Constipated for over 2 years - what's wrong with me

[sam18]

I have been suffering from constipation for over 2 years, probably longer. I go to the toilet probably twice a week and it's usually very small, dry and hard.
I am 18 and female and at this age I do not want to be on laxatives.
I have increased my fibre intake and changed my diet. I am now drinking 2 litres of water a day, having at least 5 portions of fruit or veg a day and I will only eat wholemeal bread. I have also cut back on cups of tea or coffee to no more than 3 a day. I am also quite active - I go to the gym and walk a lot. I should also mention I am 5 foot 3 and weigh around 9 and a half stone (133 lbs) though despite the diet change I have not lost weight.
I experience abdominal pain frequently due to the constipation and bloating that it causes however the intensity of this varies. Also I don't know whether it is relevant but I usually feel fatigued and struggle to concentrate. I am not diabetic (been tested) but often find if I eat something I perk up a little bit.
I have seen various doctors but they don't know what is wrong with me and I have given up on pestering them.
Lately in the last 2 or 3 months I have been feeling nauseous and I haven't been eating as much as I normally would. This has been occurring more and more recently.
I apologise for the long message but I would be grateful if you could give me an idea as to what it is that's wrong with me.
Thanks, Sam

[ggreg]

Great!  Just a reminder, any vitamins or medicines you take may be the problem.  Also, too much juice will dry a person out the same way, which I forgot to mention.  If your new doc figures you out, post back here sometime so we can learn from it.  All the best.

[sam18]

Thanks for your response.

The fruit/veg/fibre that I mentioned - I have been doing that for about 3 months now. Also I do eat activia yogurts everyday. As for the quantity of food I eat - that's never a problem!
I have booked an appointment with a different doctor so hopefully she will be able to help me.

[ggreg]

I'm not sure what diet you're on or when you went on it.  If you just started the regimen you described, give it a month before you pass judgment.  You also need to get enough food... that is to say, if you're just eating just a little of the foods you mentioned, then I would suggest you add a plateful of spagetti at least once a week, and you need to feel "full" another two more days of the week.  You also need to get enough protein from at least eggs, also salads every day helps, a little orange juice daily, and blueberries are exceptionally good for the digestion.  Some medications can dry out the digestive tract, so review those.  Also, some vitamins, if they have too much iron in them, will do the same thing, so you can switch to twice a week, if you're taking those.  Lastly, try eating some Activia yogurt from the grocery store for a couple weeks, it helps break down digestion by adding "good" bacteria to the intestinal flora.

Other than that, you are doing all the right things, so it does sound like your digestion is acting up for some reason, and a gastroenterologist could narrow down what it might be, like perhaps a problem with bile production, a missing digestive enzyme, or an intestinal bacteria, among other things.  Also, it is important when you relieve yourself, that you are not rushed and that you go at a regular time each day, and also in general you should reduce the stresses in your life as much as you can.  Oh, and you may be feeling tired and unable to concentrate because of your digestion difficulties.  But a basic blood test checking your vitamin and mineral levels, as well as for anemia and other blood platelet indicators, may provide a clue as to what's going on.

These are just general things to doublecheck.  I hope you visit a gastro doc, and if you already went to one who didn't know what's wrong, go to another.  Or even an internist would work almost as well.