Brief Answer:
Go for a MRI abdomen to rule out nerve or muscular problem.

Detailed Answer:
Hello,
Thanks for wuery dear.

Initially i would say that have a practical approach as there is no magical formula,Things will take time but they will help in long term.
Protocol should be keep on taking medications which provide relief to you like enema miralax etc plusxstart following drastic life style changes which would definitely help in long term.


A drastic change in life style is required to cure sever constipation apart from that start doing kegel exercises to strenghten your pelvic floor.Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. You can do Kegel exercises, also known as pelvic floor muscle training, just about anytime.Not exercising enough, not drinking enough water and delaying a bowel movement can worsen constipation symptoms.The most important factor in curing your problem is a natural and simple diet. This should consist of unrefined food such as whole grain cereals, XXXXXXX honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot. Adding some fat to meals or increasing the size of a meal such as breakfast can help to create the urge to defecate. You should increase the amount of plant foods they consume to get more fiber in their diet.
Secondly human gastrointestinal tract is colonized by 1013-14 bacteria of 400 different species and subspecies.They are responsible for proper digestion of food.Depletion of this flora due to various factors can lead to severe constipation and digestive problems.
Intestinal flora are types of microorganisms known as probiotics that live normally as part of the intestinal tract. These organisms have several functions that help the body.The most plentiful and important bacteria in the small intestine is the Lactobacillus species. Lactobacillus helps ferment indigestible carbohydrates. It also helps to stimulate the digestive process and aid the absorption of nutrients,as well as increase the motility of the gastro intestinal tract.I would suggest her to start taking probiotics regularly.Probiotics are live bacteria and yeasts that are good for digestion.As her gut flora will improve her constipation would be relieved and well formed stools will pass.

Apart from this other recommendations are-
-Linseed: is extremely useful in difficult cases like yours One teaspoon of linseed with warm water should be taken at night for bulk and lubrication.
-Proper chewing: The diet alone is not enough. Food should be properly chewed-each morsel for at least 20 times.
-Taking a short walk is a good way to get some light exercise. Walking time should be gradually increased until it reaches 20 minutes.
-should drink at least eight glasses of water daily. Water helps push the food through the intestines and also helps lubricate intestinal tissues. When the body is dehydrated, the intestines absorb the fluids from the food waste, which in turn leads to hardened stools
- Avoiding alcohol and caffeine is also important as these substances contribute to dehydration.
-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested
-Fruits and vegetables, which contain high amounts of fiber, aid in alleviating symptoms of constipation,Whole-grain bread, XXXXXXX oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.
-Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day
fruits: Generally all fruits, except banana and XXXXXXX fruit, are beneficial in the treatment of constipation.
Pears are beneficial in the treatment of constipation.
Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation
All these things will increase the bulk of your stool,Will soften it and will clear your ileum of the compacted faecal material.
-While sitting on the toilet, support the feet on a small stool in order to achieve a normal position that aids in bowel movement.
Don't stop laxative,initially start following all these advices then gradually taper the doses of laxatives she is on.
Take Fybogel husk-Fybogel sachets and Fybogel Hi-Fibre sachets both contain the active ingredient ispaghula husk, which is a type of medicine called a bulk-forming laxative. Ispaghula is a type of fibre. It swells when it comes into contact with fluid in the gut and thus increases the volume of the faeces.It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative.


I can definitely understand the level of frustration you must be feeling but things would definitely get better but have patience and practical approach.
There is no magical formula so only way out is through proper therapy with exercise and life style changes.


To calm your mind you can get a CT abdomen done in case there is any obstruction it would be revealed.
Basically what you are trying to explain is called impacted or struck stools caused due to severe constipation.

Go for a digital examination of your rectal canal by MD ,As you are complaining of difficulty in passing even watery stools also.There is a possibility of damaged nerve or muscle.

Don't panic,be hopeful and keep the yourself motivated.
Good luck.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hello dear,
I am again very sorry to hear about your problem.

See in case if it is a intestinal pathology(like block etc) go for a MRI scan.Its the best test.
An MRI would indicate patency of intestinal muscles,their blood supply,their nerve function and any other apparent pathology.

So if any thing is not helping it may be possible that a part of intestine is not working (paralytic) or there is atrophy of muscles or nerve damage or a blood clot etc.

All these possibilities could be ruled out by getting a MRI done.

Follow up with reports.

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