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    Suggest treatment for severe constipation

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Posted on Sat, 12 Aug 2017 in Digestion and Bowels
Question: having problem passing stool
doctor
Answered by Dr. Ramesh Kumar 50 minutes later
Brief Answer:
acute and long term management.

Detailed Answer:
Hi Thanks for query.
Acute management-
You can ask you gastroenterologist to prescribe you Polyethelene Glycol.Polyethylene glycol-electrolyte solution is used to empty the colon. PEG-ES is in a class of medications called osmotic laxatives. It works by causing watery diarrhea so that -the stool can be emptied from the colon. The medication also contains electrolytes to prevent dehydration and other serious side effects that may be caused by fluid loss as the colon is emptied.Polyethylene glycol-electrolyte solution (PEG-ES) comes as a powder to mix with water and take by mouth.You have to drink one 8 ounce of PEG-ES every 10 or 15 minutes, and to continue drinking until your liquid bowel movements are clear.It will clear your bowel.,you can take Magnesium citrate also.It is also a osmotic diuretic with same effect as Polyethylene glycol.
In case if it also does not help go for Digital evacuation.It involves the use of fingers to aid in the removal of stool from the rectum.Stool is emptied by gently inserting a finger into the rectum and removing it.


Long term management-

i would say that have a practical approach as there is no magical formula,Things will take time but they will help in long term.

Use a laxative not stool softener-
Laxative coats your stool and intestines to prevent water loss. It also lubricates your stool to help it move more easily.It irriates the intestines causing rectum to theow out stools.Take lactulose 15 mg daily.Stool softner just softens the stool and never helps in expulsion.



Long term-
A drastic change in life style is required to cure constipation. Not exercising enough, not drinking enough water and delaying a bowel movement can worsen constipation symptoms.The most important factor in curing constipation is a natural and simple diet. This should consist of unrefined food such as whole grain cereals, XXXXXXX honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot. Adding some fat to meals or increasing the size of a meal such as breakfast can help create the urge to defecate. Individuals suffering from constipation should increase the amount of plant foods they consume to get more fiber in their diet. Constipation can be treated by changing diets.
Secondly human gastrointestinal tract is colonized by 1013-14 bacteria of 400 different species and subspecies.They are responsible for proper digestion of food.Depletion of this flora due to surgery can lead to severe constipation and digestive problems.
Intestinal flora are types of microorganisms known as probiotics that live normally as part of the intestinal tract. These organisms have several functions that help the body.The most plentiful and important bacteria in the small intestine is the Lactobacillus species. Lactobacillus helps ferment indigestible carbohydrates. It also helps to stimulate the digestive process and aid the absorption of nutrients,as well as increase the motility of the gastro intestinal tract.I would suggest her to start taking probiotics regularly.Probiotics are live bacteria and yeasts that are good for digestion.As her gut flora will improve her constipation would be relieved and well formed stools will pass.

Apart from this other recommendations are-
-Linseed: is extremely useful in difficult cases of constipation. One teaspoon of linseed with warm water should be taken at night for bulk and lubrication.
-Proper chewing: The diet alone is not enough. Food should be properly chewed-each morsel for at least 20 times.
-Taking a short walk is a good way to get some light exercise. Walking time should be gradually increased until it reaches 20 minutes.
-She should drink at least eight glasses of water daily. Water helps push the food through the intestines and also helps lubricate intestinal tissues. When the body is dehydrated, the intestines absorb the fluids from the food waste, which in turn leads to hardened stools
- Avoiding alcohol and caffeine is also important as these substances contribute to dehydration.
-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested
-Fruits and vegetables, which contain high amounts of fiber, aid in alleviating symptoms of constipation,Whole-grain bread, XXXXXXX oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.
-Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day
fruits: Generally all fruits, except banana and XXXXXXX fruit, are beneficial in the treatment of constipation.
Pears are beneficial in the treatment of constipation.
Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation
All these things will increase the bulk of your stool,Will soften it and will clear your ileum of the compacted faecal material.
-While sitting on the toilet, support the feet on a small stool in order to achieve a normal position that aids in bowel movement.
Don't stop laxative,initially start following all these advices then gradually taper the doses of laxatives she is on.
Take Fybogel husk-Fybogel sachets and Fybogel Hi-Fibre sachets both contain the active ingredient ispaghula husk, which is a type of medicine called a bulk-forming laxative. Ispaghula is a type of fibre. It swells when it comes into contact with fluid in the gut and thus increases the volume of the faeces.It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative.



Don't panic,be hopeful and keep the patient motivated.
Good luck.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2438 Questions

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