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What Causes Constipation And Nausea With History Of Pancreatitis?

Posted on Sat, 21 Jun 2014

Question: I have been constipated for several days with my bowel movements being only small little round balls. I went about two days with no bowel movement until today, with the help of suppositories I was able to have one large BM and two smaller ones. But throughout the past two days I have had horrifying level 10 pain where my symptoms are strikingly reminiscent of a time about six years ago when I had pancreatitis after complications from my gall bladder being removed. Then, like as is now, I am having pain as though my ribs are being wrapped around each other with a belt and being pulled as tightly as humanly possible. It literally feels,like my ribs are caving in on themselves. Its hard to breath and hard not to panic. I haven't been able to eat, as doing so inflames that same pain and then causes extreme nausea. It was only this morning after eating a begal that I began throwing up and have been nauseated all day. now the pain is constant and I feel such horrific pain that is not letting up. please tell me if you knew what this is. I have hardly been able to ingest a thing, not even sips of water. My stomach is also distended and very very sensitive to any touch. At this point there isn't much at all that is relieving the pain, and I have 20mg Oxycodone's here. please someone tell me what to do.

Answered by Dr. T Chandrakant (2 hours later)

Brief Answer:
No Oxycodone and get hospitalized immediately.

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

I can gather the first thing is that you had pancreatitis as a complication of gall bladder removal 6 years back.

Now there is pain and all the symptoms you explained. You are unable to take anything orally and have constipation too.

The most probable problem I can think of is pancreatitis. This has caused the inflammation of the nearby pleura which in turn has caused the severe pain you have in lower chest.

I would advise you to get admitted and undergo all the relevant blood tests including liver function, kidney function, blood sugar, electrolytes, urgent ultrasonography and MRI / CT of abdomen and chest to confirm the diagnosis.
Anyway you are not in a position to tolerate anything orally so you must be in dehydration causing the secondary problems of constipation.

Rust to the Hospital, do not take anything orally. Oxycodone to be avoided as it would mask the symptoms and signs and is not a good medicine to be taken in pancratitis due to its effect on the sphincter of pancreatic and bile ducts to cause spasm and worsen the problem.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. T Chandrakant (20 minutes later)

Thank you very much doctor! You are right that I am dehydrated and that the Oxycodone is not of any real benefit at this time. I think you are also correct that I must visit the ER but it is midnight here, and I have four kids at home with no one to watch them. What are your thoughts on me perhaps waiting the night out and going in the morning? I have made myself as comfortable as could be is this situation and in the AM I will also have the help of my husband. I would only do this however as long as I knew my life was not in clear and present danger.

Thank you Doctor! Hope to hear from you soon!

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
ASAP please.

Detailed Answer:
Thanks for your appreciation.

Yes, I can understand the position you are in. But dehydration can cause further problems and can lead to a vicious cycle. I would request you to call for a help, call back your husband and visit ER ASAP ( as soon as possible)

Please do not take Oxycodone. If it is possible/ tolerable you can take water or Oral rehydration solution (ORS). No food please.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. T Chandrakant (14 minutes later)

Thank you Doctor! Besides the added pain, is there any other reason food should be avoided?

Answered by Dr. T Chandrakant (9 minutes later)

Brief Answer:
can increase the pain

Detailed Answer:
In case of an anticipated any abdominal emergency, it is better to avoid food as it evacuation time in forward direction is altered. And most important is that by reflex action it can increase the pain.
Patient is usually kept 'nil orally' till the investigations are done, proper management is started and till the Doctor feels it safe to start orally.
So better avoided till your visit to ER.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj