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.

Well after the leaking nothing else has happened. I'm still nauseous and now I'm very sleepy, I guess it must be from not eating

@Usedphone can't you even manage meal replacements?

No, the only thing I can eat today are tiny pretzels, but maybe I had like 15 max

It’s not right that nobody is helping you. Have you tried a glycerine suppository? They do help.

I know this feeling and it’s awful, I really really feel for you. I think you probably need a second (xth) opinion.
The leakage you described doesn’t really align with my past experience. I was very lucky that things you’ve tried got me moving again.
In case you’re doubting yourself, you should probably get help because if this doesn’t improve the escalations are not pleasant, and dangerous.

I've been in A&E twice with similar OP. GP not really helpful.

What I've found works is having 3 or 4 prunes last thing in the evening.

Then, first thing, drink around 300 - 400 ml of water. I used to gag at first but can now down 400ml in one go.

Give it around 15 minutes then go to the loo even if you don't feel like it. Sit & relax.
Hard with kids etc, but relaxing your muscles is key.
Wake up 30 mins earlier than normal if you have to.

Can take up to 15 minutes before anything happens, but then, whoosh!! All out.

That's the only thing that's worked after endless trips to the GP, scans, different medications and dosages.

After a while, you can alternate prune days but always have water first thing.

Good luck.

I don't know if this will help at all but I had and sometimes have your problem. Before I sit up in the morning I massage my stomach anti-clockwise pressing in with the heel of my hand. Just for a minute or so. It seems to cause movement in my stomach and works fairly soon afterwards. Perhaps try after you have had hospital treatment. Good luck

Gosh OP I really do sympathise. I had impaction after my first birth due to all the meds, I was only properly blocked for a few days but it was agony and I felt so ill! I got a suppository from a midwife and was OK after that. I'd get onto the phone to 111 and ask them to prescribe some for an OOO pharmacy. My concern is that if I take too much laxido it gives me diarrhea and the last thing you want is a load of that stuck behind an impaction. You can definitely take laxido every day, the maintenance dose is on the box. But I do think once you're over this episode you should ask your GP for a gastro referral, just to check everything is OK and to prevent this happening again.

Oh gosh I really hope you get relief really soon x

Quite!

As an ex A&E nurse I'd advise you to go. It sounds like you're grounds for a potential bowel obstruction

I certainly wouldn't be going on a plane until this is totally resolved

OP if you're going to the US you must inform your insurer before you go. You may be required to pay additional premiums or in some cases they may not insure you at all, and you'd need a specialist insurer.

This happened to me a few years back, I ended up have to pay over £1000 for coverage 🥲

I don’t understand why you don’t keep an enema kit in the house and used it two weeks ago before it got to this stage. You should probably go back to a&e before your bowel gets any more serious damage.
You need to be way more proactive as the nhs is not there for you.

My DS suffers with constipation, he is on a maintenance dose of laxido. I mostly only read your posts, so apologies if I've missed this being mentioned already but his consultant prescribed sodium Pico sulfate. It's a medicine that gets your bowels contracting to help try and push the blockage out. Would something like this help maybe? Not today obviously, I really think you need to go back to a&e tonight or tomorrow and tell them how unwell you're feeling

Movicol is Laxido 😊

Because it has never got to this stage, it normally resolves itself eventually (or at least I empty my bowels enough to get in with my life).

Prior to the leakage had you produced anything at all in the previous 3 weeks? I ended up in hospital many years ago after the meds I’d taken for an injury had bunged me up. I’d not produced anything at all in over 2 weeks, and felt I could no longer eat anything. The thing that got me going was a combination of the impacted dose of Movicol and an enema. It was a last ditch attempt at getting things moving before a manual evacuation. Thankfully it worked!

The little bit you are passing is probably overflow, coming round the blockage like water round stones in a river.
You will need to take the max dose of movical/laxido for a few days continuously until what you are passing has no lumps and is straw coloured. Then keep taking the maintenance dose.
This is called a washout and is what we do with impacted bowels in children.

Well... unfortunately, that's not true.

OP I hope you can get things moving, but honestly you sound pretty unwell, so personally I wouldn't hesitate going back to A&E again.

I’d take 8 movicol a day and 2 litres of liquid as well. Lay off the stimulants for now. Go low residue diet. If you start vomitting go to A and E immediately.

Movicol is not an as and when drug. It’s something that needs to be taken regularly. Call ERIC the bowel and bladder charity for help. Join movicol mummies on Facebook. Learn to manage your constipation. Lactulose is just sugar. Movicol is a top notch solution and probably
yoir only one. NICE best practice guidance is two weeks of max dose movicol before adding any Senna, Biscodyl etc. If it’s not soft enough inside then it can’t be pushed out you’re just going to hurt yourself.

Aww I feel so bad for you and totally understand the pain. I hope you get some movement before you go to the states. Are you able to get a colonic irrigation?

Yes, it's very good. I was prescribed it for a faecal impaction with overflow last year (very frightening at first as I didn't know what it was) and it did the trick. I took it for three and a half days initially and then a further three days.

I hope you are ok OP, you sound really unwell.