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Gastroenterology (Expert Forum)
Bowel Pressure and constipation
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Bowel Pressure and constipation
by Mel B, Aug 25, 2006 12:00AM
Hello,
I am a 38-year-old woman who has suffered from chronic constipation from infancy, (when drinking only breast milk). I have been battling my weight since childhood, (even with exercise and partaking of a “good” diet a lot of the time) and I have Bi-Polar Disorder. I have “managed” my constipation with laxatives, both stimulant and herbal, herbal cleanses, enemas, changing diet and fasting. As you can imagine my childhood was fraught with pain and fear thus I’ve developed a phobia, (bordering on hysteria) about being constipated which is why I have not sought medical intervention on this matter.
Right now I have a question about obstruction (if that is what it is). I have had this problem a few times before but after a few days or so it cleared up, (with laxatives and eating lightly). This time however I’ve been suffering for about two weeks. I have been using herbal laxatives, an enema and I have been taking an herbal cleanse and fasting for 3 days, (drinking tea, water and a tiny bit of milk). I have been able to eliminate with these, however I feel a great deal of pressure like I still need to eliminate, but no pain or blood at least. I almost feel like there is some kind of partial blockage. Since my digestive system is so slow I have had to take another laxative this morning to try and eliminate the food I ate three days ago. I still exercise, (walking, which I do 4 or 5 days a week) but because of not eating I can not exercise as long as usual, (I had been walking for 30 to 45 min twice a day)
My question is what do you think this problem is and what can I do to insure it does not come back (if it will ever go away)? Because of the emotional issues attached to my chronic constipation I am terrified to seek medical attention and do not want to eat any longer. What can I take or do that I am not already doing that will alleviate this problem?
I greatly appreciate any help you can give me with this matter.
Melissa
I am a 38-year-old woman who has suffered from chronic constipation from infancy, (when drinking only breast milk). I have been battling my weight since childhood, (even with exercise and partaking of a “good” diet a lot of the time) and I have Bi-Polar Disorder. I have “managed” my constipation with laxatives, both stimulant and herbal, herbal cleanses, enemas, changing diet and fasting. As you can imagine my childhood was fraught with pain and fear thus I’ve developed a phobia, (bordering on hysteria) about being constipated which is why I have not sought medical intervention on this matter.
Right now I have a question about obstruction (if that is what it is). I have had this problem a few times before but after a few days or so it cleared up, (with laxatives and eating lightly). This time however I’ve been suffering for about two weeks. I have been using herbal laxatives, an enema and I have been taking an herbal cleanse and fasting for 3 days, (drinking tea, water and a tiny bit of milk). I have been able to eliminate with these, however I feel a great deal of pressure like I still need to eliminate, but no pain or blood at least. I almost feel like there is some kind of partial blockage. Since my digestive system is so slow I have had to take another laxative this morning to try and eliminate the food I ate three days ago. I still exercise, (walking, which I do 4 or 5 days a week) but because of not eating I can not exercise as long as usual, (I had been walking for 30 to 45 min twice a day)
My question is what do you think this problem is and what can I do to insure it does not come back (if it will ever go away)? Because of the emotional issues attached to my chronic constipation I am terrified to seek medical attention and do not want to eat any longer. What can I take or do that I am not already doing that will alleviate this problem?
I greatly appreciate any help you can give me with this matter.
Melissa
Doctor's Answer
by Kevin Pho, MD, Aug 26, 2006 12:00AM
, Aug 26, 2006 12:00AM
Difficult to say without exam.
There are various GI tests that can be considered to rule out a variety of causes. If an anatomical obstruction is considered, a colonoscopy would be the most comprehensive test.
If negative, a CT scan can be considered to look for adhesions.
More specialized testing, including motility studies or defecography can be considered looking for any problems with bowel motility.
Metabolic causes like thyroid disorders can also lead to constipation.
These options can be discussed with your personal physician. Another GI opinion, preferably at a major academic medical center, can be considered as well.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
There are various GI tests that can be considered to rule out a variety of causes. If an anatomical obstruction is considered, a colonoscopy would be the most comprehensive test.
If negative, a CT scan can be considered to look for adhesions.
More specialized testing, including motility studies or defecography can be considered looking for any problems with bowel motility.
Metabolic causes like thyroid disorders can also lead to constipation.
These options can be discussed with your personal physician. Another GI opinion, preferably at a major academic medical center, can be considered as well.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
This is a case where going to a doctor is the appropriate course of action. If you are hypothyroid, laxatives will only mask the symptom and likely make it worse, meanwhile other problems (HBP, depression which can include anxiety, etc) can occur/worsen.
Also seek a mental health professional for the phobia issues. Of course getting the physical issues dealt with will help.
I have had thyroid tests and they have turned out normal. I also see a psychiatrist and a therapist regularly. My blood pressure is normal so is my cholesterol and I do not have diabetes. Whatever the problem is, I was born with it. I’m just so tired of dealing with it. I’m on medication for my Bi-polar, but did a lot of research before my psychiatrist and I chose a medication and one of the biggest decisive factors was wheatear or not it caused constipation, which it doesn't.
Can anyone tell me what kind of a liquid diet would not produce stool? I was wondering if broth or other soup would produce stool. What is allowed on a liquid diet?
Thank you again for your help.
Melissa
1/2 cup ice
1/2 cup kashi go lean crunch cereal
1 cup fat free milk
1 cup frozen blueberries
1 tablespoon psyllium husk powder
1 tablespoon barleans flax oil (sold at health food stores)
Good luck and hope your feeling better soon!
Thank You