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.

I guess you have to go then - you'll be in for a long wait but I suppose there's nothing for it. How long has this been going on for? I've had a lot of issues w/ constipation, its pretty much under control now. I'm always on a maintenance dose of laxido - 2 sachets daily - and take a dose of a stimulant laxative about once a week. Every day I have 70g unrefined oats, 30g prunes, and coffee in the morning. And of course, lots of water. I don't like taking the stimulant laxative because they do cause cramps, but once a week its necessary, I've had a blockage before. It seems to be the way it is for some people. Lots of IBS in this family - my brother is the other way, but he would be a lot better if he took his obvious lactose intolerance seriously. Apparently dairy is worth the pain 🙄

Oh wow. Do you think the problems you’re facing now are a result of your C-section delivery? Could you ask for a referral to see if there has been some sort of internal damage which causes these blockages? Constipation is crippling, I found it excruciating. I’ve actually been up most of the night with baby DS who is also constipated this week!

This episode? 3 weeks. As a regular thing I would say at least 8-9 years? Probably longer, but that's what I remember.

Like I said, hematologist was not bother, GP said to take them as needed but pharmacist is now saying that after I'm done with this blockage I should take laculose daily to avoid the iron to sediment in my gut and create the "rock" that causes the blockage.

I think you should go to A&E now. A pharmacist has told you to do that, as well as an A&E nurse on here and you've exhausted all other options. Go and get yourself sorted!

Have you tried Movicol? I was discharged post op with it and it’s fantastic. There’s a mixture of dosing but for blockage it’s like mix 8 with 2l of water or something. I would be extremely surprised if that doesn’t at least help.
Id never heard of it but the hospital insisted it’s the best there is.

If you really have tried everything, it’ll come down to when you last went as to where to get help. But I’d suspect this is a GP problem if you’re still going a bit.

My great grandmother 100 years ago used to be the village nurse/midwife go to. When my grandad was constipated when he was old and had dementia he used to shout at anybody trying to feed him don't put anything in that end till it's come out t'other end.
Chewing gum can help stimulate your system. But I definitely advocate a and e.

I will be quite graphic here because it’s the only way to be clear.
Your blockage is quite far down the intestinal tract. It it like a big hard rock.
Youre softening the poo higher up the tract with laxido. This has essentially created a river of sludge.
you have to MOVE the rock to let the sludge out. This means tackling the problem from the bottom as well as the top.
The only way to do this is with an enema. At home you can try microlax. It is quite effective. I might be inclined to give glycerine suppositories a go and then a micralax enema.

if that doesn’t work, no question it’s an A&E job.

I used to have chronic constipation due to large ovarian cystsand ended up in hospital after not being able to go for weeks after a pelvic surgery. Enema didn’t really work but the only thing that forced the movement was dulcolax stimulant laxatives (I took 4).

They give you stomach cramps and diarrhoea but they’ve always worked for me in emergencies!

You've been told by a medical professional to go to A&E.

Blockages are not something to mess about with - they can kill you. Stop getting medical advice from strangers who don't know your history and go and get yourself sorted.

Please follow the medical advice of the pharmacist, please don’t delay any further.

Good luck 🍀

So the OP has been advised by a medical professional (pharmacist) that the next step is A&E, but the Mumsnet 'doctors' - who would only go to A&E if a limb was hanging off and they might try 111 or minor injuries first, say no.

OP I feel like you've come here to be put off going to A&E. Go. You have been advised by a medically trained professional to do just that. You're not wasting their time.

Mumsnet should not be offering medical advice. None of you know about the person's medical history.

this is past home remedies now.
go to a&e. tell them what you told us here. including the iron mal-absorbtion and increased thirst.

take a good book and a phone charger.

all the best

Movicol is the same as laxido, and I've taken the dose you mention and nada.

According to the pharmacist (and why he adviced to go to A&E) is that the rock/blockage is too big/solid to be softened/diluted and thus why I need A&E.

