Bowel Incontinence Followed By Constipation. What Could This Be?

Brief Answer:
A physical examination needed for diagnosis.

Detailed Answer:
Hi XXXX! Good morning. I am Dr Shareef, a general surgeon answering your query.

It is good that you do not have any significant medical history.

If you had constipation earlier also, there might have been some fecal impaction in the rectum, which is a possibility with anyone at this age due to weakness in abdominal musculature resulting in inability to push the feces out. The liquid feces above this fecal impaction could have tracked down and passed out due to inability of the sphincter to function properly because of the impaction.

Although this is just a probability, if I were your treating doctor, I would have gone for a physical examination of yours along with a per rectal examination followed by a colonoscopy if need be. I won't take any chance in not investigating you with the history of inability to hold your bowel followed by a constipation in your case before labeling your problem simply as case of fecal impaction.

Therfore, I would rather suggest you to take appointment with a surgeon/gastroenterologist in your area and get yourself examined by him, as it is not possible to pinpoint exactly what the problem is without a thorough physical examination and investigations.

Till then, you can add more of roughage with plenty of liquids in your diet along with a regular permissible exercise in your case, which might help you in relieving your constipation. I would not prefer to give you laxatives without a local examination to rule out any organic cause for it.

I hope I have answered your query. Thanks for using XXXXXXX forum for doubts regarding your health. Wishing you good luck. Dr Shareef.

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Brief Answer:
Did not want to confuse you with the probabilities

Detailed Answer:
Hi XXXX! Nice to see you responding fast.

My regrets for your disappointment. As a doctor, I personally won't like to give a lot of probabilities excepting for the common ones as already stated above the reason being not to confuse and frighten the patient beforehand without a proper diagnosis.

However, if you insist to know, you may note that in this age group after excluding the case of fecal impaction due to weak musculature, I would have next thought of some kind of growth in or around the rectum which has partially blocked the passage of stool causing fecal impaction. This growth could be a benign or a malignant one which can be confirmed only by local examination and histopathological report.

I must also tell you that after all the examination and investigations, we may be happy not get any organic problem, and in that case we can conclude of the first probability.

Hopefully this answer of probabilities is not going to upset you and my apologies if it does.

Thanks and good luck.

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