Severe constipation slow bowel?

[Notthecorner]

I am going through one of the worst episodes of constipation I’ve had in years and I am struggling with it day to day. Any advice to get back on track after a bad bout?

I have seen a GP and they told me to ‘eat more oranges’. They did give me medication and a vague routine for 2 weeks but I feel on my own with this and unsure where to begin. I am keen to prevent this happening again once I can get through this episode.

I eat well and exercise, healthy weight but recently had a very stressful month where I wasn’t in my usual routines at all (wasn’t at home for much of it and travelling) and my body has reacted to change in food/eating times and I think I got a bit dehydrated. This led to some constipation that then got worse and worse, to the point where nothing I did to go to the loo was working so I was severely and painfully impacted.

The GP was considering sending me to A&E for a manual disimpaction if I had not had a bowel movement in the next 24 hours but finally I did go a bit but I am so sore and mentally fed up.

I am doing a movicol routine with prune juice (which is rank!). I tried glycerol suppositories but they didn’t do much. I’ve now got the enema syringes to try. I don’t want to do the spasmodic laxatives as they cause so much stress on your body and are only short term, aka chain you to the loo for the whole day and I have a job to go to!

I have been told by a doctor once I have ‘slow bowel motility’ but nothing was given to me to help with this and I don’t know what plan to follow I am making up my own plan! I also haven’t seen a gastro for their opinion. Helpfully the GP told me my bowel and rectum will all be stretched now so it will probably happen again. Does anyone else have slow bowel motility?

I have slow motility, didnt realise why until a coloscopy showed a transverse colon and something called a recticil (not sure of spelling) basically a sort of diversion in the bowel so the stool is sort of sideways on and difficult. I have to lean back on the loo to get things moving rather than forward like normal people!

I have to have prunes every day, I know I also dont drink enough water and liquids so that is a problem

My mother has a slow transit bowel. What works for her is Ortis cubes from Holland and Barratt, they are a natural bowel stimulant. I also suffer from constipation and find eating a lot of sunflower seeds works, about half a cup a day. For immediate relief maybe try eating some werthers sugar free sweets as a one off, then look at a more long term solution once the bowel has cleared.

After whooping cough and antibiotics plus an existing prolapse mucked up my bowel movements it was the following that helped me return to a daily routine, it took a while to settle. Women's physio advice on how to support myself when going to the loo. A breakfast every day of yoghurt, Chia seeds, milled mixed seeds, whole kiwi chopped skin on, another fruit (usually raspberries) and a handful of bran flakes plus a coffee. After lunch every day I have a few dates and I consider fibre first in all my meals. Drinking plenty of liquids, doesn't have to be water, I like rooibos tea in the afternoon and evening. Regular movement. So not exercising while I was sick made everything worse and getting regular movement helped too. I hope once you get this moving you can find a routine that makes you feel normal again. I have read that too much fibre all in one go can be a cause of constipation, so onece you get moving you may need to build up to it slowly rather than jumping in to loads of fibre straight away.

@toolate2 I went and got some of the Ortis cubes today so thanks. I would prefer natural remedies but I don’t really like dates/prunes very much so this is going to be a short sharp shock way of consuming them quickly - a lovely gross dense, sticky, gritty cube 😂. I did not get the senna version

I did a lot more exercise today, kept hydrated and tried to eat well. I had one further spontaneous BM that I don’t think was related to the enema but no other action today. A lot of stomach bloating and cramps though

Is stimulant laxative reliance that much of a thing? I ask as there are children on it daily for years. I was concerned about it but it's the only thing that actually works for my daughter. Investigations ongoing...

I'm like you @Notthecorner, awaiting urgent referral as I bounce from one extreme to the other (mainly on the diarrhoea end though). So many tests and oscopies over the years. I manage my symptoms by diet alone because while laxido is helpful in bad situations, huge amounts of daily fluids and caffeine work better for me. Stimulant laxatives chain me to the toilet in a way they do not for my daughter!

Apple juice is a brilliant natural one too that I've not seen suggested?

@NowIveSeenEverything most kids are put on laxido I thought? These are long term and not stimulant. I was told by a doctor not to take long term stimulants as it can make the bowel lazy. All the packets for stimulants have warnings on them. The water drawing laxatives are much safer long term. I also hate them anyway as they don’t fix the issue

@Notthecorner Yes they are to start with. My daughter was on laxido, increasing doses, from 6 months until over 3, would still only poo 7-10 days. We did the disimpactation regime and still no dice and no blockage. They moved her to daily senna and now she's doing great. A significant portion of ND children (she's NT as far as I can tell) and kids with constipation/withholding issues take senna daily for years though as it's deemed better than the alternative. Same for adults with mobility issues. In our case, her bowel seems lazy anyway, I await further help.

Poorly treated recurrent constipation causes a lot more problems than stimulant laxatives do. What dose of senna caused you problems? Were you taking Laxido/movicol at the same time? What dose of Laxido are you taking now?

What worked for me was eating LESS fibre and drinking warm water - a lot more water in general, in fact. I found using laxatives, movicol, etc. made my bowel more sluggish (un-toned the poo muscles). Although it did shift the blockages (for want of a better description).

Oh, and laying on your stomach with a rolled up towel between your belly button and pubic bone, bending your knees and rocking side to side. This does the work your muscles are struggling with by pushing the food round your intestines.

It wasn't an overnight cure but the issue has gone away now. Took about a month to get back to a regular, normal routine.

Drinking lots of water meant that even though I didn't go every day, when I did go, it was soft and easy enough.

Personally, I don't think everyone is cut out for a high fibre diet (especially if you suffer with IBS).

