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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Constipation While On Pain Medications

I have a slightly complicated situation going on and I really feel I need advice on what to do, so I m very grateful for any advice you can give to me! Thank you in advance!!! Background: I have had very bad diarrhea for about 15 years... often 20 episodes per day, sometimes double that!! Diagnosis... IBS. Due to pain medication that usually just normalizes me... for whatever reason, this time I am actually experiencing constipation. I haven t pooped for 4 days now and for the past 24 hours I constantly feel that I need to go, I push really hard but no results. It feels like there is a very large, very hard, very dry poo wad (from the inside it feels like it would be the size, shape and hardness of a basrball... I know that s not possible, just feels like that) it s right at the exit hole opening, just inside my anus and blocking the exit. It just won t budge! I actually put my finger inside my anus and I can actually feel it with my finger. Digging for gold in there I was able to pull out a few pebbles. I think my fingernail made a cut just inside my anus and it started bleeding a bit... bright red and thin, so I feel sure that I m not bleeding from higher up or deep inside, because I think it would be darker and thicker if I was... is that right?? I feel like if I could just soften that big, hard as a rock, solid poop just inside that is blocking the exit, that things would go ahead and move through... do you think that is possible?? My thought is to put in a Dulcolax Suppository in me as waiting 12 hours to see if an oral stool softener would work doesn t seem like a good thing AND I don t want to mess with the entire digestive system being affected, as I fear I d be right back to diarrhea again! Does that makes sense? Do you agree? Maybe I should try a half of a suppository to see first maybe? I definitely don t want to go from the frying pan back into the fire (right back to terrible diarrhea again)!!! So my concern is that I have that bleeding just inside me thing, and that the suppositoriy will make that worse??? Or take longer to heal??? what are yourthoughts on that please??? And will a suppository soften up that hard as a rock poop just right at the exit hole??? I tried eating beans two days ago and ate Spinache and an entire pkg of peas last night, but still a no go! I am sorry for the loooong and detailed questions here, but constipation, and hard stools are both totally foreign to me, with constant diarrhea for 15 years, which I definitely don t want to overshoot and end up making that come right back or continue, or for goodness sake, potentially make it worse! Eeeek!!! Thank you again for taking the time to read all of this! And any advise or wisdom you can give me would be soooo greatly appreciated!!! I am totally open to any other suggestions you might have!!! Whether it be a particular food or medicine, though it could be days before I can get to the store... so I only have the Dulcolax Suppositories, or just one ducosate stool softener, or some Bisacodyl, 50mg pills here where I m staying. Please advise!?!?!? Thank you, thank you, THANK YOU!!!
Tue, 22 Jan 2019
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General & Family Physician 's  Response
Hello,

Your problem of constipation is quite irritating that is understandable and its good that you are open on taking advice rather than trying any medicines on your own.

With a history of IBS for such a long period, it's absolutely normal to feel worried when you come across this another totally opposite problem of constipation.

Whenever a patient comes to me with complaints of constipation, I suggest them to take oral stool softners preferably the oral suspension gels. which should be taken before going to bed which generally solves the problem of constipation next day with required dose adjustment.

Sometimes few patients who don’t get relief from the oral medicines next best thing is administration of enema. For that, you have to go to a doctor as that's done under doctor’s observation.

My advice to you is, if the problem persists even after taking sufficient dose of oral medicines as per your doctor’s advice then next thing is enema administration.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Manisha Auradkar, General & Family Physician
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Suggest Treatment For Constipation While On Pain Medications

Hello, Your problem of constipation is quite irritating that is understandable and its good that you are open on taking advice rather than trying any medicines on your own. With a history of IBS for such a long period, it s absolutely normal to feel worried when you come across this another totally opposite problem of constipation. Whenever a patient comes to me with complaints of constipation, I suggest them to take oral stool softners preferably the oral suspension gels. which should be taken before going to bed which generally solves the problem of constipation next day with required dose adjustment. Sometimes few patients who don’t get relief from the oral medicines next best thing is administration of enema. For that, you have to go to a doctor as that s done under doctor’s observation. My advice to you is, if the problem persists even after taking sufficient dose of oral medicines as per your doctor’s advice then next thing is enema administration. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Manisha Auradkar, General & Family Physician