chronic diarrhoea

[spongle15]

Hi,

I was just wondering whether anyone had expereinced what we are going through...

My Dad has advanced PC which has spread to his liver. He was officially diagnosed with the biopsy results coming through about 10 days ago, although we were fairly certain that things were bad in the weeks before that once the possibilty of a tumour in the pancreas had been mentioned.

Hi first symptom was chronic diarrhoea (this started early March), which now turns out to be because his tumour is blocking the pancreatic duct and therefore he has no enzymes getting into his gut to allow him to digest his food. He was prescribed Creon about a month ago, and more recently when that seemed to have no affect, the dose of this was increased and he was prescribed Loperimide (liquid immodium). The dose of the Creon and Loperimide has now been increased again, but still he is getting no relief from the awful symptoms that he has.

Basically he eats, and with in minutes he starts getting terrible wind (from both ends), he gets severe pains in his stomach which he describes as 'gripes' but which can double him up at times, depending on how much he has eaten this will either abate after several hours or continue and end in a very unpleasant episode of diarrhoea.

He is now taking the following medication for this part of the problem: Creon, between 1 x 25000 capsules (for a cup of tea) to 3 x 25000 capsules for a main meal and 4 x loperimide spaced 4 hourly throughout the day.

He is losing weight incredibly rapidly, he has no energy, he is uncomfortable almost all of the time and is generally feeling completely wretched. He is afraid to eat as he knows the pain that will follow and the inevitable outcome. He feels like he is unable to continue like this for much longer and fears that his body will struggle to take much more of it before it shuts down (whether there is any truth in this or just how he feels I am not sure).

Has any experienced anything similar? Has anyone found a combination of medicines that works. I cannot bear the thought of him continuing to be in this sort of state for the rest of his time (however long or short this might be).

Any advice would be very much appreciated.

Thank you

Emma

[LizzyD]

Hi There,

So sorry to hear of your troubles. I am new on the board but my husband was diagnosed with PC last October. (2010). When his common bile duct blocked, a stent was fitted to allow the bile and pancreatic enzymes to flow. Would it not be possible to put a stent in your Dad's the pancreatic duct? My husband's tumour blocked the stomach exit and he had an op to reroute his digestive system. This was very successful and has allowed him to eat without constantly vomiting. It's an awful disease. God bless,

LizzyD.

[lynbo]

Hi Emma

My husband was the same, first he couldn't go to toilet, then couldn't stop, he too had pc and had spread to liver, he had a stent, but it didn't really work and was in agony with toilet trouble as you describe with your dad.

I know where LizzyD coming from, but another stent was deemed too dangerous in our case, so...... Andy was on co danthrusate, which was decreased when the diarrhoea started, also his oramorph liquid pain relief was upped to 20mg/1ml which made him a little constipated, but that wasn't a bad thing?

We had soups, and mash, easily digestible food, as my Andy also got to thinking he didn't want his meals as it resulted in pain.

I don't know what yr dads meds are, but oramorph could be an option? The pain control is a big thing and I know how you must feel, no-one should suffer.

Maybe ask palliative care or mac nurse about the above?

Hope this helps Emma

Take Care

Xxxxxxxxx

[PCUK Nurse Jeni]

Hi Emma,

Sorry that your dad is having problems.

There are a few things he could try:

1.Try opening up the creon capsules, (when having a meal or snack), and sprinkling the contents over the food, just before eating. This may help, as sometimes people are sensitive to the contents of the capsule of the enzymes. If he does this, he must eat the food straight away, as it can alter the taste of the food.

2. The wind and bloatedness may be helped by taking Omeprazole along with the creon. A dose of 20mg per day should suffice -but is a prescription drug. This will also help with abdominal discomfort.

3.He could ask to be changed to some of the other enzyme preparations, such as Pancrex -V or Nutrizym.

Hope there is a solution for him.

Jeni.