@SnugNightsss even a small dose of senna or bisocodyl gives me hours of cramps and diarrhoea. I know this is the point of them but I have to take a whole day off normal life to stay indoors and I can’t keep taking days off work to disimpact. Also they don’t really solve it long term as this is getting chronic and I am back to square 1 in a week.

The enema was pretty much instant results and didn’t ruin the whole day as it passed pretty quickly. My bowels are really active noise wise so I am also staying active and hydrated, doing all the things I was doing before this blip.

I also think too much fibre doesn’t agree with me! I did however do my fruit and fibre cube and am continuing the laxido and will see how things are. I don’t expect to be going every day but not being able to go without manual assistance is an issue I need to get checked out

hard to explain but I can tell I need to go, but nothing is far down enough to go. Then if all goes completely silent and then it’s clearly stuck. I think the last part of the cycle is the issue where you know, gravity and movement does its thing. I think this is because it’s all broken up into small pieces and not big enough that gravity/movement is helpful. So I do need to get it to bulk up and stay together somehow!

OP, have you also been checked for a prolapse, specifically a rectocele, where the bowel forms a pocket trapping the poo and stops it being passed? I have this and it's a real pain as you constantly feel you haven't finished.

I had a rectal exam recently which they were not concerned about. But I agree this could be the issue so I am going to go get it checked. This is kind of what it can feel like. I do not have any vaginal symptoms at all though so perhaps it’s higher up?

Chai seeds on cereal each morning really help me. I also add pulses and seeds to meals if they compliment what I’ve made.

Sorry for my TMI celebration but I had a BM without assistance 😂 (laxido and cube)

I have read differing things about chia seeds I am wary 😂

I have a prolapse and it only caused problems when my poo is bitty as it gets stuck - sounds like this is what you have too @Notthecorner as you talk about it being broken up. When my gut is in good shape the prolapse doesn't matter as it's in one or two smooth pieces and whooshes out nicely. I think gut health, fibre and lots of liquid should give you that. You mention you've heard different things about Chia seeds, I think they're brilliant. If you're concerned you can soak them for a few mins beforehand so they've started to swell.

@Notthecorner lf you want to check for the rectocele or any other obstructive bowel issues, you could ask your GP to refer you for a proctogram so they can a get a clear idea of what's going on. I had this and the rectocele was was clearly visible on the screen. It also means you can then get a self irrigation device on prescription (if you wish) to help flush the stuck poo out.

Ok I have good update that I am going more regularly however it’s really loose.. this is the stage where usually I would stop laxido but I don’t think I should? I honestly do think the action is not the laxido but the horror fibre cubes 😂 so I am unsure which one to stop.. or do I just carry on? This is when I really need a helpful plan 😭 I could cut down laxido to 1 or 2 a day?

Only change one thing at a time, very slowly, and keep a diary.
Maybe start by reducing the laxido by a 10 % for a week. Keep everything else the same. Document bowel function daily.
The following week reduce by a further 10%. Keep monitoring.
If things get worse, stop reducing and go back to what was working.
Then consider slowly reducing the cube. Same system.
This method takrs time and patience but you will get much more reliable outcomes.

@Notthecorner my son (25) had similar issues with severe constipation and gas and, like you, his GP was similarly unable to assist except to suggest Movicol and suchlike. The only thing which has helped my son was acupuncture and herbs from someone who used to be a GP before branching out - its not been cheap but its made such a huge difference to him and he doesn't need any more now.

I’ve had a couple of episode where my bowel just seemed to go on strike (from normal to no action for no apparent reason). First time I had a colonoscopy (to rule out anything sinister) and the bowel prep seemed to act as a control-alt-delete reset. Then had a recurrence last year which took dabbling with all sorts of laxatives to get things going again. Had 2 or 3 laxido disimpaction cycles +/- lactulose, picosulphate and a few suppositories thrown in for good measure. Eventually got things going again and weaned off the laxido and got things on a regular even keel with fastidious hydration and 2 docusate sodium capsules a day ( I found these to be the gentlest and most effective laxative). I thought I was well hydrated generally but needed a good 1.5 - 2 litres more than I was already drinking.

Dont know why this happened, I suspect (in the absence of anything being diagnosed and things eventually going back to normal) hormonal changes of perimenopause as I understand the gut has lots of oestrogen receptors but I’m very careful about hydration and fibre intake now (combination of soluble and insoluble) and things are ok - can’t believe how much I appreciate normal bowel movements now!

I recommend Dominique Ludwig and Dr Karan Raman online for healthy gut advice - especially DL’s seed and nut loaf recipe which in Dr Karan’s words will have you “shitting like a horse” 🤣

Good luck - it’s a miserable journey

Ever been investigated for Crohn's? There's a constipated type. For me it manifested in reflux and wrong diagnoses of IBS for years.

I agree with @LakeFlyPie re. the perimenopause/oestrogen receptors thing.

I'm glad you've had some relief OP. I'm unsure if this has been mentioned, but the position you sit on the toilet can have even more of an impact that diet alone. Anything to lift your feet up can help- squatty potty, large tins, bricks etc.
I was terribly constipated in pregnancy and lifting your feet up makes a massive difference.

Hi there, sounds like you've been on quite a journey but glad it's improved. Could you tell me which is the soluble and which is the insoluble fibre? Every day I take one teaspoon of psyllium husk mixed with water, and then I try to eat lots of fruit and vegetables - both cooked and fresh. But I'm not sure what kinds of fibre I'm getting and whether I'm getting enough of both.

@NaeRollsDr Karan explains it well
https://www.instagram.com/reel/DGbIznyN7SR/?igsh=cmcyN29lOG5rcG9l