This is going to be a long post but I’m in desperate need of advice as this issue has been controlling my life. I’m a 21 year old female suffering from cramping directly related to BMs. In summer of 2017 I got an IUD. For the first couple of weeks I was having terrible cramping in my abdomen. I began to notice a few things, cramping usually occur around the same time, having a BM would reduce/stop pain, and forcing a BM would prevent cramping entirely. During this time I would have alternating diarrhea and constipation, but this has occurred for over two years (blamed on a bad student diet). The cramping has continued despite having the iud over a year. I do have bad cramping on my “periods”, once or twice a month where I have light spotting with the pain being INTENSE for roughly 8+ hours. Over the time, the cramping on the periods has become better. However I still have cramping that is directly related to BM. My diarrhea and constipation have become absolutely ridiculous. I now have to resort to using my fingers to pull out the feces. Some days I have diarrhea where I’m running with no seconds to spare to the bathroom. This is usually very watery or slimy/ muscusy. Commonly I need to use my fingers to open my anus to trigger the movement despite having the nauseous feeling of having to go immediately. It’s almost as if there's a signally issues and the muscles aren’t working . Most commonly I have BMs where its a thick mush that's very sticky. I’ll have to use my fingers to almost scoop it out as no matter how hard I try to push, it won’t come out. If I wait and not force it, I’ll get painful cramps. Other Times the BMs are extremely hard and solid. Again I will need to use my fingers to pull out as pushing is useless. Commonly the BM will be black, not dark brown but pitch black. First thing in the morning I usually do not need to force BMs, it’s more later in the day. I’ll have to force BMs (force as in using fingers to pull them out or to open hole triggering movement) every other day at least. I have to force the BMs as otherwise it will not come out, and it will stop/prevent cramping. In some cases, large bms will actually cause light cramping for a few mins immediately after. I also fart all the time, usually occurring before needing to go to the bathroom. My life has begun to revolve around this issue, as I have to ensure I’ll have access to a bathroom where I can do my forced BMs (I don’t want to do this in a crowded public washroom as it’s often noisy and smelly). I haven’t seeked a doctor out for concern that this is totally normal and they’ll just tell me to drink more water/ eat more fibre (though I have noticed diet changes have no effect). But I’m concerned because it honestly feels like my intestine muscles don’t work properly. As well as Im not sure if this is due to the intestine or to the IUD. Any advice on what I can do to solve this issue?