Suggest treatment for constipation and bloating

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Posted on Wed, 10 Jun 2015 in Digestion and Bowels
Question: I have been extremely anxious and worried about my bowel movements. while I have had minimal evacuation, they have been much less than normal. I have a good appetite and have not lost any weight, but I have been very tired. No pain...but I do have bloating. I am 77 years young, under a lot of stress (selling my business), do not exercise, I am not on any medication except Nexium. I have GERD and IBS. I had a colonoscopy and endoscopy last year; one polyp (benign) and Pylori. My doctor told me to take a laxative, which has not helped. I have never smoked and do not drink. ( I own a drug/alcohol treatment center).
doctor
Answered by Dr. Klerida Shehu 33 minutes later
Brief Answer:
Stress,diet,lifestyle regimen to be well under control...

Detailed Answer:
Hi,

I am sorry for the stressful situation you are going through. Your health is more important than everything else. You can replace everything, but not your health.

Stress is one of the aggravating factors to constipation. Another factors include diet and lifestyle regimen. If you try to dominate (control) all these factors, you constipation issues will be alleviated too.

It is important to:
- increase water intake
- be more physically active
- have more foods high in fiber like fruits and vegetables (e.g. prunes, kiwi, pear, etc.)
- avoid those foods that would aggravate constipation: banana, yogurt, etc.


With regards to use of laxatives, I need to know the names of medications you are currently taking together with related dosage for a more specific advice.

Hope it was of help!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Klerida Shehu 2 hours later
An important note...although I have not had a "normal" bowel movement in over
a week, I am not constipated. I do "go" however; it is VERY little. I hate to sound impolite, but it is like "oatmeal" in its consistency, My routine is about 3 tx a day, now it is maybe one "small" amount per day. It is frustrating and frightening. The laxative is Milk of Magnesia. I am only taking Nexium on a daily basis due to my GERD. Does this help???
doctor
Answered by Dr. Klerida Shehu 19 hours later
Brief Answer:
Nexium possible cause to constipation,following advice...

Detailed Answer:
Hi back,

Constipation does not mean not to have a bowel movement (bm) at all. As you are saying, you have your daily bm but very small and with "oatmeal" consistency.

You can continue taking milk of magnesia to ease bm.

With regards to nexium, its use is associated with constipation problems. If you do not have GERD symptoms for the moment, discuss with your doctor to stop using any PPIs for some time (a couple of months) until you see improvement in your bm.

Hope it was of help!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Klerida Shehu 45 hours later
Thank you for responding. I guess the biggest concern has been my drastic change in my BMs. I had a CT scan done yesterday and there was no significant findings. My worry has been my father died of colon cancer; mother of lung cancer; maternal grandmother of mouth cancer. I know stomach cancer is difficult to diagnose in its initial stages and it is for that reason that I worry. I maintain a healthy appetite and have been eating well, but my gosh...WHERE DOES ALL THE FOOD GO?? For the amount I eat, I would expect a larger BM? I have a great sense of "fullness," am chronically tired, and a little nauseous but no vomiting. I know my worry is exacerbating my problems.
Your input has been gratefully accepted and welcomed. the feeling of being "all alone" is stressful in its self.
Thank you,
XXXX
doctor
Answered by Dr. Klerida Shehu 2 hours later
Brief Answer:
Following advice...

Detailed Answer:
Hi back XXXX,

1. I am sorry for all your family members who have suffered of cancer.

2. Please bare in mind that although you are having family history of cancer, it does not mean that you should have it in life.

3. Furthermore, your actual symptoms are not suggestive of stomach cancer. Plus, your recent examinations, including ct-scan are normal; excluding cancer and confirming IBS.
4. IBS is a fastidious condition, as it is not a proper disease. There are various things you can do to improve your actual symptoms:
- bathroom training: go to toilet after each meal to train your bowel movements (bm)
- increase physical activity
- use psyllum
-use olive oil 2-3 spoon per day
- try to control stress. Discuss with your doctor to start an anxiolytic medication to ease your stress symptoms if other steps cannot help
- Yoga, physical activity, breathing fresh air can also help

If no improvement you can start to use Linzess (linaclotide)one capsule per day
it works by increasing the secretion of chloride and water in the intestines, which can soften stools and stimulate bowel movements.

5. Do not worry about the food you eat. Your body will keep the nutrients it needs; while what is not used and needed will get cleared through bm although delayed by the constipation problems you are having.

Hope it was of help!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Klerida Shehu 27 hours later
First, I want to thank you for your insight and help. It has been very stressful worrying about cancer. I have stopped the Nexium and shall now hope for the best. I am curious as to way you think I "do not" have cancer? What symptoms lead you to believe this? I am with you, believe me, I DO NOT want any added stress in my life. Although I am 77, I have a lot I still want to do. Just to add to the information; I am a drug/alcohol counselor (I own a drug/alcohol treatment center). As such, I SIT all day as I counsel clients for one hour each. My hobbies are writing (I sit for hours up to 7/8 hours a day); I draw (I sell my artwork), which means I SIT another 8 hours a day. Since I own the agency I work only 3 days a week. So...my life has/is
very sedentary. For the first 46 years of my life I was a professional dancer on Broadway. Then I owned and taught dance until I was 63. Now...I sit. I am sure this lifestyle has added to my issues. What say you?
XXXX
doctor
Answered by Dr. Klerida Shehu 16 hours later
Brief Answer:
Sedentary life/stress affecting your bowel movements

Detailed Answer:
Dear XXXX,

I am astonished by your active lifestyle especially when I got to know you are a professional dancer on Broadway. Being such active has also had a positive impact on your bowel movements.

Switching from an active life to a sedentary one (while sitting most of time) has also effect your bowel movement by slowing them down.

Another point, all your examination resulted normal, which has totally excluded any cancer chance. Furthermore, defecating with small portions are not indicative for any organic problem, but more to a functional one (including IBS). This is completely true especially if stress is also present (as in your case).

Hope it answered to your queries!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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