Apparently, "the rock" never really goes completely away, the laxatives just move it around or make it slightly smaller, but that's why I never feel "empty".

I definitely haven't felt "empty" since I had to prep for the colonoscopy.

I’ve had it really bad once, post a surgery, and I honestly really feel for you. Are you still eating? I wasn’t able to in the end. Lucky for me I did eventually get everything moving again. But I was desperate.

Also I didn’t know they were the same, good to know, thank you. I have also recently been told by my consultant ‘I defy anyone who has constipation when drinking prune juice’. I honestly have never tried it but could be worth a shot (or a litre!).

You’re probably going to have to bite the bullet at some point if the GP can’t help. Either urgent care, and insist you won’t leave until the blockage is cleared, or A&E. The problem is this does have the potential to become life threatening. I’m just not convinced they’re going to take you seriously.

I wouldn’t bother with 111, they won’t tell you anything you don’t already know.

She asked a question and we answered. HCPs' opinions aren't based on knowledge alone but experience.

Yesterday was the first day I had to force myself to eat, maybe I've been less hungry in the past few days but yesterday was definitely noticeable.

Even the sight of food started to make me feel sick, which was a new symptom.

I'm just being a bit hesitant/cautious because doctors have been very blasé about it, and the pharmacist seemed alarmist in comparison. Big difference is that I've never seen the GP when I've had an episode, I think it was potentially a passing comment during something else and she prescribed the senna/laxido as needed.

@user9632579 OP did ask, that is correct.

In the replies, she has been advised to take different medication than she is already taking and even to perform an enema on herself.

The pharmacist, consulted with her in person, not on an online forum.

Medical advice should not be given here.

Chronic constipation can lead to serious medical problems and shouldn't be dismissed.

She is an adult, let's give her the credit to choose which advise she follows. There's even a heading on the medical boards.

listen to the pharmacist op

@Usedphone - some people really don't like to make a fuss, but sometimes you need to really push and advocate for yourself.

You said you're going abroad in a week. You need to get this sorted before you go. Travel insurance may not cover you if you've knowingly gone away with this.

Reading back on your post, you've been taking laxatives for 3 weeks - they haven't helped.

You've lost your appetite

You said you've had some breathing issues as you feel so 'full'

GO TO A&E.

@Usedphone wishing you a load of luck
please for the love of god don’t take any other medication etc that people have suggested here, sounds like you’re at serious risk of doing some damage.
still baffled by your approach to ignore professional advice 🙈

Laxido isn't a laxative, it's a stool softener and it takes time to build up in your body to work. So Laxido won't help your body go to the toilet, it's for people to take the pressure off bowel movements not help them actually go.

Definitely go to your GP and if they don't help call 111

I really don’t get this. You’ve been advised to go to A&E by the one medical professional you’ve spoken to; you’re describing a list of alarming symptoms; you’ve been advised on here by an A&E nurse to go to A&E but you’re all still - ooooh I don’t know, maybe I’ll just leave it and see if magical thinking works.

I mean - what do you have to lose by going to A&E? Apart from an immovable rock of poo?

If you have never been to the GP when you HAVE constipation it's hardly surprising they weren't very concerned. It was a hypothetical situation where you sometimes get a bit blocked. Lassing nothing for 3 weeks is a different and more serious complaint.
I feel this should a GP issue but I don't actually know, they might tell you to go to A&E but if you don't make an appointment they definitely can't help you!

Sadly, I know someone who died from constipation. She waited too long to get help, by the time she went to hospital she had an obstruction and passed away soon after.

My DD suffers from chronic constipation and has been badly backed up before. We give her the maximum dose of movicol for several days, and keep going until everything is out and it's watery. Then afterwards you need to keep going with the movicol as the bowel is damaged and needs time to repair in order to do its job properly. She's also been off school for a week or so each time as it's not really possible to keep on normal activities.