Over 20 Years of Constipation: Seeking Solutions for My Mother's Digestive Issues

For 20 years, unable to have normal bowel movements?

Hello, doctor.
My mother was born in 1945, and she is very troubled by her bowel movements.
She eats well and drinks at least 10 cups of water a day, with each cup being 300cc.
Since our family follows a vegetarian diet, her fiber intake is certainly adequate.
She consumes fats primarily from olive oil and perilla oil.
Additionally, she has tried laxatives, stool softeners, and even purchased an enema kit and enzymes, but none of these have been effective.
She finds that only when she consumes extra virgin olive oil along with other health supplements can she have a bowel movement.
However, she often experiences a pattern where she can have a bowel movement a few times, but then it stops working again.
Sometimes, she even has severe abdominal pain that prevents her from passing stool, leading her to visit the emergency room.
Once the pain subsides, she returns home, but the bowel movement issue remains unresolved.
She underwent a colonoscopy at Taichung Hospital, which showed no abnormalities.
Is it possible for someone to go a week or even longer without a bowel movement? This situation has persisted for over 10 years.
What should I do?

Guo, 30~39 year old female. Ask Date: 2016/05/22

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Slow colonic motility is a bothersome physiological issue, but it does not affect your health or lifespan.
You may still need long-term medication assistance and should maintain hydration and exercise as part of your lifestyle.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2016/05/22

More Info

Constipation can be a frustrating and distressing condition, especially when it has persisted for over 20 years, as in your mother's case. Given her age and the duration of her symptoms, it is essential to approach this issue comprehensively, considering both dietary factors and potential underlying medical conditions.

Firstly, it is important to understand that constipation is defined as having fewer than three bowel movements per week, and it can be caused by a variety of factors, including diet, lifestyle, medications, and underlying health issues. In your mother's case, it seems that she has made significant efforts to address her constipation through dietary changes, including a high-fiber vegetarian diet and adequate fluid intake. However, it appears that these measures have not been effective in resolving her symptoms.

Since your mother has already undergone a colonoscopy with no abnormalities found, it is crucial to consider other potential causes of her constipation. One possibility is that she may have a condition known as "functional constipation," which is characterized by infrequent bowel movements and difficulty passing stools without any identifiable structural or biochemical abnormalities. This condition can be influenced by factors such as stress, lack of physical activity, or even certain medications.

In addition to dietary adjustments, there are several other strategies that may help alleviate your mother's constipation:
1. Increase Physical Activity: Regular exercise can stimulate bowel function and improve overall digestive health. Encourage your mother to engage in activities she enjoys, such as walking, swimming, or yoga.

2. Establish a Routine: Encourage your mother to set aside time each day for bowel movements, ideally after meals when the body's natural reflexes are more active. This can help train her body to have regular bowel movements.

3. Consider Probiotics: Probiotics are beneficial bacteria that can help improve gut health. Incorporating probiotic-rich foods such as yogurt, kefir, sauerkraut, or taking probiotic supplements may help restore a healthy balance in her gut microbiome.

4. Review Medications: If your mother is taking any medications, it is worth reviewing them with her healthcare provider to determine if any could be contributing to her constipation. Some medications, particularly certain pain relievers, antidepressants, and antacids, can have constipation as a side effect.

5. Hydration: While you mentioned that your mother drinks a significant amount of water, it is essential to ensure that she is also consuming enough electrolytes, particularly magnesium, which can help with bowel movements. Foods rich in magnesium include leafy greens, nuts, seeds, and whole grains.

6. Laxatives and Stool Softeners: If dietary changes and lifestyle modifications do not yield results, it may be necessary to explore the use of over-the-counter laxatives or stool softeners under the guidance of a healthcare provider. However, these should be used cautiously and not as a long-term solution.

7. Consult a Gastroenterologist: If your mother's constipation persists despite trying these strategies, it may be beneficial to consult a gastroenterologist for further evaluation. They may recommend additional tests or treatments, such as biofeedback therapy for pelvic floor dysfunction or medications specifically designed for chronic constipation.

8. Psychological Factors: Sometimes, psychological factors such as anxiety or depression can contribute to constipation. If your mother is experiencing stress or emotional difficulties, addressing these issues through counseling or therapy may also be beneficial.

In summary, while your mother has made commendable efforts to manage her constipation, it may be time to explore additional strategies and consult with healthcare professionals for a more tailored approach. Constipation can significantly impact quality of life, and finding the right combination of dietary, lifestyle, and medical interventions can lead to improvement. Encourage her to be patient and persistent in seeking relief, as managing chronic constipation often requires a multifaceted approach.

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