Active discussions

Meet the Other Phone. Flexible and made to last.

Meet the Other Phone.
Flexible and made to last.

Buy now

Please or to access all these features

Talk
General health

Mumsnet doesn't verify the qualifications of users. If you have medical concerns, please consult a healthcare professional.

Original poster

Not urinated for 2 days and not had bowel movement for over a month

60 replies

Bepis · 18/03/2023 14:53

Just wanting some advice really.

My daughter is in hospital, currently sectioned under the mental health act.

I'm really worried though because she's not urinated in 2 days. She had a bladder scan yesterday at 11:45am and her bladder was full at that point but she still hasn't been. I don't understand why the hospital aren't taking any action.

Also, she's not had a poo since being in hospital (13/02/23). Granted she didn't eat for a long time but she has been eating full meals for the last 4-5 days but still no poo. Doctors have felt her stomach and there are no hard masses but shouldn't they be scanning her bowels or something?

I'm really worried about her.

OP posts:
Original poster
Bepis · 18/03/2023 15:45

@Blushingm she wears incontinence pads which they do check just in case and the staff haven't mentioned her leaking or anything.

I'm not sure about the ml for the last bladder scan yesterday - DH just said it was full. Time before that when they scanned, it was 571ml but she did do a wee after that one.

@TwoBlueFish Yes dd has a learning disability nurse assigned to her. She's a lovely nurse. She's not back on duty until Monday though.

OP posts:
RaisinforBeing · 18/03/2023 15:46

OP I am not sure how to quote but yes her tummy was extended and she was bent over in discomfort looking quite poorly. She didn't really have words to explain what was happening. She was still pooing a bit but there were masses further up. She was probably in hospital about 6 hours before they did the ultrasound. They were most worried that she couldn’t pee though I think that’s a red flag.

Original poster
Bepis · 18/03/2023 15:53

Should she have had a bowel scan by now?

OP posts:
RaisinforBeing · 18/03/2023 15:56

I’m afraid I don’t know but with my child once it became apparent that she couldn’t pee after trying multiple times after a lot of liquid they did a scan.

Fifi0000 · 18/03/2023 15:59

You can't force physical health treatment under the Mental health act. They have to do a capacity assessment if she does have capacity you can't force any medical treatment until it's dire.

CustardySergeant · 18/03/2023 16:06

RaisinforBeing · 18/03/2023 15:31

This happened to one of my children as a toddler. A mass in the bowel (constipation) blocked the urethra and she had to have a catheter inserted. She had an ultrasound where the constipation was evident. A huge amount of urine came out it soaked everyone in room. I think she was well over 24hrs since going. They kept trying to get her to drink more initially until they saw the mass. The catheter procedure was over very quickly. The constipation took about a week to get over with movicol and she was a few days in hospital.

How could it soak everyone in the room?

CoedenNadoligLanOHyd · 18/03/2023 16:09

If she's sectioned and on an medical ward, then I imagine she has someone with her all of the time. So they should know if she's been to the toilet/her pad is wet.

She has a learning disability and mental health needs so they absolutely can treat her for her physical health.

There is best interests/capacity. And if her physical health needs are due to her mental health then they can treat her.

Medication for mental health can cause constipation, and some can cause urine retention. Urine retention can also be caused by neuroleptic malignant syndrome.

I would contact the ward and express your concerns that her physical health is being neglected, and you are concerned that this is a safeguarding issue.

She absolutely should not be left like thus over the weekend. Unfortunately her learning disability and mental health make her at increased risk of being neglected and given poor care.

RaisinforBeing · 18/03/2023 16:10

Because there was a huge volume of liquid suddenly released.

Original poster
Bepis · 18/03/2023 16:15

@RaisinforBeing My daughters stomach is distended too, which was noticed yesterday. I hope they manage to do something to help my daughter as I am worried it is going to cause further damage.

@CoedenNadoligLanOHyd Unfortunately, she doesn't have someone with her all the time. When me and her dad cannot get there, she is pretty much left in the room by herself apart from the staff checking up on her every so often. I would say her physical health is definitely linked with her mental health as her mental health is the reason why I think she hasn't gone for a poo whilst in hospital. I have tried to contact the ward but no one is answering but I will try again soon.

OP posts:
neurosensitive · 18/03/2023 16:24

Mental health units are damaging to autistic people (and possibly people with learning disabilities) because care in those places is for neurotypicals and people who fit what the medical textbooks say. I think you need to keep on at the staff, complain to PALS, your MP and get her out of there as soon as possible. Speak to the National Autistic Society or a local autism charity for advice. Since your daughter is hospitalised they might be able to speed up the autism assessment as I know someone in Hertfordshire who had that done. I think you need to keep pestering the staff and though it will be distressing to have a catheter they should be able to use sedation and help make it as comfortable as possible. She would have wet herself by now so there must be a physical problem stopping her pee. They also need to get her bowels regular. You can't fully trust hospital staff to fully help her so you or other trusted relatives/friends need to visit as much as possible to make sure things are being done well and your daughter is safe. I hope you and your daughter get the help you need very soon. If not NAS can hopefully help.

