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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18435
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My 82 year old mother with alzheimer's and now on hospice for

Customer Question

My 82 year old mother with alzheimer's and now on hospice for liver bile duct blockage (possible cancer). She has not had a bowel movement in 7 days. We have given her Milk of Magnesia and Senna for the past couple of days and today baking soda in water. We are noticing for the first time tonight--she has 2 large hard knots or lumps on each side of her anal area--approx inch or two away from anus. Could this be fecal material or something else? Can't imagine that we would feel hard fecal material like that?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
It would not be stool in the location that you describe, at least not with normal anatomy. It is possible to form an abnormal path, called a fistula, that can fill with stool, but this would be less likely than some other possibilities.
It is more common that a hard knot around the anus is due to a blockage in a gland or an infection. The infection can also form into an abscess and fill with pus. If the area is very tender, then it would likely be an abscess or infection.
It is also possible that it could be a tumor. It is possible that there is a cancer of the anus or rectum that has spread locally to the area that you can now feel the spread. This type of cancer also can spread to the liver and cause blockage of the bile duct.
It is also common for cancer to cause an absence of bowel movements, either by blockage or interference with the nerve and muscular activity of the gut.
Treatment would depend upon the underlying cause. If it is an infection, then antibiotics would be appropriate. An abscess would usually need drainage. A tumor would usually not be treated aggressively in someone in hospice, although use of laxatives to help with bowel movements would be appropriate. If she is more uncomfortable, then a stronger laxative, such as Mag citrate, may be necessary.
If I can provide any further information, please let me know.