Brief Answer: Get Colonoscopy done after constipation relieved Detailed Answer: Hi Mrs. XXXXXXX Thanks for your query. Firstly, in order to PINPOINT the exact cause of your problems; give you a SOUND professional advice; and, TRUE VALUE FOR YOUR MONEY, I request you to kindly provide additional information as follows :- # Since when have you been suffering from constipation? # Have you ever passed blood in the stools? # Are you passing through mental stress/anxiety or depression? Nevertheless- pending receipt of additional information as requested- chronic constipation with passage of clear sticky substance at your age- the possible causes are :- * Irritable Bowel Syndrome (Constipation type)- a condition in which the symptoms are similar to those of yours. The symptoms are usually aggravated by mental stress. * Chronic amebic infection * Obstruction in the Colon due to either impacted stools or a growth. Pending additional information, I will therefore recommend the following course of action :- (a) The first priority should be to clear the bowels with a short course (3-5 days)of strong laxative, such as Liquid Paraffin or Lactulose. Once the bowel movements become normal, switch over to stool bulk-forming agent, such as Psyllium husk. (b) A 5-day course of anti-amebic drug, such as, Metronidazole Once the bowels are clear, Colonoscopy of the Colon is STRONGLY RECOMMENDED for direct visualization of the inside of the colon for evidence of a growth (if any), diverticulosis or colonic lining pathology. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order Colonoscopy, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. I will be looking to additional information as requested. Fond regards and have a nice day,

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Brief Answer: Follow given recommendation + get Colonoscopy done Detailed Answer: Hi Mrs. XXXXXXX Sorry for the delay in reply : there was a server failure. Thanks for the invaluable additional input, which has helped me in short-listing the causes to two :- Irritable Bowel Syndrome (Constipation Predominant Subtype) (IBS) and a possible obstruction in the intestine due to a growth/ Polyp/ Diverticulosis. In general, we consider long-working hours as stress on the body; and, sedentary habits responsible for IBS. Episodic, severe lower abdominal pain is due to over-stressing of the colon to expel impacted stools. Hence, the recommended course of action REMAINS THE SAME, AS ALREADY MENTIONED IN THE LAST REPLY :- 1. RELIEVE CONSTIPATION INSTANTLY : Take Duphalac 30ml thrice daily till stools normalize and; thereafter, regular intake of Psyllium husk. 2. EARLY COLONOSCOPY as soon as bowel movements become normal. 3. MEDICATIONS RECOMMENDED :- (a) Regular Rifaximin, Anti-depressants (such as Serteraline or Citalopram) Probiotics (such as lactobacilli) and pancreatic enzymes (b) Continue with Ganaton + Spamomen; Pariet can be STOPPED. 4. OTHER RECOMMENDED MEASURES : - high fiber diet with plenty of water daily; - regular physical exercises as much as possible. - Eat slowly; avoid chewing gum and carbonated drinks. I am confident that, with the above-mentioned recommendations, your IBS symptoms will remain under control. However, even at the risk of repetition, Colonoscopy should be done to exclude - once for all- possibility of polys/growth. Consult your doctor and discuss my opinion and recommendations with him. I am certain that he will agree with my opinion and prescribe suitable treatment as advised. I am also confident that he too will recommend Colonoscopy, particularly at your age. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day,

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