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Dr. Andrew Rynne

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Suggest treatment for constipation, lower left abdominal pain and racing heart beat

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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16463 Questions

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Posted on Thu, 10 Sep 2015 in Digestion and Bowels
Question: I am 76 ,male with IBS which was first diagnosed in 2010. With the help of hypnotherapy it the symptoms ( Primarily trapped wind ) disappeared. In August 2014 it flared up again, and persists to this day. The most
recent flare started a month ago, and has seen it at its most severe.
I have been constipated all my life, and whilst I can manage my pain during the day, most nights the wind
pain is severe, occurring lower left abdomen. The main problem, apart from the pain, is that I am woken
at irregular times during the night recently with a racing heart beat.
I have seen a local Gastroenterologist who is convinced that I have constipation predominant IBS.
I was described Macilax sachets 3 weeks ago, 2 a day, and dioctyl 100 mg capsules 4 a day.( 2 weeks ago )
Whilst my stools are much runnier, I am still straining on the toilet, and whilst I have no reason to doubt my Specialist's diagnosis, I am concerned at my sleeping patterns, particularly, my racing heart which goes to 80, my resting pulse being 60.
Any advice would be appreciated. XXXXXXX
doctor
Answered by Dr. T Chandrakant 20 hours later
Brief Answer:
Seeking a cardiologist is my first preference.

Detailed Answer:
Hi,

Thanks for your query and an elucidate history about IBS-C, medicines you are taking with the benefits you have got, persistence and concerns of straining at stool, sleeping patterns and racing heart with which you have to get up at irregular times, the wind pain still severe and occurring at left lower abdomen.

I would suggest you the following in such a case:
1. Though acute pain can transiently increase heart rate, I would insist you get a cardiac check-up done to rule out any underlying heart related problems.
2. Secondly, you may please ask your Gastroenterologist to add on medicines which act on the bowel like dicyclomine in lowest possible dose just to relieve the pain at night to be taken at bedtime as late as possible so that you may get sound sleep and the heart rate then may automatically not occur.
3. Addition of an anxiolytic (Hypnotherapy helped you) again at bedtime which quietens the mind and helps in sleep also may help you get get over the problem.
I am aware that these medicines may cause a bit of constipation but since you are already taking Macilax 3 per day, dioctyl 4 per day, this may not occur and yet make the life comfortable.
This will be a sort of permutation and combination which you and your Doctor has to do to get most effective treatment yet not cause constipation.

I am sure all relevant investigations must have been done by this time to indicate that you have IBS- Colonoscopy, CT scan, tests of blood including thyroid function tests, stool examination on 3 consecutive days and so on. If any of these are missed, I will urge you to get it done.

I hope this answer helps you to alleviate your symptoms, please feel free to ask relevant further queries if you need to or if you feel that there s a gap-of-communication.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. T Chandrakant 10 hours later
This is not a question. It is to thank you for your informative reply, in line
with my Consultants response.
I am to have a thyroid function test shortly, and would advise that my heart
is regularly checked, having a By pass some years ago.
When next discussing my symptoms with my doctor I will refer him to your
comments regarding dicyclomine, and addition of an anxiolytic.
Thank you for your prompt and informative reply. XXXXXXX
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
Thanks for your appreciation.

Detailed Answer:
Hi.
Thanks for your appreciation.
I hope this should help you to have a better life.
I shall be waiting for your reports and feedback and assist you further.

http://bit.ly/askdrtchandrakant
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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