). I now have the constipation (am on a totally liquid/pureed diet) but not usually the diarrhoea - only occasionally.

Does the particular Acid Reflux medication you are on typically cause diarrhoea? I guess that is the first and obvious thing to eliminate (hehe)! Is it possible that the neuropathy has affected your whole bowel motility and sphincter control?

I hope you get some resolution to this .....and quickly!

Hugs Megan!

The Acid reflux medicine I am on is Omeperazol (Prescription Prilosec) I have been taking it since Last July and never had a problem with it. Because some of the issues I had with Gastroparesis seem to be improving, his thinking was that perhaps the medicine was causing my stomach to produce too little acid to properly digest my food and it is now emptying partially undigested.

When I was first diagnosed I was put on a low fat/low fiber diet. I have been able to re introduce much of the foods I used to eat and if anything I am eating more fiber than I was when I was diagnosed. So I dont think adding more fiber would fix the problem.

The only thing I can think of is 1) This is nerve damage related - although with my stomach getting better that seems odd. or 2) This is medication related.

I dont take Metformin which would be the most likely culprit for something like this in a diabetic. I take Lantus insulin instead. The other medicines I take are Neurontin (Gabapentin) and Cymbalta. Both of these are for pain from my peripheral neuropathy. I know that my PN is getting worse. The whole situation is a little frustrating.

Now when I go places, I check where the bathroom is first - Just in case.
One more thing to stress over

Gabapentin can cause fecal incontinence.

Lefthanded had this problem. You might message her for
more details.

Yes it is true that acid blocking drugs will affect protein digestion and make more gas, due to bacteria fermenting the undigested protein.

Also a big culprit can be fructose. So avoid all fructose for a couple of weeks and see if it is better.

If this all fails, consider: Are you eating low fat foods with Olestra in them (chips etc)? This will liquify stools. So will Alli the OTC diet pill.

Check any dietetic candy you may be using. The ingredient sorbitol is a laxative. Hershey's is even putting it in REGULAR candies now, so read all your labels to see if you are getting sorbitol. Sugar free gums, mints included.

Also becoming incontinent may be a result of cauda equina syndrome...a stenosis in the lumbar region. This is considered a medical emergency and should be evaluated ASAP.
Loose runny stools suggest something else, however.

Cymbalta can also cause diarrhea. But if you have been on it a while, this is not likely. It mostly does this side effect at the beginning of treatment. (increases serotonin in the GI tract).

Another rare cause could be Carcinoid syndrome. It would be a last resort if other solutions do not work. Carcinoid would be made worse with Cymbalta.

Are you taking one of the anti-cholesterol drugs? That might have something to do with it.

And to help with digestion, yogurt is very good.

Also, a stool softener might help. Even if you're not constipated, it still helps keep your s**t together, so to speak.

Oh, I don't agree! Colace will make this mess much worse!
I know many patients without PN who get this leaking running type stool they can't control! For patients not taking opiates Colace can be very disasterous!

Hello!

I do realize now that your post was a long time ago. I was wanting to share with you that I am having the same "messy" and distressful problem you are/were, but I have discovered why. It's the Gabapentin. I did a lot of clinical digging into their research and they said that it can cause some issues, but they admitted to nothing like what we are going through. It's several times a day and happens at night. I guess one good point about being a girl is Ive just gone out and bought a ton of period pads, but (and sorry for the graphic nature) the slimy mess left on me to clean is disgusting. I've never experienced this an don't know what to do! There is NO warning, ans I cant even feel it happening. It's not like a regular bowel movement at all.

Do you have any answers? I have to be on it a few ore weeks

Thanks. Amy