Unordinary Constipation

[Nogodsnomasters]

Background: I've had IBS for 15yrs, with varying changing symptoms over the years.

This year I've become constipated but it took months to work out that that was what it is as I don't have the obvious traditional constipation symptoms of not going to the loo or hard stools. It took myself and my GP a while to come to the conclusion that it is constipation. I have a bowel movement every day, sometimes several times per day, and the more constipated I become the more frequently I go to the bathroom?! The movements are not hard themselves they're actually soft/fluffy (not sausage shaped at all but rather in pieces) but they are difficult to pass, I have to squeeze and push to get them moving and they are incomplete movements, small amounts each time but I have the urge to go several times per day with each stool getting smaller as the day goes on.

My GP prescribed fybogel which I've been using on/off for about 6 months now. It works to a varying degree, as in after a few days usage I will have more complete and full bowel movements and therefore less trips to the toilet per day and this will remain the case for a week or two and then the symptoms come back and I take the fybogel again for a few days and round and round we go.

I have tried upping my fibre intake through diet, fruit, veg, shredded wheat, chia seeds and flaxseeds in yogurts and on the cereal etc, I drink plenty of water. I don't do a great deal of high intensity exercise but I walk a lot and do yoga.

Has anyone else had this kind of constipation that I'm describing? If so what do they do about it? I'm getting really tired of it. Other symptoms of it when it's flaring up are nausea, some mild tummy pain, excess wind but those have always been the case with my IBS anyway.

I also think this could be rectocele, I have this though my symptoms aren't as bad as yours. I had a forceps delivery which damaged the structures between my vagina and bowel, so sometimes the bowel can form a sort of pocket and get in a position where my muscles can't move the poo along.

If I eat a healthy diet and exercise I can keep things moving, but if I get dehydrated or eat badly the problems start.

I can help myself go by pressing down on my perineum.

I know you said the GP examined you but GPs are t very expert in this and many doctors will tell you a degree of prolapse is normal. One person might manage fine with a slight prolapse whereas another might have issues going to the loo.

I have a rectocele and the same problem.
Not constipated but I cannot have a natural bowel movement...no urge, and nothing happens ever.
My bowels are managed by a daily (or every other day) suppository (prescribed). It's a nusiance but one I have learn to live with. Laxido/fibrogel just made my bowels more full without it going anywhere!

Would a rectocele be felt in an rectal examination? She did not examine my vagina.
I've been on the laxido for 3 days now rather than the fybogel and this morning my stomach is killing me. I have the urge to go but unless I profusely strain nothing comes out and even when I do strain or raise my feet on a stool etc only a small amount comes out each time, I've been 4 times this morning, I'm sure it wouldn't be so many times if I could have a full bowel movement on the first try.

@Nogodsnomasters you could try gently inserting your finger into your vagina when you are sitting on the toilet. See if you can feel any bulges. In my case, it isn't obviously seen by the GP when I lay down, but I know it is there, and if I put my finger in my vagina and gently push back and down, it releases my bowel and I can pass my stools. When I don't do that, the bowel bulges into the weakened vaginal wall and forms a stopper.

Could you afford to see a pelvic physiotherapist privately? They would likely do a much more thorough examination than your GP. You could also ask to be referred to one on the NHS by your GP.

https://thepogp.co.uk/patients/pelvichealthhadvice/bowelhealth.aspx

Possibly more useful: https://thepogp.co.uk/userfiles/pages/files/POGP-Prolapsee_2.pdf

I tried this but honestly I couldn't tell what I was feeling, when I pushed down towards my back passage it felt hollow and then I pushed forwards/more upwards I could feel bulges but I have no idea if they are meant to be there or not, I'm a bit clueless on the mechanical side of things. Neither direction of pushing made the bowel movement come out any different.

Did you try it at a time that you felt the need to empty your bowels but couldn’t? This is when you would feel a bulge in your vagina. You could ask your GP to do an internal examination, both standing and lying down - a rectocele is often more visible when you’re standing.

private gynae
He diagnosed mine
i had prolapse op
man’s best thing i have ever done

You could try a suppository and see if that helps at all. It gives you a strong urge to go in about 10 minutes. Not the most dignified but it might give you some instant relief.

• glycerine suppository I meant to say. It's just like the stuff you put in your royal icing.

