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Dr. Andrew Rynne

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What is the cause and treatment for constipation?

Answered by
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Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2228 Questions

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Posted on Sat, 23 Aug 2014 in Digestion and Bowels
Question: I am constipated but have no urge to poop for the last 3 days. I have a history of constipation but that never experienced lack of peristalsis before. I have tried warm water with lemon juice in the morning, adding more fiber through apples, senna, triphala, tablespoon of olive oil in the morning, taking magnesium oxide before bedtime, running, drinking lots of water (urine clear). Not sure what I should do at this point?
doctor
Answered by Dr. Klerida Shehu 18 hours later
Brief Answer:
Following suggestions...

Detailed Answer:
Hi,

I am sorry for the situation you are in.

Before giving my final conclusions, I'd like to know if you are passing gas. If no gas, but you feel bloated, then, should go to ER as soon as possible for further evaluation.

Otherwise, I advise to:
- schedule colonoscopy for further evaluation
- take lactuloze (30 ml 4 times daily)
- take sena supplement (laxative)
- do rectal enema (to induce bowel movement)
- if still no improvement, should take clean prep or botania laxatives which are preparations used during colonoscopy to empty bowel.

Hope it helped!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Klerida Shehu 1 hour later
Hi Dr. Klerida,
I was typing a reply and the screen moved back to previous screen. Hope it didn't send my response to you unfinished. As I was saying...I took 10mg of Bisacodyl last night and had a small BM this morning. This is surprising as this med in the past has caused severe cramping and diarrhea. I'm not sure why my system is so sluggish. Should I take more this evening or wait? What should I do next if I stop the laxative and can't have a BM again? (BTW, I meant to tell you I have a redundant colon, but have managed fine in the past by taking magnesium oxide at night...not sure what has changed.)
doctor
Answered by Dr. Klerida Shehu 2 days later
Brief Answer:
Can use Bisacodyl for this evening...

Detailed Answer:
Hi back,

Thank you for following up!

At this point, I suggest to add another dose of Bisacodyl for today (this evening) until symptoms improve. Then, you can reduce the dosage as per progression.

It is necessary to schedule colonoscopy to evaluate your bowel condition better.

With regards to using laxatives, fiber and lactulose, you should use them until symptoms will improve, then, gradually, reduce the dosage until your bowel will take normal function again.

Hope it helped!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu 9 hours later
Hi Dr. Klerida,
Thank you for your replies. I have one last question. It occurred to me that this problem started after I stepped off a curb by accident last week and came down down hard on one side. I've seen a chiropractor in the past for issues around L2/L4. I'm wondering if the lack of peristalsis and feeling in my rectum at first maybe because I may have caused some nerve compression there? Since taking ibuprophen the last 3 days, the Bisacodyl on Wednesday and Friday nights and using a Fleet enema today (Sunday), I do have some feeling back in my abdominals and rectum again. I also have some lower back and sciatic pain and was wondering if you think it would be helpful to see someone to evaluate my lower spine. I was thinking about seeing a chiropractor who uses activator method, to relieve pressure there but would also like to get some imaging done in my lower back. Would I see a neurologist for that? If so would I need a referral from a regular doc to see one? Since I new to the state I'm in, I haven't been able to find a GP yet. Thank you again for your help.
doctor
Answered by Dr. Klerida Shehu 3 days later
Brief Answer:
Might not be related to nerve compression

Detailed Answer:
Hi back,

Thank you for following up!
Sorry for the delay.

I doubt the relation between the lack of peristalsis and the nerve compression which you might have got due to injury around L2/L4 as nerve compression related stool retention don't present this way typically.

Continue with the medications as advised in my previous reply.

For your lower spine issues you can see a Neurologist or an Orthopedician who will evaluate you and might ask for a MRI of the lower spine.

Yes, a referral from a local GP would be required to see a specialist. Please contact your nearby GP for evaluation and referrance.

Hope it helped!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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