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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I have had Chrones for 3 years. I also have

Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2349 Questions

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Posted on Sat, 30 Mar 2019 in Digestion and Bowels
Question: I have had Chrones for 3 years. I also have CFS/ME and Fibromyalgia. Asthma and Gerd
I have been on Humira once a fortnight for 6 months, and then once a week for six months.
I have now developed constipation. I have taken two lots of Colonoscopy Prep to clear the bowel, but I still have constipation issues. However although I have originally cleared the bowel My bowel after two days is loaded and I am constipated again. Then I have to take constipation tablets again to help releive the bowel. We did a bowel Xray which showed the large bowel loaded but no obstructions. My ESR is 97 and has continued to be high since May last year. Before that it was 30 - 33 always. When I do get to go to the toilet I have diarrhea and the water is maroon colour in the toilet cisten. I suffer with Fatigue .
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Follow up: Dr. Ramesh Kumar 0 minute later
I have had Chrones for 3 years. I also have CFS/ME and Fibromyalgia. Asthma and Gerd
I have been on Humira once a fortnight for 6 months, and then once a week for six months.
I have now developed constipation. I have taken two lots of Colonoscopy Prep to clear the bowel, but I still have constipation issues. However although I have originally cleared the bowel My bowel after two days is loaded and I am constipated again. Then I have to take constipation tablets again to help releive the bowel. We did a bowel Xray which showed the large bowel loaded but no obstructions. My ESR is 97 and has continued to be high since May last year. Before that it was 30 - 33 always. When I do get to go to the toilet I have diarrhea and the water is maroon colour in the toilet cisten. I suffer with Fatigue .
doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
Please follow detailed answer.

Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
As far as I could understand your main query is regarding constipation followed by Watery stools.
Pathophysiology
When ever a person is constipated bad bacteria's and yeast form colonies in that area. These bacteria's then ferment the food and releases large amount of toxins these toxins causes severe inflammation of Wall of intestines hence they fail to digest as well as absorb food properly which causes flushing out of this contaminated food in form of liquid and fatigue due to inability of gut to absorb proper nutrients.
Now constipation itself has a number of causes. You are on medications and have multiple ailments as written by you.
So first thing is that instead of panicking you have to understand that things would get better with time but they will take time so don't panic.

A drastic change in life style is required to control constipation. Not exercising enough, not drinking enough water and delaying a bowel movement can worsen constipation symptoms.

The most important factor in curing constipation for you is a natural and simple diet. This should consist of unrefined food such as whole grain cereals, XXXXXXX honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot. Adding some fat to meals or increasing the size of a meal such as breakfast can help create the urge to defecate.

You should increase the amount of plant foods they consume to get more fiber in their diet. Constipation can be treated by changing diets.

Secondly human gastrointestinal tract is colonized by 1013-14 bacteria of 400 different species and subspecies.They are responsible for proper digestion of food.Depletion of this flora can lead to severe constipation and digestive problems.
Take a probiotic like Econorn twice regularly.
-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested

-Fruits and vegetables, which contain high amounts of fiber, aid in alleviating symptoms of constipation,Whole-grain bread, XXXXXXX oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.

-Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day
fruits: Generally all fruits, except banana and XXXXXXX fruit, are beneficial in the treatment of constipation.
Pears are beneficial in the treatment of constipation.
Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation.
These things may sound normal but would help you a lot on long runs.

All these things will increase the bulk of your stool,Will soften it and will clear your ileum of the compacted faecal material.
-While sitting on the toilet, support the feet on a small stool in order to achieve a normal position that aids in bowel movement.
Start taking a laxative like Lactose in a dose ranging from 30 to 60ml.
Initially start following all these advices then gradually taper the doses of laxatives.
In the mean while if you feel impacted you can take Fleet enemas of Peg lep solution.
Take Fybogel husk-Fybogel sachets and Fybogel Hi-Fibre sachets both contain the active ingredient ispaghula husk, which is a type of medicine called a bulk-forming laxative. Ispaghula is a type of fibre. It swells when it comes into contact with fluid in the gut and thus increases the volume of the faeces.It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative.

Initially follow the above mentioned advice for 1 month,And have patience even if you would follow half of the above mentioned points you would start feeling better.

2)ESR is elevated due to inflammatory condition like fibro myalgia Asthama etc.
3)If you feel like having impaction of stools in the mean while you can take colonoscopy preparation medicine.

Don't panic,be hopeful and keep the your self motivated.Things would take time but you would start feeling better very soon.
In case you have any other question please follow up.
Hope i was clear and easy to understand my dear.
Good luck and thanks.

Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Ramesh Kumar 0 minute later
Brief Answer:
Please follow detailed answer.

Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
As far as I could understand your main query is regarding constipation followed by Watery stools.
Pathophysiology
When ever a person is constipated bad bacteria's and yeast form colonies in that area. These bacteria's then ferment the food and releases large amount of toxins these toxins causes severe inflammation of Wall of intestines hence they fail to digest as well as absorb food properly which causes flushing out of this contaminated food in form of liquid and fatigue due to inability of gut to absorb proper nutrients.
Now constipation itself has a number of causes. You are on medications and have multiple ailments as written by you.
So first thing is that instead of panicking you have to understand that things would get better with time but they will take time so don't panic.

A drastic change in life style is required to control constipation. Not exercising enough, not drinking enough water and delaying a bowel movement can worsen constipation symptoms.

The most important factor in curing constipation for you is a natural and simple diet. This should consist of unrefined food such as whole grain cereals, XXXXXXX honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot. Adding some fat to meals or increasing the size of a meal such as breakfast can help create the urge to defecate.

You should increase the amount of plant foods they consume to get more fiber in their diet. Constipation can be treated by changing diets.

Secondly human gastrointestinal tract is colonized by 1013-14 bacteria of 400 different species and subspecies.They are responsible for proper digestion of food.Depletion of this flora can lead to severe constipation and digestive problems.
Take a probiotic like Econorn twice regularly.
-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested

-Fruits and vegetables, which contain high amounts of fiber, aid in alleviating symptoms of constipation,Whole-grain bread, XXXXXXX oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.

-Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day
fruits: Generally all fruits, except banana and XXXXXXX fruit, are beneficial in the treatment of constipation.
Pears are beneficial in the treatment of constipation.
Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation.
These things may sound normal but would help you a lot on long runs.

All these things will increase the bulk of your stool,Will soften it and will clear your ileum of the compacted faecal material.
-While sitting on the toilet, support the feet on a small stool in order to achieve a normal position that aids in bowel movement.
Start taking a laxative like Lactose in a dose ranging from 30 to 60ml.
Initially start following all these advices then gradually taper the doses of laxatives.
In the mean while if you feel impacted you can take Fleet enemas of Peg lep solution.
Take Fybogel husk-Fybogel sachets and Fybogel Hi-Fibre sachets both contain the active ingredient ispaghula husk, which is a type of medicine called a bulk-forming laxative. Ispaghula is a type of fibre. It swells when it comes into contact with fluid in the gut and thus increases the volume of the faeces.It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative.

Initially follow the above mentioned advice for 1 month,And have patience even if you would follow half of the above mentioned points you would start feeling better.

2)ESR is elevated due to inflammatory condition like fibro myalgia Asthama etc.
3)If you feel like having impaction of stools in the mean while you can take colonoscopy preparation medicine.

Don't panic,be hopeful and keep the your self motivated.Things would take time but you would start feeling better very soon.
In case you have any other question please follow up.
Hope i was clear and easy to understand my dear.
Good luck and thanks.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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