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Dr. Andrew Rynne

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Suggest treatment for constipation and abdominal pain followed by diarrhoea

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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16961 Questions

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Posted on Tue, 3 Nov 2015 in Abdominal Pain
Question: Hi Doctor,
I have this bowel movement problem for two weeks now. I have constipation for two days in a row, then I get a severe abdominal pain. When I go to the toilet I have to force my muscles to get a stool to the exit, when it does eventually exit it is solid. Relief?Not so. This is then followed by more abdominal pains, and diarrhoea, whitch last for about another six or seven trips to the toilet. When it eventually stops, the cycle starts all over again...two days of constipation etc.

Regards,
XXXXXXX xxxxxx
PS. For those two days in between I have no pain, until the cycle reoccurs.
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
Isabgol as required, colonoscopy and other tests.

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.

To recapitulate:
Male/69 - Symptomatic for 2 weeks - constipation - has to strain to have hard stool but the pain is not gone - followed by more pain and diarrhea - 6-7 trips - all over again with 2 days of constipation.

This is sort of a vicious cycle that starts over.
The constipation of 2 days makes the most distal part of the stool hard as the more water is absorbed. The food taken later has less time for water to be reabsorbed to the level to make this stool as well formed. In addition the body reflexes may secrete more water in the large intestine in response to the hard stool that has passed in the initial stage.
The pain will continue till the large bowel feels that it is evacuated.
This is bit of a physiological phenomenon exaggerated with age.

Another important point to be remembered by considering your age of 69 is a chance of some colonic pathology.
Hence a colonoscopy is imperative. Ultradonography and/or CT scan of abdomen if required on clinical evaluation, examination and other investigations.
In addition I would advise to have tests of blood and stool.
If the colonoscopy is normal, bowel regularization by isabgol husk in a glass of warm water, the dosage adjusted for the requirement may help.
If there is an evidence of infection in the stool or so, a course of an antibiotic and probiotic may help.

I hope this answer helps you, please feel free to ask for further relevant queries if you need to or if you feel that there is a gap of communication.

Take care
With regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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