Brief Answer:
Follow advice below to ease constipation problems first...

Detailed Answer:
Hi XXXXXXX

I am sorry for the situation you are going through.

1. Not being able to poop for 3 consecutive days but only a little with much straining are indicating that you are constipated.

Epson salt can help but you can't use for long time.

To help ease constipation problems, I advise to:
- take more fluids especially water
- avoid banana, yogurt, or other foods that would aggravate constipation
- have more fiber rich foods like prunes, kiwi, figs, watermelon, pear, etc. that will help form the stool mass and induce bowel movements (bm)
- take senna supplement and lactulose to induce bm
- start taking psyllium (fiber supplement)
- can use anal enema to help you empty your bowels
- try to increase physical activity (walking, jogging, breathing fresh air) to help ease bm

2. With regards to feeling sore anus, and swollen when cleaning yourself, these are indicating possible external hemorrhoids due to too much straining and constipation.

You should keep good local hygiene, wash with warm water and salt and follow the advice as given earlier. Once constipation is relieved, you won't feel swelling neither soreness in the anus.

3. There are various things that would cause constipation, including:
- medications (but you are saying not to take any, so this is excluded)
- diet (not too much fiber-rich or fluids)
- sedentary life (the more you sleep, the more you'll need to sleep, and constipation would be more severe; try to walk and breathe fresh air and you will see the difference)

4. Being HIV positive and low immunity are not affecting directly your bm unless you are taking medications that would affect bm.

5. Your case is not emergency for the moment; if you follow the above-mentioned advice, you'll be better.

6. What worries me is you being sleepy all the time. It might be due to low immunity, or possible common virosis.

Try to ease your problems with constipation first. If you will still have sleep problems, then, should schedule an appointment with your family doctor first to run a complete blood count and a HIV panel to evaluate if the virus is reactivated.

If cannot manage to talk to a doctor, then, should go to ER.
But, first, try to manage constipation first and see what happens.

All the best!
Dr.Albana

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