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Have hemorrhoids and ibs. Feeling constipated. Drinking lots of water and taking extra fiber. Thoughts?

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General Surgeon
Practicing since : 2008
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I've been constipated for the past few days and having small stool when I try to go to the bathroom after eating poorly/drinking on vacation. No pain or gas that is hard to pass. I was diagnoses with XXXXXXX hemorrhoids and ibs after having a scope about 8 years ago. I get constipated when I don't drink enough water or eat poorly. My hemorrhoids have been bothering me as I try to use the bathroom or wipe too much. I started taking extra fiber and drinking lots of water yesterday. My question is how long should I wait for the fiber to work before making a dr. appointment and can the hemorrhoids cause smallish stools.
Posted Thu, 4 Apr 2013 in Digestion and Bowels
Answered by Dr. Grzegorz Stanko 42 minutes later

Thank you for the query.

Pencil like stools (if this is what you mean by smallish) are a symptom of narrowing of the large intestine. It can happen due inflammatory bowels disease, colon polyps, colon cancer. Sometimes such symptom also appears when bumps are squeezed during pushing the stool (to increase pushing pressure).

It is very important to rule out bowels obstruction when such lac of stool appears. If you pass gases freely, have no vomiting, bloating, most likely this is only a constipation. But if any of mentioned symptoms has appeared, you should go to ER and have abdominal X-ray.

It can take up to 3 days for the fiber to work. However as the stool which is already in the large intestine is hard, fiber can not reach it. I suggest you to try Lactulose or other stool softeners along with plenty of mineral water and probiotics.
Physical activity or massage (especially in the lower and middle left area of the abdomen - here is sigmoid colon located; if you are thin person, you should be able to palpate hard and long structure in this area, this is the stool) should stimulate bowel movement. Same effect should give hot bath.

Hemorrhoids do not cause smallish stools, as long as anus is not narrow. Avoiding constipation is the most important part of hemorrhoids treatment. Other things which might be helpful are sitz baths with Quercus Cortex and hemorrhoids suppositories.

Hope this will help. Feel free to ask further question.
Above answer was peer-reviewed by
Follow-up: Have hemorrhoids and ibs. Feeling constipated. Drinking lots of water and taking extra fiber. Thoughts? 6 hours later
I saw a dr and he didn't think I needed an X-ray because I had no pain or difficulty passing gas. He told me take 1/2 bottle magnesium citrate and the other 1/2 four hours later. Repeat in 48 hours if it doesn't work. I'm drinking vitamin water. So far all I've passed is brown water with a few tiny hard specs. Is it normal to not pass anything more substantial and why wouldn't the laxative completely flush me out the first time?
Answered by Dr. Grzegorz Stanko 7 hours later

You need to know that the stool which is in your large intestine is very hard and needs time to get softer to be able to get excreted. That is why you wont get all stool out in one bowel movement.
However with laxatives your stool should be more ample. Magnesium citrate might be not effective. I suggest you to use Lactulose (should be available without prescription) as well as probiotics and mineral water (please see the steps I have mentioned before).

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Have hemorrhoids and ibs. Feeling constipated. Drinking lots of water and taking extra fiber. Thoughts? 5 hours later
Lactulose is not available in us without a rx. Do you have another suggestion?
Answered by Dr. Grzegorz Stanko 6 minutes later

Than you can try Bisacodyl 5mg 3x1. It is OTC in USA.

Above answer was peer-reviewed by
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