I am a 60 yr old man in very good physical condition.
I have had constipation problems for the last 5 years. I have had a colonoscopy and the doc found lots of diverticuli. Recommended I take more fiber. I have tried everything with very little improvement. I have no urge to go to the bathroom.
Fiber, laxatives, stool softner, oils etc all make the stool softer but do not stimulate elimination. I go to the bathroom and strain and strain with no result. The only thing I can do to start the movement is to stimulate the anus with my finger. This seems to make it release and once started I can produce a movement. If I dont go to the bathroom the stool becomes very large and hard with extreme difficulty in starting and completing the elimination. What can I do to improve this situation
You can consider some lower GI tests to ensure there isn't an anatomical or physiological problem leading to the symptoms.
A lower endoscopy can evaluate for polyps or masses. More specialized testing can include anorectal manometry, motility studies, endorectal ultrasound, or defecography. Each of these tests can evaluate for more uncommon causes of constipation - such as motility disorders or problems with the anal sphincter.
A referral to a gastroenterologist can be considered to discuss these options. If everything is negative, a routine bowel regimen can be recommended.
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.
Instead of direct stimulation of your anus with your finger, try jostling one buttock while defecating. The vibrations transmitted to the rectum reduce friction with dry stool and stimulate expulsion. Also try to go more than once per day. This technique has help me so well after 20 years of my own constipaption that I'm compelled to share it.
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