Question: Hello,

Starting in early March. My wife had sudden onset of chronic and severe constipation. She initially didn't go for 8 days. She took a laxative and was able to go. Since then, she would go 3-4 days without going, then go a few times over a couple of days and that pattern would start again.

Her symptoms are feeling tired all the time, constipation, lower abdominal bloating, cold hands/feet, feeling like she has to pee when she doesn't. The main issue is the constipation. Also, a new sympom that started 2 weeks ago, she has some pain in her chest when swallowing food or liquid. We were thinking that perhaps due to the chronic constipation for weeks before this started that this could be reflux or some irritation due to the constipation. Thoughts?

She had a transabdominal ultrasound of the pelvis at the ob-gyn which was normal. Her blood work came back good, except her thryoid is under-functioning. Her thyroid numbers -
TSH - 5.110
Thyroxine (T4) - 5.9
T3 Uptake - 23%
Free Thyroxine Index - 1.4
She was diagnosed as hypothyroid. She started 25 mcg a day of Levothyroxine about a week ago.

We understand that constipation is very common with hypothyroidism and the hope is that once her thyroid meds take effect, this will calm down. She is eating more fiber and drinking lots of water as well.

She began taking miralax and colace over a week ago and since that time, she has gone to the bathroom once a day and a couple of times twice a day. However, it seems that due to being so constipated since the beginning of March. She's been unable to get caught up, she is still uncomfortably constipated and her stomach is physically bloated. The miralax also seems to cause bloating. Her bloating seems to get better after she goes to the bathroom. But, then just seems to build back up as the day goes on and after taking the miralax.

Are there any tips for getting everything out to relieve the uncomfortable constipation and bloating? Trying to get back to a baseline of normal if you will. We have dulcolax (haven't taken yet) and were thinking of taking the miralax and a couple of dulcolax to try and help with this. We understand the constipation will likely continue until the hypo meds are right. We're just looking for a way to get most everything out and then a safe way to manage the constipation until the medication starts helping.

Since starting the miralax and colace. Most of her stools have been loose and watery. Not diarrhea, but not solid either. Before starting the miralax/colace, everything seemed consistent with constipation - small and hard stools. I understand that miralax and colace bring water in to soften things up, so this may be normal. She has been able to go what she considers a full amount on most days since starting the miralax - just softer than normal.

Also, I've read about 2 complications or causes of chronic constipation - impaction and obstruction. She doesn't seem to have symptoms for either of these - i.e. none of the following - crampy stomach pain, nausea/vomiting, mostly diarrhea. And she is able to go for the most part on the miralax and colace. But, I'd like to run that by you as a potential concern to get your thoughts.

Optional Information:
Person's Gender: Female
Person's Age: 42
What have you tried so far?: Miralax and colace. More fiber and water. Started Hypothyroid meds a week ago.