Night Incontinence "Tools"?

I wear mens depends at night when needed better than shields

Susan, please let us know what you've already tried, or we'll be throwing darts blindfolded. In any case, I'd 1) rule out or treat for pouchitis, 2) add Lomotil at bedtime, 3) add Metamucil at dinner, 4) start a regular regimen of kegels, and 5) experiment with evening eating (quantity, fat content, etc.). If you're really just stuck with adult diapers, try different brands for the best fit.

Agree with Scott's suggestions. Since this is a new problem, I would also say that the very first thing I'd want to rule out is pouchitis. I've had leakage only very rarely, but when I have there was pouchitis simmering. Once you treat the underlying pouchitis, the leakage generally improves considerably, if not completely.

If pouchitis has been ruled out, I would suggest taking 2 imodium (or lomotil if that has been prescribed) at bedtime. This perhaps goes without saying, but make sure he tries to empty the pouch before going to bed, even if he doesn't feel the need for a BM at that time. I would also add that he should avoid alcohol and large meals within at least 3 hours of going to bed. As for dinner, it might be a good idea to include a bulking food with the meal, such as rice.

Another thing to look at is dietary changes. If he has recently changed his diet at all, this would be something to consider, as any dietary change can affect the pouch and stool consistency, if even temporarily as the body adjusts.

Finally, though this may not apply to you, look at any new medications that may have been added, if applicable. For instance, for some who take sleeping pills, this can make the muscles overly relaxed such that leakage can occur, or put you in such a deep sleep that you don't wake up when the pouch is full. Pain relievers/anti-inflammatory medications such as NSAIDs (ibuprofen) can cause loose stools or diarrhea (I'd add that these can be contraindicated for IBD patients anyway, so if he has been taking them, I'd look to that as another culprit).


Hope you can get this sorted out!

Hi All: Thank you for your helpful input! We just got back (this morning) the biopsy results from Hubby's sygmoid last week. They showed inflammation ulcers with no chronic changes to the rectum and pouch. His doctor is going to prescribe "topical" treatments, which he will explain when we see him in four days hence.

Hubby's problems are exacerbated by diabetes, so diet changes need to be weighed both for gut stuff and diabetes stuff, which often conflict. We eat our evening meal at 4pm, and there does not seem to be a link between certain foods and poop-a-rama.

Hubby's tried, for his nighttime dis-ass-ters, face towels in his underwear, men's underwear shields, and men's underwear that did not fit particularly well. I'm thinking we need to spring for some good disposable undies, at the very least. Maybe double them at night?

Good luck with all new recommendations but can I suggest setting an alarm and getting up every few hours to empty. When I had my ostomy I had to do this every 2 hours but now with my recent takedown -10 days ago- I set alarm for 3-4 hours. Not great for sleep but worth it to me. Start with 2 hours and then trying increasing the intervals.Good luck with all!

And he should be doing kegels to strengthen sphincter tone.

Sue

Yeah, for the mean time: I am such a heavy sleeper that I would sleep right through using the bathroom as well when I first started out. I realized I needed to set an alarm about 4 hours into the night so I could get everything out and go back to bed. I still normally get up once in the middle of the night but my body has started to realize the feeling that signifies bathroom time now.

Okay, a very long-overdue update: I found Hubby a new gastroenterologist. This fellow looked carefully at the sigmo results the last guy found. He told us that Hubby's pouch and intestinal lining was very inflamed and there were many ulcers. He said "That's why you poop all the time---the inflamation." So, he blessedly took Hubby off the very expensive and as it turns out worthless for my Hubby's condition, and put him on a nightly cortisone enema. As the inflamation died down, the muscles tightened up, and he now has just about no "leaks" during the night, half the amount of BMs during the day, and no total, wet "voids" during the night. It is a miracle. And so much LESS expensive!!!

Since Hubby had his surgery way back in '88, and was mostly likely one of the first having this "new" pullthrough procedure, his current doctor said it is just about impossible to tell for sure if Hubby originally had Chrohn's Disease, or ulcerative colitis. Part of the rectum was left behind, and the doctor says it looks like (after many decades of scar tissue) he has ulcers on both the rectal and the intestinal tissue.

Next week, after six weeks of cort. enemas, Hubby returns for another sigmo to see how it all looks. Thank you folks for all your help. You are so kind and knowledgable. It is so reassuring to know I can come to this forum for help and reflection!