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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for constipation

Answered by
Dr. Ratnakar Kini


Practicing since :1996

Answered : 1956 Questions

Posted on Mon, 9 Nov 2015 in Digestion and Bowels
Question: Hello Doctor, I have been having hard stool problem for the last 6 months. I visited a physician in XXXXXXX who put me on a laxative for a couple of days, which worked only for the period I took it. Afterwards the problem persisted. I have had daily bowel movement all the time. After initial hard stool is passed (after a long struggle everyday), the stool becomes normal. But as a result of the hard stools I started bleeding in the anus. I started noticing this very frequently and was/am very distressed. I increased my water intake but it did not help much. Then someone suggested few drops of castor oil before bed time with warm milk/water which has been helping me address this problem. Whenever I don't take castor oil, the problem reappears. I am very worried and feeling uncomfortable to visit the doctor again. Please suggest if there is a permanent cure to the problem I am facing. Please note that I am taking medication for hypertension for the last 8 years. Both my parents are diabetic but my sugar levels are under control for now.
Answered by Dr. Ratnakar Kini 34 minutes later
Brief Answer:
Need more information

Detailed Answer:
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

I need some more information before I can give my opinion.

1. What exactly do you mean by "but my sugar levels are under control for now". Does that mean that you are a diabetic and your blood sugar is under control now? What is your HbA1C level?
2. Have you checked your thyroid?
3. Are you on any antacid or cough medications?
4. What laxative was prescribed by the physician?
5. What are all the tests done so far with regards to your constipation?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ratnakar Kini 56 minutes later
Hello Dr,

Please find my answers to the questions you have asked.

1. I am not diabetic. The last time I checked my sugar levels HBA1C, it was 5.8. But this was almost 5 months back.
2. No, I haven't checked my thyroid
3. No, I am not on any antacid or cough medication
4. I was prescribed Creamaffin plus laxative (6 months back) I was specifically asked to take only for 2 or 3 days, which I followed.
5. Haven't done any stool tests. I had done full body check-up about 4 months back which included ultrasound scan, nothing was reported then. As I said earlier, I am having daily bowel movement, its just that I have hard stools initially which becomes very difficult to manage & causes bleeding.

Please note that I was also having Vitamin B12 deficiency (79 pg/ml) and Vitamin D was around 59.6 nmol/L. I was prescribed Eldervit injection which I took for 4 times and then did not continue.


Answered by Dr. Ratnakar Kini 9 hours later
Brief Answer:
Stool softeners, high fiber diet, sitz bath

Detailed Answer:
Thanks for the additional information.
Check your thyroid levels.

You need to increase the fiber intake and also take stool softeners.
Include more greens, vegetables and fruits in your diet. Drink enough fluids.

Take Movicol (1 sachet-0-1 sachet) mixed in 200 ml of water for one week followed by Cremadiet Duo 2 scoops in 250 ml of water at night after that.

The bleeding could be probably be due to anal fissure.
The medications I have mentioned above will help.
In addition do a sitz bath twice a day and apply anovate in the anal opening after sitz bath.

Sitz bath is done by sitting in a tub of lukewarm water exposing the anal part to it.

I hope that answers your query.
Let me know if you have any more questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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