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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can abdominal bloating and constipation be treated?

Have been bloated after eating for about two months. Cannot burp to release gas. Have constipation. Tried laxatives but not a good response. Have used an enema a few times and it does clear the bowl. Noticed some dark stringy blood clots on the outside of the feces a few days later. Stopped using the enema and started a course of Ciprofalxin 500 mg every 12 hours. Blood is better but not eliminated after three days of treatment. Your advice? Will be seeing my doctor on this Wednesday.
Mon, 5 Feb 2018
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General & Family Physician 's  Response
Hello! Welcome to HCM!

Severe constipation can lead to hemorrhoids (known commonly as piles) that may be responsible for your bleeding. You need to address the problem carefully before it aggravates:
1) Most importantly you need to incorporate certain dietary changes: ensure adequate dietary fibre by include vegetables and wheat products in your diet. Try reducing the amount of refined carbohydrates. Ensure at least 1 serving of fruits like banana and guava daily
2) Ensure adequate water intake (thumb rule is at least 8 glasses of water 8 ounce each)
3) adequate sleep of 7-8 hours at night to regularize your bowel
4) You can include natural probiotics in diet in the form of 2 servings of curd/yogurt daily. Probiotic supplementation can also be used
5) Antibiotics are not recommended as they may alter your normal gut flora and even cause rebound diarrhoea
6) To reduce hemorrhoid associated bleeding you may take Dobesil 500mg capsule 1 cap twice daily for 5-7 days
7) Pan-D capsule 1 cap once daily at bed time to reduce acidity and improve bowel motion. This may be used daily upto a week
8) Carminative enzyme mixture 2tsp twice daily after meals to improve your digestion
Note that long term use of laxatives is not recommended, As a stool softener Lactulose syrup once daily at bed time (15-30ml) occasionally when required.

Take care

Regards,
Dr. Nirvik Sinha, General & Family Physician
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