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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Normal When Stool Is Large And Difficult To Pass Every Morning Despite Taking Lactulose For Close To 6 Months?

Every day,my first bowel movement is extremely big and thick,and I have to squeeze my buttocks and move slightly to the left,leaning back a bit,to get it out.I have been taking lactulose every night now for six months(15ml). After this I go about another 2-3 times during the morning and the rest is easy to pass(probably because of the lactulose)I drink plenty of fluids and eat enough fibre
Thu, 30 May 2019
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General Surgeon 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here are my thoughts.

Constipation is a symptom of some disease and the meaning differs from patient to patient. You have very well explained your complaints and thus we can assist you in a better way as you understand the problems.
First of all, whenever there is a problem like the one you have mentioned it is mandatory to go for colonoscopy and CT scan of abdomen to rule out any organic pathology like stricture, cancer or masses. Secondly to change over to another medications from time to time so that you find the best suitable for you and the right dosages to be taken. Initial hard stools means you have to take the stool softeners in the morning also as this is the food that forms the initial hard part. Make a list of foods and beverages that cause such stool changes and stop these altogether. Also get the blood tests for thyroid and other functions. Stool tests for three consecutive days. If all the investigations are normal then a possible IBS-C that is irritable bowel syndrome of constipation variety can be though of and correction of stress and anxiety factors helps a lot.

Hope I have answered your query. Let me know if I can assist you further.
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Is It Normal When Stool Is Large And Difficult To Pass Every Morning Despite Taking Lactulose For Close To 6 Months?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here are my thoughts. Constipation is a symptom of some disease and the meaning differs from patient to patient. You have very well explained your complaints and thus we can assist you in a better way as you understand the problems. First of all, whenever there is a problem like the one you have mentioned it is mandatory to go for colonoscopy and CT scan of abdomen to rule out any organic pathology like stricture, cancer or masses. Secondly to change over to another medications from time to time so that you find the best suitable for you and the right dosages to be taken. Initial hard stools means you have to take the stool softeners in the morning also as this is the food that forms the initial hard part. Make a list of foods and beverages that cause such stool changes and stop these altogether. Also get the blood tests for thyroid and other functions. Stool tests for three consecutive days. If all the investigations are normal then a possible IBS-C that is irritable bowel syndrome of constipation variety can be though of and correction of stress and anxiety factors helps a lot. Hope I have answered your query. Let me know if I can assist you further.