Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Help! I've been constipated for a year...

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Constipation


I've been constipated for about a year now. It seems to have started
when my doctor first placed me on Calan for high blood pressure.
I was switched to Prinivil (20mg) about 6 months ago, and the
constipation seemed to let up for about 2 weeks, but it's back again,
as bad as ever. It is almost impossible to function normally. I
have cramps, pain, alternating diarrea and hard dry stools. I have
been taking Fibercon daily per my doctor's suggestion, but it doesnt
help much anymore.
In February of this year, I woke up with horrible stomach pains
and after an hour or so, vomited and had bad diarrea (all at the
same time!) Later that day, I began bleeding bright red blood....
It felt as though I needed to have a bowel movement but just passed
a couple tablespoons of blood. This happened all day....about
8 times. Anyway, I had a colonoscopy done and it didn't find anything
except for a benign polyp which was removed.
The night before the colonoscopy, when I was drinking the
nu-lytely stuff, it took over 2 1/2 hours to start working. The
package said 1 hour....so I'm wondering if I have something not
right down there...
About every 2 months or so, I'll wake up in the middle of the
night with terrible gas pains and cramps which seem to come more
frequently. Sometimes I feel gurgling in the left side of my
stomach, which usually produces some relief.
Basically, I just don't feel right. There have been very few
days this past year that I feel that my intestines are functioning
normally. I'm a 30 year old woman with a fairly low-stress life
(except for this problem) and I've never been constipated in my
life before this. Any suggestions will be greatly appreciated.

______
Dear Becky,
Constipation is a very common problem. The obligatory first step is to exclude obstructing colon lesions, which was done by the colonoscopy. The next step is to assess colon transit, using a marker technique, and analrectal function by a motility study. Usually these tests are normal. Often physicians will check thyroid function because impaired function can be associated with constipation.

Fiber is the cornerstone of symptomatic treatment. You should take as much fiber as you can tolerate. If this treatment does not work, I will usually add an osmotic laxative such as Lactulose to the regimen. The next step is to use Golytely to facilitate defecation. The dosage used varies depending on the volume necessary to precipitate defecation.

This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.

HFHSM.D.-rf
*keywords: constipation
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