Abdominal Pain After Constipation: When to Seek Medical Help

Q: Abdominal Pain After Constipation: When to Seek Medical Help

Hello： In response to your questions. <br>1. <br>Dulcolax promotes gastrointestinal motility, so a small number of patients who are more sensitive to the medication may experience abdominal pain or diarrhea. <br>This side effect can improve simply by discontinuing the medication.

Abdomen

Hello Doctor,
I haven't had a bowel movement for a long time, so last Thursday night I took one of my grandfather's medications, which I believe was Dulcolax 5mg, a yellow enteric-coated tablet.
Around 10:30 PM, I started experiencing diarrhea, and the next day I had some pain in the upper left part of my abdomen.
I felt abdominal pain throughout the day.
In the evening, I went to a clinic to see a doctor, who said I had injured my stomach and intestines.
He prescribed me medication and gave me injections of Tagamet, Buscopan, Kolantyl, Strocaine, Supergel, and Imodium.
After eating congee for two days, I thought if it was gastroenteritis, I would be better by the third day, so I returned to my previous diet and ate two pieces of pineapple cake.
The next day, my abdomen hurt again, so I went back to the same clinic, received the same medication, and got the same injections.
However, my abdominal pain persists; I feel uncomfortable after eating, and I experience some pain while walking.

I would like to ask:
1.
Should I go to a major hospital for further evaluation?
2.
If not, when can I return to my previous diet?
I hope to receive a prompt response.
Thank you.

Hsu, 10~19 year old female. Ask Date: 2008/02/20

Dr. Xiao Yongxun reply Internal Medicine

Hello: In response to your questions.
1.
Dulcolax promotes gastrointestinal motility, so a small number of patients who are more sensitive to the medication may experience abdominal pain or diarrhea.
This side effect can improve simply by discontinuing the medication.
2.
There are many potential causes of abdominal pain, which can involve not only the gastrointestinal system but also endocrine, urinary, gynecological issues, vascular diseases, and more.
Diagnosing the exact cause can sometimes be challenging.
3.
If there has been no improvement with the primary care physician at the clinic, it may be advisable to ask if there are better options available or to directly consult a gastroenterologist for further evaluation and treatment.

Reply Date: 2008/02/20

More Info

Abdominal pain following constipation and the use of laxatives can be a concerning issue, especially when it persists despite treatment. Based on your description, it seems that you have experienced significant discomfort after taking Dulcolax, which is a stimulant laxative. This type of medication can sometimes lead to cramping and abdominal pain as it stimulates bowel movements.
1. When to Seek Medical Help:
Given that you have already visited a clinic and received treatment, but your symptoms have not improved, it would be wise to consider seeking further medical evaluation at a larger hospital or a gastroenterology specialist. Persistent abdominal pain, especially if it is severe, can indicate underlying issues such as bowel obstruction, perforation, or other gastrointestinal conditions that may require more advanced diagnostic tools like imaging studies (e.g., ultrasound, CT scan) or endoscopy. If you experience any of the following symptoms, you should seek immediate medical attention:
- Severe or worsening abdominal pain
- Fever
- Vomiting, especially if it is persistent or contains blood
- Changes in bowel habits, such as blood in the stool or severe diarrhea
- Signs of dehydration (e.g., excessive thirst, dry mouth, reduced urine output)
2. Dietary Considerations:
As for resuming your previous diet, it is generally advisable to start with a bland diet after experiencing gastrointestinal distress. Foods that are easy to digest, such as rice, bananas, applesauce, and toast (often referred to as the BRAT diet), can be beneficial. Gradually reintroducing other foods is recommended, but you should avoid heavy, greasy, or spicy foods until you feel completely better. If you notice that certain foods exacerbate your symptoms, it may be best to avoid them for a while longer.

3. Understanding Your Symptoms:
The pain you are experiencing could be due to several factors:
- Irritation of the Gastrointestinal Tract: The laxative may have caused irritation or spasms in your intestines, leading to discomfort.

- Gastritis or Gastroenteritis: If you have a history of gastritis or if the laxative caused an upset stomach, this could explain the pain after eating.

- Bowel Movement Irregularities: After a period of constipation, your intestines may still be adjusting, leading to discomfort as they work to normalize.

4. Follow-Up Care:
If you decide not to go to a larger hospital immediately, it is crucial to monitor your symptoms closely. If the pain persists beyond a few days or worsens, or if you develop any of the concerning symptoms mentioned earlier, do not hesitate to seek further medical care.
In conclusion, while it is common to experience some discomfort after taking laxatives, persistent or severe pain warrants further investigation. It is always better to err on the side of caution when it comes to abdominal pain, as early diagnosis and treatment can prevent more serious complications.

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