Oblique muscle pain, prolonged constipation, prior Baycol user

[Matthes]

Currently I have had six months of left-side pain and constipation for five months. The pain is in the Lliacus or Gluteves Medius Muscle area and is constant and intensifies as the constipation intensifies. Berium Cat scan, ultrasound, and air-inflated colonoscopy show extremely healthy colon.  Presently, I am on high fiber diet, take four stool softeners, three doses of Metamucil, and three tablespoons of Mineral Oil per day and am walking and drink 8+ glasses of water a day.  Still, I have soft stools but they cannot pass.  I have had to "enema" it out at least three times in the last six weeks.  Also, I cannot lift any thing toward the left side if in a sitting position. I was on Baycol for nine months from Dec 2000 to August 2001 and during that time I had weight loss, chest pains, and had 400+ on a test that shows muscle damage (maximum on test for normal person is 219). I am a 65 year old male and am otherwise quite healthy--no high blood pressure, no more high cholesterol, no meds other than the ones mentioned above.  Do you have any idea of what is wrong with me or how I can get help from this excruciating pain and constipation?  I'm especially concerned about what other things could start to go wrong due to this prolonged problem of constipation.

[Kevin Pho, MD]

You have had a pretty good evaluation for chronic consitpation including barium study, CT scan, and colonoscopy.  

The next approach would involve whether there is any impairment in motility.  You may want to consider a colonic transit study.  Another test to consider would be anorectal manometry to evaluate the anal sphincter.  

In terms of treatment, there are of course the various laxative and constipation-focused medications that you can discuss with your personal physician.

Non-medication approaches that you may want to consider would include biofeedback therapy which can improve inappropriate contraction of the pelvic floor muscles.

Of course if none of the aforementioned approaches work, surgery can also be considered.  

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.

Thanks,
Kevin, M.D.