Chronic Constipation: Seeking Relief and Effective Treatment Options

Q: Chronic Constipation: Seeking Relief and Effective Treatment Options

Hello： 1. <br>Regarding the bloating you mentioned, in addition to constipation causing gas accumulation and pressure in the left upper abdomen, it is also important to consider the possibility of newly developed gastric ulcers or duodenal ulcers. <br>2. <br>The medication prescr

Severe constipation

Hello: I have had severe constipation since childhood, with bowel movements occurring only once or twice a month.
Often, I experience several days of abdominal pain followed by diarrhea, creating a cycle.
About four to five years ago, I took traditional Chinese medicine for over two years, which helped me have bowel movements as long as I was on the medication.
However, I eventually developed a tolerance to it.
I understand that I cannot rely on medication, as it may lead to a loss of gastrointestinal function or dependency! I have also visited a small clinic for an ultrasound examination, which indicated that there were no issues.
I consulted a traditional Chinese medicine doctor who mentioned that my peristaltic function is very weak.
Despite exercising daily and consuming plenty of fruits and vegetables, I have not seen any improvement! The lack of bowel movements is truly painful! Recently, I have often felt significant discomfort and bloating in my stomach, which I would even describe as painful! My stomach appears distended, and my lower abdomen is quite large! What should I do? I remember that if I need to undergo gastrointestinal examinations at a hospital, they usually provide medication the day before to clear the bowels.
I am really suffering; can I take that kind of medication to help eliminate the stool in my intestines? Is that type of medication available at regular pharmacies, or is it only available at hospitals?

Yang Yang, 20~29 year old female. Ask Date: 2013/03/22

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
Regarding the bloating you mentioned, in addition to constipation causing gas accumulation and pressure in the left upper abdomen, it is also important to consider the possibility of newly developed gastric ulcers or duodenal ulcers.
2.
The medication prescribed before a colonoscopy is likely a bowel prep agent.
Although these bowel prep agents are self-pay medications, it is safer to have a physician's prescription, especially for individuals with liver, kidney, or heart dysfunction, as they may not be suitable for use.
It is not advisable to stop the medication on your own.
3.
In addition to increasing your intake of fruits and vegetables and exercising more, daily bowel movements are also very important.
Do not wait until you feel the urge to defecate, as this can prevent excessive absorption of water from the stool, leading to hard stools.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2013/03/22

More Info

Chronic constipation is a common gastrointestinal issue that can significantly impact your quality of life. It sounds like you have been dealing with this condition for a long time, experiencing cycles of constipation followed by diarrhea, which can be quite distressing. Given your history and the various treatments you've tried, it's understandable that you're seeking effective relief and treatment options.

First, it's important to understand that chronic constipation can have multiple causes, including dietary factors, lifestyle habits, and underlying medical conditions. Since you mentioned that you consume a diet rich in fruits and vegetables and engage in regular exercise, it seems you've already taken some positive steps towards managing your condition. However, the fact that you still experience severe symptoms suggests that there may be other factors at play.

One potential issue could be related to your bowel motility, as you mentioned that your doctor indicated weak motility. This can lead to slower transit times in the intestines, making it difficult for stool to move through the digestive tract effectively. Additionally, the discomfort and bloating you are experiencing could be a result of stool buildup in the intestines, which can cause distension and pain.

In terms of treatment options, there are several approaches you might consider:
1. Dietary Adjustments: While you are already consuming a lot of fruits and vegetables, you might want to ensure that you are also getting enough fiber. The recommended daily intake of fiber is about 25 grams for women and 38 grams for men. You can also consider incorporating more soluble fiber sources, such as oats, beans, and psyllium husk, which can help to soften stool and promote regularity.

2. Hydration: Adequate fluid intake is crucial for preventing constipation. Aim to drink plenty of water throughout the day, as this can help to keep your stool soft and easier to pass.

3. Over-the-Counter Laxatives: If you are considering taking medication to relieve your constipation, there are several over-the-counter options available. Osmotic laxatives, such as polyethylene glycol (MiraLAX), can help draw water into the intestines and promote bowel movements. Stimulant laxatives, like bisacodyl (Dulcolax) or senna, can also be effective but should be used sparingly to avoid dependence.

4. Probiotics: Some studies suggest that probiotics may help improve gut health and promote regular bowel movements. You might consider trying a probiotic supplement or incorporating fermented foods like yogurt, kefir, or sauerkraut into your diet.

5. Medical Evaluation: Since you have been experiencing significant discomfort and bloating, it may be beneficial to undergo further medical evaluation. A gastroenterologist can perform tests such as a colonoscopy or motility studies to assess your bowel function more thoroughly. This can help identify any underlying issues that may be contributing to your constipation.

6. Behavioral Therapies: Sometimes, behavioral therapies such as biofeedback can help improve bowel function by teaching you how to better coordinate the muscles involved in bowel movements.

7. Prescription Medications: If over-the-counter options are not effective, your doctor may prescribe medications specifically designed to treat chronic constipation, such as lubiprostone (Amitiza) or linaclotide (Linzess).

In summary, while it is understandable to seek immediate relief from your symptoms, it is essential to approach chronic constipation with a comprehensive plan that includes dietary changes, lifestyle modifications, and possibly medical intervention. If you decide to use over-the-counter laxatives, it is advisable to consult with a healthcare professional to ensure that you choose the right option for your situation and to avoid potential complications. Remember, managing chronic constipation often requires a multifaceted approach, and working closely with a healthcare provider can help you find the most effective treatment strategy for your needs.

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