Yeah I did it when I was actually on the toilet trying to go. Damn I should have asked when I was there on Friday, I hate ringing them over n over. They did say ring back in 2wks if the laxido doesn't help so if that's the case I could ask about a vaginal examination. How would I go about bringing that up?

Thank you. Do you buy those in the chemist?

OP please ask your surgery if you can be referred to women's physio. You may be able to self refer. They specialise is uro/gynae problems. I was diagnosed over the phone (rectocele also), then had an appointment. No pressure to be physically examined. I was given exercises, you tube videos and plenty of advice.

Seems to be a lot of people who've have a rectocele have had this experience of soft poo but straining to pass it? I wonder why my GP has not thought of this as a possibility, I've spoke to them several times regarding it in the last 6-7 months.

is it out of the question you going private?

In my experience GPs are not great at spotting rectoceles. I have one, already assessed by a consultant, but two GPs have examined me and told me I don’t, even after that diagnosis.

I have exactly the same symptoms as you. I have diverticular disease (had it for years) which has narrowed my bowel. It's too narrow now for a colonoscopy. I have to have virtual ones (MRI) instead.

Wow, and what treatment do you have to maintain this?

There's no treatment as such. Try and eat a healthy fibre rich diet. I use fybogel if I think I'm getting constipated, drink loads of water and exercise. I still get occasional flare ups of diverticulitis which require antibiotics, sometimes intravenously.

Yes I couldn't afford that.

Update: one week nearly on the laxido, the dosage was given as "one per day but if not working take more" so I took one sachet per day for the first 3 days and then moved to 2 sachets the last 3 days, today is day 7 and there is no change in symptoms.
I did a poo this morning that was a bit more solid than mush and it was flat looking rather than round. Anxiety is starting to get the better of me now. I know I'm not going to work out what's causing this without a colonoscopy and the idea of one terrifies me.

If you're still around, how are you getting on @Nogodsnomasters ?

I've been having similar symptoms since December, after a lifetime of completely normal function. My natural urge to pass a bowel movement seems to have completely disappeared, and I have to strain to pass the smallest, softest amount.

Dr was unconcerned and told me to continue with lactulose/Laxido even though it's completely unusual for me to need them.

I booked a private women's physio who said no prolapse (at least nothing that she wouldn't expect to see in a woman who's had three vsginal deliveries) but did say that my pelvic floor muscles are extremely tight, so I've been wondering if I have pelvic floor dysfunction, caused by straining when I first became constipated.

Too much time for googling is no good for anyone!

I'll need to go back to the Dr because it's just not normal for me.

The misery caused by this kind of thing is massive. It's on my mind constantly. I never used to think about it because it all just happened naturally!

I hope you're doing better.

@HungerlosMcMungerlos Hi,

Well I knew something wasn't right but I was having a hard time believing I was constipated because I was moving my bowels every day and the stool was soft so I was convinced the straining was caused by something else. Anyway it got so bad to the point I could no longer eat and was nauseous 24/7 and filled with trapped wind that I was even struggling to pass farts without extreme force/straining. I took myself to a&e where I was checked over and given a stomach X ray which showed that I was chock full of stool and almost impacted, this was despite already being on a low dose of laxido! I was advised to do the high dose disimpaction regime for a week (and then gradually reduce the dose), in the last 10 days I have had 60 bowel movements and I was shocked and traumatised by the amount of stool passed, I felt so ill for the first 4 days of this and eventually gotten better as the almost blockage has cleared.

Sorry for lengthy reply, any chance this is what's happening with you? Are you in any pain? I wasn't in excruciating pain personally just some mild non-specific pain but it was the other symptoms that were getting to me. I know what you mean about how it takes over your life, your thoughts, it's horrible not knowing what is the cause.

Oh wow, thanks for the update. 60 bowel movements in 10 days? That sounds traumatic. I hope you're at the end of it now.

I'm like you - my stools are soft and i have a movement (mostly) every day but only once a day, but they're always very underwhelming. Sometimes solid-ish, other times verging on diarrhoea, but I figured that was down to the lactulose. It does feel like force is required. Sometimes feels like I can't get wind out. I almost celebrated when I did a noisy fart earlier today!

I don't have any pain, nausea or feel particularly bloated.

I need to go back to the GP really because it's just not normal for me. He was very unconcerned last time, just told me to improve my diet and exercise and drink more water. He didn't even feel my stomach.

I hope things start improving for you now.