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    Suggest treatment for chronic constipation

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Posted on Mon, 22 Jun 2015 in Digestion and Bowels
Question: My father is aged 80 years and suffering from chronic constipation which causing blockage of stool causing gas and nervuseness! Pls suggest!
doctor
Answered by Dr. Rakesh Madhyastha 18 hours later
Brief Answer:
Chronic constipation

Detailed Answer:
Hello

Thanks for the query

Constiption is a common symptom in that age group. In order to help you better I need a few more details

1. how many times does he pass motion in a week?
2. is there a feeling of incomplete evacuation?
3. what drugs have you tried till now ?
4. was any examination done to rule out hemorrhoids ?
5. was he a smoker ? or a diabetic ?

Please get back to me, I am awaiting your reply

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Madhyastha 2 hours later
Thanks.
1. He passes motion daily but once or twice but feels incompelete evacuation. It causes gas and no hunger. It results he feels weak and we are feeling he is going under depression
3.kayam churna , lactulose etc etc
4. His all lab test including stool and ultrasound is very perfect
5. No smoker , no alcohal
6. Diabetic for last 10 years
doctor
Answered by Dr. Rakesh Madhyastha 5 hours later
Brief Answer:
Diabetic enteropathy

Detailed Answer:
Hello

Thanks for getting back with the details

Diabetic enteropathy is very difficult to treat. However here is how you should go about it. Please follow all the instructions properly for a successful outcome

1. Lifestyle changes
-Eat high fiber diet. Every meal should have salads and fruits with skin.
-Fluid intake should be high. Only plain water will do. Do not try juice or other products. Coffee is good for constipation. I recommend 4-6 glasses of water minimum
-Exercise, daily walking of about 15-30 min. Since he is aged, let him do how much ever possible
-Most importantly urge to go should be tackled, a regular time should be set up for motion. Trying several times a day will only spoil the next cycle

2. Medications

-Syp Lactulose can be taken upto 30 ml twice a day
-Bulking agents like isisabgol husk can be added onto meals to add fiber
-Stimulants like Bisacodyl tablets has given good results in my patients

I hope I was of help, if you have any further doubts/queries then please do get back

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Madhyastha 10 hours later
Constipation, gas, indigestion, stomach pain
Joint pain, muscle pain
Depression, fatigue, anxiety, brain fog, mood swings, poor memory
Thanks you for briefing details. He is taking medicines except the stimulant you are suggesting. Pls brief diabetic enteropathy. How long stimulant and what doses to be taken. Pls reply. Regards
doctor
Answered by Dr. Rakesh Madhyastha 5 hours later
Brief Answer:
Diabetic enteropathy

Detailed Answer:
Hello

Diabetic enteropathy is an usual complication of long standing diabetes. Here the patients can have two variants. Constipation variant where one has difficulty in passing motion, they have indigestion and gaseous distention of the abdomen.
The other variant is diarrhea predominant where patients will have loose stools. Both these situations are difficult for the patient and hard to treat.

I usually tell my patients to try lifestyle modification first. It is important to realize that one need not pass stools everyday. 3 times a week is sufficient. I give Tab Dulcolax ( bisacodyl) 10mg at night, not more than 2 times a week.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Madhyastha 21 hours later
He has started taking dufelac lactulose 30 ml two times after meal , in the morning and bed time. Its helping. Is it also habit formig like kayam churna? Can he take it three times daily , if yes , the same dose ? Pls advice! Regards
doctor
Answered by Dr. Rakesh Madhyastha 7 hours later
Brief Answer:
Constipation

Detailed Answer:
Hello

Thanks for getting back and I am happy it is helping

You have asked a very important question. Yes it is habit forming that is why I insist that passing stools daily is not a necessity. 3 times a week is more than sufficient.
You cannot take it three times a day. Even 30 ml twice a day is the maximum dose, please reduce it after he has passed good stools

Please dont forget the lifestyle changes I have recommeneded

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4360 Questions

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