When would you go to A&E?

[Usedphone]

I suffer from chronic constipation, I've been to the GP in the past and they just have me tons of laxido and senna to use "sparingly/when needed" but that was it.

The hematologist mentioned it was related to my iron malabsorption (by not dieting it, it sediments in my colon and causes blockages). He also said there was nothing that could be done, and it had never been mentioned again.

So I've been suffering from a blockage for the last 3 weeks I still go, so I get some relief, but this time the laxatives have stopped working which made me go to the pharmacy. There the very kind pharmacist gave me like 20 mins of his time because he was shocked that after 4 senna tablets NOTHING has moved. I took them in one go btw. He then told me the next step was A&E because there was not much more tablets could do.

So then he told me to take 8 sachets of laxido and that if still nothing had moved it was hospital time.

So here I am 12 hours after I took the first 2 sachets, and about 6 since I took the last 2 (8 total) and still nothing! I just have pain but that's it.

Given that I'm not a priority case, would it make more sense to wait it out another day (and take 8 more sachets)? I'm thinking of popping in after my 9am meeting hoping that they see me before the school run, and if they don't, I just walk back home. The only thing is that for the past 5 days it has become super painful, especially my lower back.

Damn OP sorry to hear that. Surprised bisacodyl (Dulcolax) didn't work - the max dose which is supposed to be on a doctor's instruction only is 20mg, I've had that for colonoscopy prep and it was a bit of a nuclear option. Hurt like hell but everything came out, which I guess is the goal. Can you try and talk to your GP and explain the hospital sent you home?

Oh for sure, but not nurses in primary care. That really isn’t our area of expertise. ANPs can manage constipation but only prescribe and advise, they won’t do any more than the GP has already done.

Better than A&E visits surely. I think a practice nurse with any common sense and experience could see this is an ongoing problem that requires ongoing primary care management not trips to A&E when it gets unbearable.

Again, @Janiie absolutely it is best managed in primary care but this really isn’t the nurses job.

A proper disimpaction routine and a possible routine referral for gastro can be done by the GP.

Don't worry, the hospital will wait until there's something seriously wrong before they treat anything. Here's hoping that doesn't happen and you take a mega poop soon.

Can you find your local health board's written criteria for GPs making a referral for colonoscopy? Most are online if you google

your diet sounds amazing @Usedphone
I have a good friend in Asia who had similar problem and eventually the stomach pains got worse and worse. Ended up having a small operation as had a blockage in intestine. It wasn’t cancerous or a tumour just sediment build up. They removed a large part of intestine in the middle where the food couldn’t pass through properly and sewed it back up again and everything was as good as new. He paid for the operation - around 8 years ago and has been fine ever since.
He just turned up at hospital to get it done.
I wish you luck. X

To be fair it's my first time at A&E so I have been able to manage it OK, and realistically I was even in two minds about going

Rarely have I been so invested in whether someone successfully voided their bowels.
Fingers crossed for you, Op.

And the reason was because that was against the medical advice.

God op hope you ok. Would plenvu clean you out had it for my colonoscopy in nov. Its awful stuff though.

Looking forward to an update OP fingers crossed.
Not saying this lightly my DS had a blocked bowel a couple of years ago and had a heart attack while waiting on a trolley in the a and e corridor for 36 hours. It's not to be taken lightly.

Oh that will be reassuring .

Hope you're feeling better op.

Sorry to hear that about your DS

Thankfully the OP had bowel sounds. non-acute abdomen and no vomiting when examined in A&E yesterday so not experiencing a 'blocked bowel' in that way

Just a bit of an update. And sorry for the TMI, but I still haven't been properly but I've started leaking wonderful!

So I'm hoping that's the start of actual movement.

Still fairly nauseous though

I asked my dh , he is colorectal surgeon. He said if you can't eat and or sick you need to go back.

Leaking may be overflow diahorrea - it might be the start of a wonderful satisfying experience, but it might be your body squeezing something out around the blockage while it can.

It sounds very uncomfortable OP.

I think I'd be using suppositories over the weekend and booking a private enima/colonic irrigation for early next week.

You don't have time to wait much longer because of going abroad. Hopefully something will move soon.

Fingers crossed!

Hope the leak turns to a gush. Sorry for the graphic, but there is only one direction for this effluence to go, and that is out.

Get massaging

I know it sounds like a load of crap (literally!) but have you tried looking on YouTube for some physio/yoga type workouts for constipation? It might well just move something slightly to help push things along.

Well done OP, you're being very brave and stoic about this!

I'm very invested in your bowel movements and rooting for you!

Do keep us updated, I really hope you get some relief soon.

I'm no medical professional but I would have thought attacking it from both sides/ends would be a good plan so to try the suppositories

OP, if your bowl movements are “leaking” and very watery, this is probably because only the wet stuff can leak past the blockage, not that the blockage is moving. I’m really shocked that A&E/the GP/a lot of posters haven’t taken this more seriously!

She was seen in A&E, she had bowel sounds and her abdomen was not distended. Before the 'leakage' her bowels had been moving to some degree just not as was the norm for the op.

Hcps who assessed the op are the best placed to decide on what is a 'blockage'or just bog standard constipation. I'm honestly not minimising the op's discomfort and if she does develop vomiting and pain then I'm sure she'll seek further medical advice via 111.