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.

OP has seen a pharmacist who advised A&E.

Please tell me you’re going to a&e?

I don't like recommending things because we are all different and I am not a doctor but I noted you have, or have had, iron malabsorption. I have been low in B12 and folate which is similar and have had bowel problems, particularly constipation in recent times; Woods Bowel Care Plus is marvellous. I take 1-3 tabs two or three times a day with food and it works. It doesn't cause pain and does no harm. This is just a suggestion. I buy mine from Amazon or direct from the Woods site. Good luck.

After a horrendous school run with difficulty to breathe while driving and some gag reflex / feeling sick, I've decided to definitely go to A&E. I think this now beyond anything I can do/take at home.

If you are able to go to a 9 am meeting and in your own words "pop in after"...is it really an emergency?
Laxido or movicol needs to be taken in bigger doses. The 8 sachets need to be taken within 6 hrs.
If you have impacted faeces in your rectum then glycerine suppositories which you can get from pharmacy, as well . This clears the impacted lowered faeces and the laxido works from above

Usedphone would you take advice from someone who has been in the same position more than once?
It is not a good idea when you are very impacted to wait as you could cause all sorts of things to happen many of which could be serious and involve surgery.
anyway it is ok to say take this take that it wont work or cause you great discomfort.
i ended up going into a and e the only solution was to have an enema. they did try glycerine suppositries but they did no good so it was off for an enema for me. it was like releasing a torrent the release of below seemed to bring down what was above. the relief was tremendous!
i personally think for your health's sake that you need to get to a and e then worry about sorting things out to stop it keep happening

You are doing the right thing. Good luck.

It's not the rectum, it's slightly above (from where the sharp pain is).

I have taken the 8 sachets within 6 hours btw

What is the point of consulting a professional if you then decide instead to take the advice of some randomers on an online forum?

The pharmacist told you to go to A and E if things didn't move, so thank goodness you are going.

If these can be got from a pharmacy, why wouldn’t the pharmacist have recommended them?

Sorry, but I think the OP should take the pharmacist’s advice only.

From what my hematologist drew for me about 3 years ago, this is where the iron sediments. So not the rectum.. just noticed I can't attach images , but yeah not the rectum

8 sachets of laxido in one day won’t do anything yet. You need 8 sachets of laxido every day. I wouldn’t have thought there would be a point trying bowel stimulators if the poo if still rock solid- that will just be agony. I do think you need to be seen because you’re feeling unwell with it but for the future you need to keep taking the max dose of laxido daily until it comes out. You might get some overflow like diarrhoea and think it’s worked but it doesn’t mean it’s done- it’s just overflow. It can take a good few days even a week or so to work. Unfortunately for disimpaction like this you would probably need time off work.

my daughters had chronic constipation for 8 years. She is now fine but takes a maintenance dose of one sachet laxido a day. Without it the constipation comes back. I wouldn’t think you would need a maintenance dose too. Laxido is fine to take long term.

This sounds horrendous. I hope you get something to help.

Wow that was a painful thread ! advice was given by medical experts but yoga poses were suggested!! Why on earth do people seek medical advice via a social media channel and ignore professionals ?? I wonder if it’s attention seeking .

My maintenance (according to the pharmacist and once I get out of thi) would be laculose

Definitely get yourself to A&E OP.
Massive sympathies.
Ongoing issue for me, but I'd second the prune juice suggestion. I always keep some in my house & for maintenance I find a glass a day is really helpful!
Good luck! x

I think go to A & E.

Then make an appointmant with your GP to discuss sending you to a specialist to form a better plan for your chronic problem.
Have you had a Colonoscopy?

Yes , I had one 3 years ago

If the OP has an obstruction she'd be in extreme pain and quite soon vomiting bile. It's not really something that you have without noticing.

Hope you get soon quickly op, A&Es tend to be backed up for hours. I echo pp though you really need a gastro review you can't go on like this and also Google Urgent Treatment Centres, we have quite a few locally. If you don't ring your gp then n UTC may be a better starting point next time. Good luck.

OP, you poor thing. I'm glad you're heading to A+E. Don't leave this any longer, you can become really poorly. I hope that they can sort this out for you quickly and that you can get a good bowel management plan going forward.

I honestly think that constipation (and good bowel management) isn't talked about enough or taken seriously enough (I'm a nurse). It can lead to all sorts of issues, not to mention the awful discomfort you get. Honestly though, when I was a younger HCP, I knew the theory of course, but never appreciated how bad it could feel until I got terrible constipation whilst pregnant (and that was a walk in the park compared with some of the patients I've seen). Since then, I make damned sure that everyone I look after has what they need to keep themselves regular and consistent (I did before, but I'm now next level with it!!).

I have a disabled relative that suffers from chronic constipation.

Daily movicol and prunes in her breakfast help keep it in check most of the time, but she does sometimes become impacted and need an enema, which is dealt with at the hospital as by that point, medical intervention is definitely needed.

The last time she was in they gave her 3 or 4 enemas before it was cleared completely.

Do you take anything daily as routine? If not, it's worth asking for advice on what you should do going forward to try and keep it at bay for longer.

Right now, you're definitely beyond the point of waiting for it to sort itself out, so I would agree with PP about calling 111 or doing an online 111 assessment, or going to an Urgent Treatment Centre if you have one nearby. I just did a pretend assessment online and it said to contact your GP or gave me details of a "nearby" (20 miles away) UTC.

Good luck OP - think of how "relieved" you'll feel once it's clear!

'I honestly think that constipation (and good bowel management) isn't talked about enough or taken seriously enough '

Tbh though it is an unusual picture. If a haematologist thought she had iron deposits in her bowel with a risk of obstruction (iron deposits not something I've ever heard of before) then they should have referred the op to gastro or at least a practice nurse to manage it. It isn't so much it isn't talked about it just seems mismanaged by the hcps who have seen the op previously.

It will be frustrating and there’s a good chance that A&E staff, including the docs will think it’s not an emergency. Or urgent treatment centre but call GP first and ask them to send you the link so you can book into UTC yourself.

You should go because years ago I had a patient go unconscious. Crash cart called etc. No one knew why she had gone unconscious as she was young and relatively healthy. Turned out to be vasovagel reflex. She was so impacted the stool was pressing against her vagus nerve. Fine after a few enemas.

A&E is the right place. You’ve not had a bowel movement for absolute days - you are at risk and they need to rule out toxic megacolon, blockages etc.

Going forward you need to see a consultant about this and perhaps trial drugs such as prucalopride or linaclotide.

Good luck OP