CoedenNadoligLanOHyd · 18/03/2023 16:25

Ask if they are keeping a record of her bowel moments, as they should have this information.

You can't always tell if someone is constipated by feeling their stomach. I've seen constipation missed many times before.

If she is detained, then she should be offered have an advocate. So I would be asking for one, and also find out about carers advocates.

Constipation is a leading cause of preventable death for adults with a learning disability. I would be pointing this out to the nursing staff.

And as a previous poster said, contact PALS. Make sure you have it in an email.

Blushingm · 18/03/2023 16:26

@Bepis 571ml is a pretty much normal sized wee - so if she went after that it should be ok.

It's also difficult to tell with pads if someone has had little wees as they're designed to absorb more than just one big one.

If you're worried ask the staff to do a bladder scan it's very straight forward. A catheter is quite invasive (and very undignified to insert particularly for females) and if she does have some problems if she tried to pull it out it could cause trauma. Plus a catheter increases the risk of UTI

Original poster
Bepis · 18/03/2023 16:39

Update from my mum - bladder scan done. She is holding 589ml but no action taken as of yet.

OP posts:
Blushingm · 18/03/2023 17:27

That's a normal wee and nothing to worry about

Original poster
Bepis · 18/03/2023 17:39

Blushingm · 18/03/2023 17:27

That's a normal wee and nothing to worry about

According to my mum, they are preparing to catheterise. They said it's protocol for over 500ml. I'm just worried about the bowel side as well with it having been so long. I told my mum to mention about obstruction stopping her from weeing and they said it's very rare.

OP posts:
SNWannabe · 18/03/2023 17:42

Blushingm · 18/03/2023 17:27

That's a normal wee and nothing to worry about

Nonsense. We catheterise with a volume over 500ml and an inability to pass urine. Normal would be more like 250-300 and a history of no urine output for 24-48 hours is never normal.

SNWannabe · 18/03/2023 17:45

Bepis · 18/03/2023 17:39

According to my mum, they are preparing to catheterise. They said it's protocol for over 500ml. I'm just worried about the bowel side as well with it having been so long. I told my mum to mention about obstruction stopping her from weeing and they said it's very rare.

Show quote history

Why is your mum there and not you? Who normally consents for your daughter or does she have capacity? You need to get it documented that you are concerned about when she has last pooped and ask them to flag it up to her Dr. Of course constipation can impact the bladder, and fine well they know that. But if she can go to the loo independently it can be hard to monitor bowel

Original poster
Bepis · 18/03/2023 17:55

@SNWannabe My mum lives literally round the corner from the hospital and I live about a half an hours drive. I may have Covid so I'm having to stay away at the moment as I don't want to pass anything onto dd or other patients.

She was deemed to not have capacity before but I don't know if the ward has done a recent assessment.

Nurse apparently phoned the doctor and next step is a catheter but I know that will be distressing for her. Hopefully she will be ok when they do it.

OP posts:
bellac11 · 18/03/2023 17:57

SNWannabe · 18/03/2023 17:45

Why is your mum there and not you? Who normally consents for your daughter or does she have capacity? You need to get it documented that you are concerned about when she has last pooped and ask them to flag it up to her Dr. Of course constipation can impact the bladder, and fine well they know that. But if she can go to the loo independently it can be hard to monitor bowel

Show quote history

Do you expect OP to live in the hospital, one presumes she has to go home to have rest, eat, change clothes, try to get some space in her head. Clearly family are taking it in turns to support the daughter.

Toddlerteaplease · 18/03/2023 18:03

They said her bladder wasn't full. And she'd be in agony if she was in retention. This is the second post today about someone In retention.

Original poster
Bepis · 18/03/2023 18:05

Toddlerteaplease · 18/03/2023 18:03

They said her bladder wasn't full. And she'd be in agony if she was in retention. This is the second post today about someone In retention.

They said yesterday that her bladder was full and today it is 589ml so I am assuming that is more than yesterday considering she hasn't had a wee.

OP posts:
lljkk · 18/03/2023 18:08

Are you sure she's not bulimic? What is her weight now?

Original poster
Bepis · 18/03/2023 18:09

lljkk · 18/03/2023 18:08

Are you sure she's not bulimic? What is her weight now?

Her weight is 10 stone 6. She's lost 2 stone in 3 months

OP posts:
FlutterbButterfly · 18/03/2023 18:52

How old is she @Bepis ?

Blushingm · 18/03/2023 18:52

@SNWannabe many people hold more than 1 pint of urine especially if they're someone who is used to holding it as the bladder does stretch - it's the stretching that send a signal to the brain saying you need a wee. Same as people who have a catheter often have small bladders as they've shrunk as they don't hold any urine as they free flow.

It's obvious this lady has urinated as 500 is way less than someone would produce in a day with the amount of fluid she consumes - she has been an in patient for almost a month. So it's not nonsense - fair enough if someone can't urinate but in this instance it sounds like she is but the staff aren't aware. A pad can hold well in excess of 1 litre.