Feces surprise

I have been experiencing unexpected fecal discharge. Just a small piece of poop that somehow just squeezes itself out at any given moment. This just happens randomly, I never suspect it is coming. I’m thinking it is due to the phosphate binders, is there anyone else that experiences this strange occurrence?

There is something called intraabdominal pressure that is higher when you are on PD and have fluid in your peritoneum. This may be forcing out some stool. Are you doing CAPD or CCPD? The intraabdominal pressure is lowest when you are lying down, so if you’re doing CAPD, you might want to think about switching to a cycler. (Sorin V, Ron Y, Smetana S, Avni Y. Fecal incontinence secondary to CAPD. Am J Kidney Dis. 2003 Jan;41(1):E2) If you are already using a cycler, do you need a daytime exchange as well?

If you are using a standard abdominal PD catheter, there is also another option for you. One review study found that the presternal catheter (implanted in the chest for PD instead of the abdomen) caused fewer problems with fecal incontinence. (Twardowski ZJ. Presternal peritoneal catheter. Adv Ren Replace Ther. 2002 Apr;9(2):125-32.)

Even though this problem is embarrassing, please do talk to your PD nurse and nephrologist. They’ve no doubt seen it before and can help you. This isn’t something you should have to live with.

Most patients say that phosphate binders constipate them. Although it seems like it would be impossible, you can be constipated and leak feces. I’d ask the doctor or nurse whether any health condition or medicine you are taking might have this side-effect. You might want to read about bowel incontinence on the government website Medline Plus. it includes symptoms, causes, home care, and more.