severe gas

  : : I wrote earlier about my constipation and upper stomach pain. Iam 36 female, Ive never been regular maybe once a week, but in the last few months its worsened. I go three weeks without a bm unless I take a couple stool softners and fiber tablets daily. When I do have a bm its very severe, pain, cramping hours in the bathroom.  I went to the DR. which was a waste of time, she said eat more fiber, drink more water like I didn't already know this. I work in a pharmacy so I've tried everything possible before making a Dr. appt. She finally scheduled a h. pylori test which I go for next week. I have no diarehea but now when I strain to have a bm which I can't, when I wipe theres green mucas I guess you would call it that. I also have severe gas that would choke a horse. I can't stand to be around myself. I've had gas before but never this way.  Please give me some advice.
  : Dear dar,
  : Constipation, as you know, can be secondary to inadequate fiber, immobility, drugs, endocrine causes, neurological diseases and psychological factors. It is important to rule out structural lesions and mechanical obstruction with barium x-rays and colonoscopy. Blood tests to exclude systemic disease should be routinely obtained. These tests include: hemoglobin, erythrocyte sedimentation rate and a biochemical screen to include thyroid function tests, serum calcium.
  : Many laxatives and stool softerners are available with different modes of action. Prior to considering surgery (last resort), I would recommend that you have testing to document poor colonic transit (colonic marker transit study) and defecography to look for problems with rectal emptying, pelvic floor weakness or structural abnormalities such as a rectocele. Preoperative psychological assessment is also recommended. It may also be necessary to exclude a generalized gastrointestinal motility disorder by obtaining a gastric emptying study, small bowel transit study and segmental colonic transit rate.
  : Another potentially treatable cause for severe gas and constipation is lactose intolerance. You might want to stay away from dairy products or use Lactaid tablets and milk. Furthermore, keeping a food diary might help identify foods that cause increased intestinal gas and bloating. I hope you find this information helpful.
  : This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
  : If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians