Irritable Bowel Syndrome or More serious?

[PanicGirl123]

About 3 weeks ago I noticed a slight change in my bowel movements.  Nothing too unusual, they were just different--not as frequent and were a little more difficult to get through, but nothing alarming.  Then about 10 days ago I had a terrible virus, or I think it was a virus, and I had terrible stomach pains and cramping and eventually diarrhea.  I called my doctor, coincidentally a gastroenterologist, and he told me to take Imodium, which worked like a dream.  Pains gone and I felt good within a few hours.  But the aftermath has been disturbing because I now suffer from constipation.  I've tried to go on my own and all I see are little "rabbit pellet" type excrement even after 15 minutes of sitting there, pushing.  I tried exlax, which ripped apart my stomach and then, at the suggestion of my doctor, Milk of Magnesia.  I have been in to see the doctor and he examined me (though no rectal exam) and he said he thought I had a "spastic colon" or mild IBS.  I've been very worried about this and have gotten very depressed over this whole situation.  I am a known obsesser and occasional hypochondriac.  The doctor also said that the down mood and the hypochondriac tendencies could contribute to the constipation.  Last night, after 3 days of nothing but rabbit pellets, I took the Milk of Magnesia and it worked very well.  But I still worry that there might be something wrong that he's not seeing or considering.  I don't have any real nausea, no vomiting, no blood in the stool and I'm generally very active and healthy.
My question: What do you think is wrong with me--Why am I constipated and how long will this last?  Is this left over from the Imodium (it shouldn't be b/c it's been like 10 days).  Is having a bowel movement with the aid of Milk of Mag. a good sign?  I took it last night and have had several bowel movements today--they were brown in color and no blood was present.  Do you think I should have a colonoscopy or fear colon cancer or Crohn's or something like that?  What should I do--I'm a little scared.  I would love your thoughts.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Chronic constipation can indeed be a frustrating problem.  Before attributing the cause to irritable bowel, an endoscopy - either colonoscopy or flexible sigmoidoscopy - should definitely be considered.  Any change in bowel habits (especially change on stool caliber) should be evaluated to make sure cancer or a mass is not the cause.  

Other tests that can be substituted for endoscopy would be a barium enema which can also detect structural causes of constipation.  

If the endoscopy is negative, then you may want to consider more specialized testing such as anorectal manometry (to test the pelvic floor), or colonic marker studies (to test for colonic inertia).  

If every test is negative, you may want to consider irritable bowel as the diagnosis.  

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.

[ConcernedGB]

Hang in there!  Don't worry.  See your doctor as soon as possible and you'll feel relieved when you find out you're OK.  Bowel habits can change from time to time, I think.  I tend to worry a lot too.  If this has been happening for only 3 weeks, you're on top of it and if it is something you'll be "nipping it in the bud."  Be proactive and get a colonoscopy for piece of mind!  You'll feel glad you did!  Good luck!

[tessa0825]

Chronic constipation is NOT any fun at all, I feel for you...After having a cancer surgery in 1995 I was left with a paralyzed bowel...Horrible is the only word to describe it..The cancer Dr. worked with me for many months to try and get things working right..I mixed mineral oil with orange juice, it didnt work, I took synakot(sp), it didnt work, I walked miles, that didnt work, I drank water until I couldnt drink anymore and nothing worked...Over time I excepted it as a new normal and just lived with it...I didnt want to become dependant on laxatives so I would wait until I couldnt walk, about a week or 10 days many times and then I would take something...Sometimes they worked and sometimes they just gave me bad cramps and would make me vomit....I finally started seeing a GI Spec. (8 yrs after the fact) who did a colonoscopy and was very upset that I had never been sent to a GI before...I now take Miralax 17gm twice a day and have been for more than a yr. ...It has made so much difference....If miralax produces watery stools then I think there is a chance you could get an elctrolyte imbalance but for true chronic constipation it never gets to the point of watery stools...The downside is that it is very expensive, about $100.00/month....Once you have everything checked out and if you still have the problem I would ask your GI about it...Its the only thing I ever found that actually works......Please keep searching for answers.....Tessa

[PanicGirl123]

Thanks so much for the words of encouragement!  I think I'm gonna give it a few more days before I get a colonoscopy or any of the other tests.  I've spoken to a few of my friends and to my cousin and have found that I am not the only one in this world who gets constipated! (Gee, what a shock!)  Many of them take things to make them go quite often in fact and this is my first bout with this sort of thing.  I have actually been feeling much better since my stomach virus 2 weeks ago--no symptoms whatsoever, except for the constipation.  No more cramps, pains, nothing.  So I'm gonna try to RELAX (and I capitalize b/c my husband thinks that's what is largely behind this) and see if it passes.  If not, I'll head to the Gastro man and get the colonoscopy and put my mind at ease.  But thanks for the words--I thought the response from Dr. Kevin was lame, generic and impersonal.

[ConcernedGB]

Glad you're feeling better about it!  <<BTW, I totally agree with you!>>  Good luck! :-)

[sunflower68]

Hi there:)
I feel your frustration having similar symptoms since last December.  Throughout my adulthood ( I am a 35 old female ), I always had problems with constipation, but was able to control it w/ high fiber supplements (ie flax seed ) Last summer I started having high colonics ( every other month ) and taking psyllium daily - worked like magic. I never felt soo "clean" prior to that in my life, I had 2-3 "healty looking" bowel movements per day.
But in December suddenly became 5-6 lb heavier ( I am very self conscious: work out every day, eat healthy etc.... )started feeling nauseous, bloated after every meal and felt hardness in my bowels ( around my belly button area )and my bowel movements, despite the psyllium, produced minimal results.  Of course I panicked, and went to see a gastro-enterologyst - where I had a humiliating experience.  I saw a smirk on the doctor's face while I was telling him about my symptoms - and soon as I finished he gave me a quick diagnosis: IBS.  He totally made me feel like sh...t, I felt no comfort talking to him.  Anyway, to date, I still feel nauseous and bloated every day, and the little hard "pot belly" around my belly button worries me.  Next week I am going to see another doctor for a second opinion and this time I am going to demand more than just a diagnosis. I think doctors nowadays are very quick to diagnose IBS without having any tests done.  Anyway, if you had your second opinion, please inform us how you are doing.  Good luck, take care :))

[PanicGirl123]

Thanks for the replies and for the info...I went to my family doctor, who is coincidentally a gastroenterologist and he diagnosed me as IBS too.  But in the last day or so I have had abdominal cramping (usually after a meal) so he put me on dicyclomine (aka Bentyl) and it's been working ok.  Except after I take it, a weird sort of woosiness hits for about a half hour but then goes away.  The doctor also scheduled an abdominal sonogram for me tomorrow (Friday) and said we would go from there.  He wanted a sonogram first before doing a colonoscopy--I'm 29, female, healthy, 5'6" and 130 pounds (so not overweight by any meals)--because he doesn't think what i have is something as serious as colon cancer or colitis.  But from what I read while IBS is not life threatening, it can be "life style" threatening and may cause discomfort in spurts for the rest of my life.  Oh well, I guess we all have our burdens in life.

[RudyG]

Here is some valuable info for anyone with digestive and bowel
problems.  I am a 57 yr old male and was diagnosed with a hiatal hernia over a year ago and acid reflux.  I also had problems digesting almost everthing I like to eat. My doctor gave me nexium but that gave me diarrea and headaches. I then tried
cimetidine which helped with the acid reflux. I kept searching the web for help and came accross 2 products that I use and have helped me immensely without any side effects. The information is too large to list here but for anyone who is interested check out
these websites.   www.molocure.com  (product is A.M.P.) which is great for diarrea and constipation and stomach problems.
                  www.1to1vitamins.com  (Cease Fire) wafers for
stomach distress.

These products work and there is a wealth of information on these
2 websites.  I hope this helps some of you who have these problems.

Rudy

[PanicGirl123]

Well I am here to report that my symptoms have mostly gone away and, with a safety supply of bentyl just in case, I have returned to what I guess I would consider normal.  I still have occasional constipation, which I clear up with 2 bowls of raisin bran and caffeinated coffee (I have gotten to know the interior of the far right stall in my office bathroom really well!) usually at breakfast.  What helped me the most, and I know my symptoms were much milder than some other people's on this board, was great faith in my doctor, supportive husband, and a positive attitude.  I started taking yoga classes and taking walks in Central Park and generally started to relax more and more.  I know that the symptoms of IBS are very real and can be physically debilitating, but I have read many "panicky" emails from people talking about how "worried" and "Stressed out" they are by their symptoms.  Relaxation goes a long way, especially with IBS, and I think could help.  Just a thought I'd pass on to everyone.  Thanks for your helpful comments and support.

[kerr40]

A related discussion, i had a recent change in bowel habbits was started.