Suggest Treatment For Chronic Constipation And Severe Stomach Pain

Posted on Tue, 3 Mar 2015

Question: Hi Doctor
My father, aged 67 years has problem of constipation since many years. But lately, it is getting severe. It is now manifesting in the form of gastric troubles. He complains of bowel gas not getting released. Due to this he faces severe stomach pains. He also faces problem of feeling gas rotating in his stomach.
Can you please suggest solution for this ? I am afraid it could be heart related problem. Is that possible ?

Answered by Dr. Dr Samir Patil (8 hours later)

Brief Answer:
polyethylene glycol and mebeverine should help

Detailed Answer:
Hello,
I have gone through the details you have provided.
I would like to know a few things about the pain.
1 is it related to meals?
2 is it relieved by passing stools?
3 how long does the pain last?

Considering that the colonoscopy is normal the two possibilities I would consider are IBS (irritable bowel syndrome) and mesenteric ischemia.
In case the pain is not severe then it is most like my to be IBS.

Is he on fibre supplement for the constipation?
If yes I would advise to shift to polyethylene glycol as fibre could be responsible for the bloating and gas.

Dicyclomine or mebeverine tablets should help him with his pain

I don't think this is a cardiac or heart issue.

Hope this helps

Regards
Dr Samir Patil

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr Samir Patil (15 hours later)

Hello doctor
Thanks for the quick and detailed reply. Please see my answers below:
1. No, it's not related to meals. And he is not strictly on fibre diet though he eats salads at lunch time.
2. Yes, passing of stools help in relieving the pain.
3. Pain lasts for less time. But burning sensation last for more time. Sorry, i missed point of burning sensation in previous mail.

I hope this answers your questions. Pls advice further. One more request, will getting done a CT scan of abdomen help in thic case ? Since endoscopy and coloniscopy are both done and showed no problems, ct scan was suggested to him.

Thanks a lot again!!

Answered by Dr. Dr Samir Patil (7 hours later)

Brief Answer:
Get CT

Detailed Answer:
Hello,
As per the history the symptoms suggest Irritable bowel syndrome, except for the burning.
I would suggest to get a CT abdomen done to rule out any small intestinal pathology( as small intestine is not seen during a colonoscopy or endoscopy).
In the mean time dicyclomine and polyethylene glycol should help.
Regards
Dr Samir Patil

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Above answer was peer-reviewed by : Dr. Prasad