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 was about to ask if you've had your appendix out. I know someone who ended up with a bowel obstruction because the scar tissue from the appendix surgery was constricting the bowel.

If you start being sick you need to go back. It's graphic, sorry, but after normal sick the next stage is vomiting poo. You are eating and drinking (not suggesting you stop drinking btw!) it's not going anywhere. It can't go down, it can only come up.

I think you need an emergency appointment at the GP, today, and hopefully they'll send you to the assssment unit at the hospital rather than A&E.

Out of curiosity, do you have haemochromatosis? If not, have you been tested for it because of your iron overload?

Yeah I did say that, I even said I ended up here one way or the other by originally following the GP advice.

So, more laxido for me until I guess something happens

I have the actual opposite I have iron deficiency, I get IV iron twice a year.

I know this sounds disgusting, but take your shower head off so it's just the hose, run some warm water and put the water up there as much as you can bare. Leave the water in as long as you can then you should have some instant relief. it's basically an enema, do it as many times as you need.

@Usedphone
Did you tell them you had problems breathing this morning?

I honestly would not be accepting that from A&E
Squeaky wheels get the oil...do not accept being sent home!

Honestly, I don't mean to frighten you but I know someone who ended up very very ill from severe constipation, I would rather waste a little time (which you are not doing BTW) than risk ending up more ill! Please go back!

Yeah! I guess because I'm not screaming in pain it can't be that bad (according to them.obs)

Have you tried suppositories? They work very quickly to stimulate the bowel

According to the doctor that saw me, I need to dissolve it, my bowels are "still working" so just need to wait (and hope) until it melts.

I'm a bit disillusioned as I did things by the book, I would have expected at least an x-ray

When did you last open your bowels OP?

An actual normal poo? Like 3/4 weeks ago. Moose consistency mini egg tiny bits on Sunday. So over the past 3/4 I've had some of that soft poo come out always tiny amounts, always that consistency (and only once a day). The pain has gotten progressively worse, and haven't passed anything since Sunday.

So you are having some motion daily?

111 follows a script and is no replacement for actual medical advice which can be dispensed via qualified pharmacists if the GP is unavailable. 111 is no better than NHS online. In-fact, NHS online is better IMO.

How did they know you were bowels were still working...it sounds like they barely examined you!

If you've got a volvulus then it's a serious issue and you do need a&e. That seems to be what they're saying if they're talking about scans.
My mum had one, they made her wait twelve hours but then it took only 15 minutes to untwist it and it didn't even hurt much! She had to stay for a couple days in the ward for obs, but it worked out fine in the end.
If your stomach is really hard and massively swollen and you're having really bad pain, that's what volvulus feels like. You may also feel sick and unable to eat or pass any feces.

No I don't. Sometimes I do, sometimes I don't, but it's never the "normal" amount at all

I haven't passed anything in 5 days.

I know it sounds so obvious but remember to drink plenty of water with Laxido.

Laxido takes at least 48h before starting it or changing dose takes effect, so (by the sounds of it) too early to say that taking 8 sachets hasn't worked. You need to stay at that dose until things happen.

Suppositories can be incredibly effective but I wouldn't try one until you've had a couple more days of max laxido OP, you need things to be soft rather than hard before they come out at speed otherwise as pp said it will be agony.

I'd purchase an enema, and or do a disempaction with the laxido.
Laxido takes time to build up in your system though.
You should contact your GP.

I am glad you went to be seen OP and I am shocked that they have dismissed you so readily.

I am hoping you get some relief soon.

They listen with a stethoscope so bowel sounds must've been present. They will have palpated her abdomen to make sure her abdo wasn't distended.,

5 days isn't the norm for the op but there obviously isn't anything acute goign on.

Book in with the practice nurse op and see if they can help you come up with a bowel management plan.

A&E for an enema.
If it's an impacted bowel it can be dangerous..causing it to twist.. forming scar tissue ( speaking from experience )..
Please go and l hope all goes well.

I second the person who said prune juice. I had stomach surgery 2 years ago and nothing would go through me. I didn't go weeks without a poo, but definitely days. I took the lactulose which had zero effect. Senna - nothing. So I tried prune juice. A litre of prune juice, drunk as quickly as I was able (over a couple of hours - it literally makes me gag). To start with, it would only work overnight. But then once things were moving again, it would work within 2 hours.

I recommended it to a friend who has a medically supported, long-term constipation problem and it worked for her (until she stopped using it and the constipation came back).

I don't know if it would work for you though @Usedphone, your issue sounds more serious. BUT if you can get it down, it might help? You need to drink a lot though.

Don't do this, you could perforate something.

Lots of fluids, lots of physical activity walking etc, lots of fruit and veg and carry on with laxatives.

Do you have a good diet generally?