Decreased kidney function, nausea and diarrhea in the elderly

Patient

Q: My dad is 83yr old father has been suffering with nausea and diarrhea for approx. 1 month. He has had his stools tested which came back fine but has had to give a second blood test as his first one came back borderline. He was not told anything other than he is slightly anemic. We also believe that his kidney level was 'borderline'. Some days he has a good appetite and will eat normally but other days he has a poor appetite. The strange thing is that the diarrhea always starts on an evening or through the night. Because of his age we are very worried that it could be something serious. The worries that we have are cancer, kidney failing or boweL disorder. Can you please offer any advice as to what it sounds like? We are waiting for his further blood results to come through but as this has been going on for some time we are all getting more concerned. Thank you in advance. Mrs C Ward

Doctor

A:   I understand your concern and worry. However these changes and symptoms could be either non specific or could indicate an underlying problem. A change in bowel movements and calibre may indicate a colon cancer and this can be ruled out by testing the stool for occult blood and a possible colonoscopy if doubt exists. The other causes of diarrhea could be a parasitic or bacterial infection which takes longer to clear out in the elderly. However the appetite changes could be linked to either some condition or just old age as appetite usually varies in the geriatric population. In terms of his kidney function since he has had borderline tests this time you could repeat the same in s few months and he could have some borderling kidney problem like failure as i notice he is a hypertension patient. Blood pressure affects the kidneys long term. It is best right now to keep him hydrated since he has diarrhea and if it worsens please take him to the ER since the elderly can dehydrate very soon just like children. Also arrange to see his GP and maybe consider stool testing for occult blood and also a colonoscopy if desired. All the best.

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