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How long can I go without having any bowel movement before I need to be concerned?

DOCTOR OF THE MONTH - Sep 2013
Sep 2013
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How long can I go without having any bowel movement before I need to be concerned?
Posted Sat, 28 Dec 2013 in Digestion and Bowels
 
 
Answered by Dr. Het Ram Bishnoi 59 minutes later
Brief Answer: 72 -120 hours . Detailed Answer: Hello In my practical cases I have seen that 72 -120 hours ( 3-5 days ) are maximum for no bowel movement without trouble. This is because of eating habits of an individual as well intestine habit . If no bowel movement within 3 day (72 hours) ,it is a cause of concern. Most persons have at least three bowel movements per week. Hope this information will be helpful for you . Further any question I will reply in follow up. Good luck. Dr. HET
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Follow-up: How long can I go without having any bowel movement before I need to be concerned? 1 hour later
Thank you for your answer. I have been suffering from worsening constipation for about three years now. I do take probiotics and fiber supplements which initially improved my bowel habits. Since that though it started to worsen again to the point of me frequently not being able to move my bowels for seven days or more . I take OTC laxatives which bring no relief for the most part but cause cramping. I also use OTC enemas, usually also with very little success. Right now I am on day ten of no bowel movement, the longest so far. I am in quite intense discomfort. My stomach is painfully bloated and I am nauseated. Frequent burping brings no relief from the bloating. I feel a lot of intestinal pressure, there is also a significant amount of cramping. My abdomen is painfully tight and visibly distended (so much so that pants that are usually lose won't fit). I took laxatives in the first four days ,with no success, but stopped as they worsened the cramping. My partner gave me an OTC enema twice (the first one two days ago, the other one this morning), also with no success. How concerned should I be?
 
 
Answered by Dr. Het Ram Bishnoi 1 hour later
Brief Answer: Severe constipation . Detailed Answer: Hello Very sorry to hear such type of condition. You seem to have symptoms of severe constipation - bloating, burping , abdominal distension. As enema did not work, in my opinion you will need a manual evacuation of stools where stools are removed through per rectal examination. It would be done at a nearest ER or urgent care clinic. Once fecal material removed , you will get relief. A small minority ( probably < 5%) of all patients with constipation have cases that are considered SEVERE or "INTRACTABLE" these are patients most likely seen by GASTROENTEROLOGIST . As you are having this constipation from three years , this is a cause of concern . You need to investigated with colonoscopy & barium meal examination to isolate the case. I would recommend you visit a gastroenterologist at the earliest & sort this problem. Hope this information will be helpful for you. Further any question I will happily reply. Good luck. Dr. HET.
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Follow-up: How long can I go without having any bowel movement before I need to be concerned? 1 hour later
Again, thank you for your answer. I just recently had my partner give me a third enema in the hope this will finally allow me to pass at least some stool. I had to be manually evacuated once before and remember it as an extremely unpleasant, painful and embarrassing procedure that I obviously want to avoid. But I understand that if I can't move my bowels soon I will have no other choice. Do you have a suggestion on how much longer I can try to wait it out? And anything I can do prior to visiting the ER to make this procedure easier on me? I also was previously told that the more often I need a manual evacuation of stool the harder it will get to have a 'normal' bowel movement. Is there any truth to that? Thank you.
 
 
Answered by Dr. Het Ram Bishnoi 21 minutes later
Brief Answer: not more than 1 day... Detailed Answer: Hello, I understand manual evaculation is embracing and unpleasant; but in this instance we have almost no options. Please don't take it otherwise as this is necessary for your relief. At the most you can wait for 24 hours before visiting a doctor. You may repeat enema in the meantime and see if it helps you, but I doubt you will find relief. Therefore do not wait for more than 2 days. The more you wait, the harder your stool would get which inturn will make manual evacuation more painful. I haven't read or heard that manual evacuation will impair future bowel movement. However I would recommend that you consult a gastroenterologist after the current situation is solved. He/she can investigate for reasons of constipation and treat you accordingly. Hope this helps. Dr. Het
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Follow-up: How long can I go without having any bowel movement before I need to be concerned? 1 hour later
The recent, third enema was again unsuccessful, I still haven't been able to pass even a minimal amount of stool. I have to agree with your opinion that trying another enema will not produce any different results. My discomfort and pain has greatly increased in the last few hours. Can waiting for another 24hours have other consequences than harder stool and a more painful manual evacuation?
 
 
Answered by Dr. Het Ram Bishnoi 1 hour later
Brief Answer: Urge you to see the doctor at the earliest... Detailed Answer: Hello, It is better to try manual evacuation by an expert after applying xylocaine over gloved finger at the earliest. It would cause minimum pain. An alternate option would be to use soap water enema - retain soap water inside rectum for at least 10-20 minutes so that stool become soft. No doubt the stool becomes more hard and painful, it may cause intestinal obstruction where the condition may deteriorate. It is better to seek medical attention now. Good luck. Dr. HET
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Follow-up: How long can I go without having any bowel movement before I need to be concerned? 9 hours later
First I would like to thank you for your patience and very helpful answers. Thanks to your urging I did visit the ER shortly after your reply and had my bowels manually evacuated. Since returning home I was able, with very great difficulty and pain, to have two more small bowel movements. Unfortunately relief of my symptoms is so far only minimal. My abdomen is still severely distended and the painful feeling of tightness persists. The bloating of my stomach has also not decreased so far. Only the intestinal pressure and cramping has improved. I have never experienced the discomfort being so persistent even after moving my bowels. Is this possibly because of the longer period of no movement? Is there anything I can do to ease the symptoms? I have been trying warm compresses on my abdomen and walking (which is uncomfortable and difficult), both with no results. Thank you.
 
 
Answered by Dr. Het Ram Bishnoi 4 hours later
Brief Answer: Bowel movement. Detailed Answer: Hello my dear. I can understand your agony as this thing I have seen in my so many patients. In my opinion drink plenty of water , however this is not feasible at this time but try . Pain and cramping is no doubt due to immobility of intestine for long time. Take antacid (oxetacaine with in them is good for you) for bloating. Also take 1-2 phenolphathaline ( chewable ) tablets for laxative action. Good luck. Dr.HET
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Follow-up: How long can I go without having any bowel movement before I need to be concerned? 1 hour later
Thank you for your answer. Agony is certainly the right word as my discomfort persists. I have not been able to have anymore bowel movements despite multiple difficult and painful attempts and the now constant urge to evacuate. I will certainly follow your advise in the hope it will ease my symptoms and allow me an other successful movement. In case neither occurs, would you suggest I revisit the ER? And if so, how long should I wait? I hope all my questions are not a bother and I thank you kindly for your replies.
 
 
Answered by Dr. Het Ram Bishnoi 4 hours later
Brief Answer: Bowel movement & constipation. Detailed Answer: Hello my dear . This is my pleasure to answer but I am sorry I can't help you personally as a doctor. You may wait for 3-4 days before visiting a doctor if you have no stool. Alternatively you can try enema daily at him. It might help to use stool softener / laxatives for few days to restart normal bowel movements. Discuss with your treating doctor for a prescription. Continue to drink plenty of water. Cucumber also relieve constipation. AMALTAS, a purgative medicinal plant ( cassia fistula ,botanical name ) also help in constipation. Hope I have been helpful. I will be here for future questions. Good luck. Dr. HET
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