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Taking miralax for irritable bowel syndrome with constipation and hiatal hernia. What is the solution?

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Practicing since : 2009
Answered : 4362 Questions
I hope you can advise. I have several gastro related problems developed over the years. I was told I had GERD in 1997 and about a year later I noticed that I no longer felt the urge to evacuate. It has been that way since. Unless I take a really powerful laxative and then I would get cramping but cannot fully evacuate in timely manner. Then I was told that I have irritable bowel with constipation, hiatal hernia, and in more recent years was told by a gyn/obs that my rectum is too tightwhen he did a manual check. Feel heaviness and sometimes pain in rectal area. Shape of stool is small and sparse. I use Miralax but even that is not sufficient to feel comfortable.. Is there any solution to this problem? ptying bowel kin timely manner is impossible and have problems emptying bowel. when i was examined by a gyn/obs i was told that my rectum is too tight.
Posted Sun, 1 Dec 2013 in GERD
Answered by Dr. Rakesh Madhyastha 1 hour later
Brief Answer: Need specialist advice Detailed Answer: Hello Thanks for the query I understand that you have constipation and feeling of heaviness. You have two separate issues. 1. GERD due to hiatus hernia 2. Irritable bowel syndrome For the GERD I recommend you use an antacid and pro motility combination like Pantoprazole with domperidone one a day before food. I also suggest the following 1. Do not sleep immediately after dinner, wait for atleast 2 hours before getting to bed after dinner 2. Avoid spicy food 3. Is you are symptomatic, you have pain abdomen or feeling of reflux avoid bending exercises 4. Avoid caffeine, alcohol and smoking when you are symptomatic. Other times it should be in moderation Your second issue is Irritable bowel syndrome, here the stools are usually small and sparse. I see that you are confused about the tight rectum, I would like to add here that Obs/gyn are not specialist in treating this condition and not trained as well, I strongly suggest you to meet a gastroenterologist or a general surgeon instead. Its been several years since your colonoscopy and even the previous one was not successful. Here is what I suggest to you 1. Continue taking the laxative 2. Drink plenty of water as it helps preventing hardening of stoolss 3. Add bulk to your food in the form of vegetables and fruits 4. Ispaghula husk 2 tsp added to water three times daily and consumed also helps in the formation of stools I hope I was of help, if you have any further queries please get back to me I wish you good health Regards
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