Constipation Issues Related to Medication in Gastrointestinal Health

Issues Related to Constipation Caused by Medication

Hello Doctor: I have been experiencing long-term bloating and gastroesophageal reflux issues, and I have been undergoing medication treatment.
Due to severe bloating over the past few months, the medication has not improved my condition, so I underwent an endoscopy.
The results showed only mild gastric erosion and mild gastroesophageal reflux.
The doctor prescribed a treatment plan for four months with medications including MOTILIUM, MOZAPRY F.C., SUNPYLON TABLETS, and SCRAT SUSPENSION.
I later started taking probiotics, which significantly improved my bloating and indigestion, but I found that I began to experience constipation.
Despite drinking plenty of water and taking stool softeners and probiotics, the results have not been very effective, which is quite distressing.
Sometimes I squat until my legs go numb, only managing to pass a few small round stools.
Therefore, I would like to ask the doctor:
1.
Is this related to the medications I am taking? It seems that I started experiencing constipation after beginning these medications, and it has been at least a month since then, whereas I did not have this issue before.

2.
If it is related to the medications, how can I improve this? Should I change my medications?
3.
Given that my endoscopy showed only mild gastrointestinal issues, but I feel that my indigestion and bloating are quite severe, especially in the area below the ribs on the left side, which the doctor indicated is the stomach, could this be irritable bowel syndrome or a functional issue? (Sometimes, consuming overly fatty foods or low-quality dairy products causes diarrhea, and now I am also dealing with constipation...)
4.
Should probiotics be taken on an empty stomach or after meals? Recently, I have been taking the second-generation vegetarian capsules of Lele Tong.
In summary, my recent constipation has been a significant concern for me.
Although my bloating and indigestion have improved, they still persist.
I used to be able to eat a lot, but now I can only eat a little.
Due to work-related stress and my high self-expectations, I appreciate your help, Doctor.

WEI, 20~29 year old female. Ask Date: 2022/01/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

You may schedule an earlier follow-up appointment to discuss medication adjustments, dietary changes, or the use of probiotics with your outpatient physician.
You can also temporarily discontinue the SCRAT to see how it affects your constipation.

Reply Date: 2022/01/03

More Info

Constipation can be a frustrating and uncomfortable issue, especially when it arises in the context of existing gastrointestinal problems such as bloating and gastroesophageal reflux disease (GERD). Based on your description, it seems that you have been experiencing significant gastrointestinal distress, which has led to the use of various medications. Let's address your concerns one by one.

1. Medication and Constipation: It is indeed possible that the medications you are taking could be contributing to your constipation. Some medications, particularly those that affect gastrointestinal motility, can lead to constipation as a side effect. For example, medications like Motilium (domperidone) are designed to enhance gastric motility, but they can sometimes have paradoxical effects, especially if the underlying gastrointestinal function is already compromised. Additionally, certain antacids and medications that contain aluminum can also cause constipation. If you have noticed a direct correlation between starting these medications and the onset of constipation, it is worth discussing this with your healthcare provider.

2. Improving Constipation: If your constipation is indeed related to your medications, your doctor may consider adjusting your treatment plan. This could involve switching to alternative medications that have a lower risk of causing constipation or adding a stool softener or laxative to your regimen. It is crucial to communicate openly with your healthcare provider about your symptoms, as they can provide tailored advice and may suggest a gradual approach to changing your medications.

3. Underlying Conditions: Given that your gastrointestinal issues have been persistent and severe, it is important to consider whether you might be experiencing a functional gastrointestinal disorder, such as irritable bowel syndrome (IBS). IBS can manifest with alternating symptoms of constipation and diarrhea, often triggered by dietary choices or stress. The fact that you experience diarrhea after consuming certain foods, particularly fatty or low-quality dairy products, could indicate a sensitivity or intolerance. Keeping a food diary may help identify specific triggers. Additionally, stress can significantly impact gastrointestinal function, so managing stress through relaxation techniques, exercise, or counseling may also be beneficial.

4. Probiotic Use: Regarding the use of probiotics, it is generally recommended to take them on an empty stomach for optimal absorption, although some people find they tolerate them better when taken with food. The specific strain of probiotics can also make a difference; some strains are more effective for constipation, while others may help with bloating or diarrhea. It might be beneficial to consult with a healthcare provider or a dietitian who specializes in gastrointestinal health to find the right probiotic for your needs.

In summary, your constipation may be linked to your current medications, and it is essential to discuss this with your healthcare provider. They can help you find the right balance in your treatment plan while addressing your gastrointestinal symptoms. Additionally, consider lifestyle modifications, such as dietary changes, stress management, and possibly adjusting your probiotic use, to help alleviate your symptoms. Remember, it is crucial to maintain open communication with your healthcare team to ensure that all aspects of your gastrointestinal health are being addressed effectively.

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