Chronic Constipation

Hello Doctor,

I am a 21 year old Native American male living in Arizona. About a year and three months ago, I started experiencing constipation. It never has gone away and has stuck with me since. It feels like my instestines are inflamed or something. I'm beginning to wonder if I have parasites because it seems like doctors have ruled out everything. I've been tested for blood, had a barium x-ray on my lower abdominal, had colonoscopy and even did a diet regimen. I'm taking fiber everyday which helps but I'm constantly bloated at my lower abdomen just under my belly, like there's always a mass there or something. It's very uncomfortable. I have medium stools and I think the fiber helps. I don't know what to do anymore. The only thing that I haven't been tested for is my stool. I had a spincterotomy done for an anal fissure about 6 months ago but I was having problems already before. The only time I felt completely relieved was after I drank barium sulfate suspension and had my x-ray done. I don't know if the contrast added to it but I felt like that really worked. It passed out my gas and fecal matter. Then after I ate, I had abdominal discomfort again. I haven't had diarrhea naturally in a year unless I drink a laxative or prune juice. I don't know what's wrong with me.

[Kevin Pho, MD]

The tests that you have had thus far would exclude many of the major GI causes.  

Irritable bowel can lead to chronic constipation, and there are a variety of medications that can be considered - including Amitiza.  

You may also want to exclude thyroid dysfunction and diabetes, since these conditions can also lead to chronic constipation.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com