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Stopped bowel movements, pain in right side pain, taken Lactulose. Feels like muscle pain. Thoughts?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
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Hi,

I went to my primary care doctor yesterday be cause I had not had a bowel movement since Friday (I normally go couple times a day), and that was associated with right side pain on Saturday and left side pain on Sunday & Monday. He gave me Lactulose and that totally cleaned me out and I have eaten some organic oatmeal and other fiber foods today as he recommended. I have not yet had a regular bowel movement yet, but do not feel sick at all, except for the pain in my lower left abdomen which feels more like a bruise than anything else. It is to the lower left of my belly button. He wants to do a CT scan, but I'm not sure what that will show as this feels more like muscle pain than anything else....thoughts?
Posted Tue, 11 Sep 2012 in Abdominal Pain
 
 
Answered by Dr. Ketan Vagholkar 8 hours later
Hi,
Thanks for writing in.
Sudden onset of constipation requires prompt and meticulous work up.
A plain x XXXXXXX of the abdomen in standing position for any evidence of obstruction and a perdigital rectal examination is required to look for local causes. If that is ruled out then a enema followed by stool softners for a week is recommended.
If the patient does not respond to this then a radiological investigation like a double contrast CT scan is required to rule out any lesion higher up.
The pain which you are experiencing may be due to a loaded colon.
I would suggest that you undergo preliminary tests before going in for a CT scan.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
 
Follow-up: Stopped bowel movements, pain in right side pain, taken Lactulose. Feels like muscle pain. Thoughts? 17 minutes later
I've already taken the Lactulose and that cleaned out my system pretty well for about 16 hours. What preliminary tests could be done before going for the CT scan? My primary DR did a rectal exam yesterday during my visit and said the result on the instant smear test was normal, and he said that an x-ray was a worthless exam at this point. Is it possible to still have a loaded colon after taking the lactulose (60 ml) within 4 hrs and having frequent bowel movements over the next 16 hrs?

Kind Regards,
XXXXXXX
 
 
Answered by Dr. Ketan Vagholkar 8 hours later
Hi,
Thanks for the feedback.
If lactulose has caused complete evacuation of the large intestine then at this point of time no further investigation is warranted. You can continue with stool softners for a week. If that regularises your bowel movement you do not require any further investigation.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
 
Follow-up: Stopped bowel movements, pain in right side pain, taken Lactulose. Feels like muscle pain. Thoughts? 53 minutes later
I'm assuming that the Lactulose cleared my intestine as I had nothing but liquid come out for about 18 hrs, the last thing I ate was a berry smoothie on the advice of my dr and I could see the seeds, but since the lactulose has left my system I have not had a regular bowel movement, I'm assuming that my system is in shock, and I have been eating nothing but fiber (except for a salad last night) oatmeal, fiber cookies, raspberries since about 1pm yesterday, but still do not feel the need to go to the bathroom, does it take some time to get back to normal after taking that much lactulose? For breakfast I'm eating oatmeal again with raspberries and I have had an abnormal amount of gas as well, so I am hoping things are clear down there but no evidence of that yet. Also, the abdominal pain is much better, I would say it is about 75% gone maybe more so that seems good to me. I think I will start a stool softener as well, do you recommend anything specific?
 
 
Answered by Dr. Ketan Vagholkar 3 hours later
Hi,
Thanks for writing in.
I would suggest the following.
1. start a stool softner and continue it for 7 days.
2. drink plenty of water.
3. the best fruit for good bowel function is banana. Strawberries will not help much.
4. restrict the consumption of red meat for the time being.
5. it will take a day or two for the bowels to come back to normal after the bowel clearance.
As long as you are feeling fresh you do not have to worry at all.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
 
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