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Suggest Treatment For Chronic Constipation

Posted on Thu, 10 Dec 2015

Question: I am seeing a gastro doctor this week. I wanted to ask if you have any experience with gastroparesis?

I dont know this is what I have. I thought initially I had a blockage because stool kept coming out small and hard but frequency was very regular. My main symptom these last 3 months is constipation. I do not have nausea, gerd, or vomiting. I am able to eat normally and my stomach does not hurt. I am quite constipated in my opinion and it takes me using Miralax,& suppositories to stimulate bowels. It came on rather slowly with normal frequency but dry stools for like a month.Then slowly i lost urge to go. Now I dont have much urge as i did before and have gained 1.5-2 kilos as a result.I often feel bloated, although i try to keep things moving to releive the bloat. My weight now is 64 kilos. I was 62.5 kilos before this started 3/5 months ago. I am 5ft5

Answered by Dr. Dr. Klerida Shehu (4 hours later)

Brief Answer:
Please follow....

Detailed Answer:
Hi and thank you for asking on HCM!

I read carefully all your concerns ,previous medical history and I can say as follows:
1. You are experiencing chronic constipation since three months.To my opinion constipation at your age needs to be evaluated.

The most probable cause of your situation is:
- IBS with constipation/pre menopausal syndrome/stress
- gastroparesis
- bowel tumor( even you signs are not typical)
Even I have rated the first cause IBS, firstly you should rule out bowel organic issues with:
- colonoscopy( even your don't have blood in your stools)
- GI motility study exam

If all exams will result normal than I can say that your symptoms are due to IBS.

Mean time I suggest to:
- take plenty of water
- use fresh fruits and vegetables
- use kiwi and prune
- use olive oil three teaspoon per day
- use stool softener
- use bisacodyl tablet if needed
- avoid beans, broccoli, sugar foods
- increase physical activity
- avoid unnecessary stress

Hope it was helpful to you!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (1 hour later)

I will ask for these tests. You said I needed a colonoscopy to rule out tumour though symptoms are not typical. Is my presentation typical of gastroparisis, or are there stages? Thank you

Answered by Dr. Dr. Klerida Shehu (19 hours later)

Brief Answer:
Please follow the suggestions below

Detailed Answer:
Hi back

Usually gastroparesis is associated with nausea, vomiting and constipation.
Otherwise gastroparesis has stages like mild moderate and severe.
So constipation may the only symptoms of mild gastroparesis.

Wish you all the best.
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (17 hours later)

I didnt quite understand that. Are you saying that,

A.Constipation is ususally/always the only symptom of mild gastroparesis?

Or are you saying that,
B.Constipation possibly can be the only symptom in mild gastroparesis?

There is a major difference between A & B.

Also I just wanted to add that I did go to my gastro yesterday and after a consulation she beleives I only need a colonoscopy & endoscopy.

She thinks that I am suffering from "Girl Bowel". Basically I use to have the bowels of a man and now my bowels have become slow much more like a female. This can be emotional/hormonal.

I did specifically ask about gastroparesis and if I should have motility studies and she said definately NO it was not necessary. I didnt want to argue so I said ok, but I am not sure if I should push for this??

Please advise??
Also I wanted to add that I took a Dulcolax suppository last night, which is a stimulant suppository and it did not work at all. I had completely no action at all. I read reviews that everyone was so pleased with them and how they worked so well and nothing at all happened with me.

Does this mean anything in particular?? :0(

Thank you!!

Answered by Dr. Dr. Klerida Shehu (20 hours later)

Brief Answer:
Please follow the suggestions below

Detailed Answer:
Hi back,
Sorry for my late.

Thank you for giving more of your medical data.
Let me explain again:
1.With regards to mild gastroparesis what I try to say is.B.constipation possibily can be the only symptoms in mild gastroparesis.
2. You are mentioning "girl bowell"and it similar to
IBS with constipation that I have mentioned above.
3.To my opinion firstly you should perform colonoscopy . If your doctor dosen't see bowel peristaltic wave during the colonoscopy procedure than you should do motility study testto rule out gastriparesis.
4.The fact that dulcolax suppository wasn't succesive , dosen't means something in particular.
It only shows a severe constipation or that ampula region of the rectum was empty.

Wish you all the best!
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar