OpenHealth Q&A

Gut and Motility Challenges

I’m a 35-year-old female standing 5'7" and weighing 190 pounds. My daily routine includes walking, and I also take over-the-counter vitamins and supplements. For my Rheumatoid Arthritis, I resort to Tylenol and Ibuprofen as needed. I abstain from smoking and drinking alcohol, and I have never used narcotics. Digestive problems have plagued me since birth. Due to financial constraints, my family couldn’t afford the necessary specialist consultations for my condition. Over the past decade, particularly, my situation has deteriorated significantly. It takes my stomach about 5 to 7 business days to fully empty, and my intestines lack the ability to contract independently. Finding effective laxatives has been a frustrating endeavor; their effectiveness seems random and largely depends on how severe the blockage is at that time. I have noticed that intravenous Reglan works substantially better for me than the oral form, likely because my stomach has difficulty digesting pills as well. All my blood tests and stool samples have returned normal results. No metabolic or thyroid issues were identified, and my hormonal levels are considered normal, except for an increase in testosterone. Nonetheless, my reproductive health remains intact, as I have successfully had five children, with only one ovary and one fallopian tube functioning. Recent tests showed elevated cholesterol levels, and I had low sodium and potassium levels, along with increased folate. Since experiencing a miscarriage in early March, I’ve noticed a decline in my hemoglobin levels. It’s worth noting that my digestive concerns began long before this event. I’ve chosen not to take prenatal vitamins or iron supplements because they exacerbate my constipation. I recorded a high Rheumatoid Factor, but I’ve been diagnosed with RA since October 2016. A CT scan of my brain came back normal, whereas a contrast CT scan of my abdomen indicated a blockage in the S-shaped section of my intestines, though it found no obstruction lower down. I also have internal and external hemorrhoids. I underwent a colonoscopy in January 2018, which revealed multiple benign polyps, and I was 28 years old then. Though I typically can pass gas without too much trouble, achieving a satisfactory bowel movement is quite the challenge. Just last weekend, I had to visit the emergency room after consuming a 10-ounce bottle of Magnesium Citrate. The liquid lingered in my stomach for hours, causing me severe heartburn that left me tasting the citrus flavor with every burp. This is a recurring issue with food as well. I can only manage to eat once a day if I take laxatives regularly; otherwise, I find myself skipping meals entirely. During particularly difficult periods, I stick to liquid or soft foods. Regardless of my diet, my body continues to struggle with digestion. Certain foods, like salads and nuts, are particularly troublesome, and fiber and fats seem to work against me. Even when I experience diarrhea, when the laxative is effective, my intestines have trouble contracting to expel the liquid. Although I attempt to avoid straining during bowel movements and use laxatives daily, stool softeners and coffee do not seem effective. I maintain good hydration, and my doctor has complimented me on the clarity of my urine. I have a consultation scheduled with a gastroenterologist in May, and I’m eager to understand what’s happening within my digestive system. Since January 2012, I have been drug-free and have maintained sobriety since October 2016. I quit vaping as of January. I believe I’ve shared all pertinent details about my condition.

Answers (1)

3/28/2025, 5:30:56 AM

OpenHealth AI

Thank you for sharing such a detailed account of your health. It’s clear you’re facing significant digestive challenges, and your concerns regarding management are valid and understandable. Since you're waiting for a gastroenterology consultation, let’s focus on immediate steps you can take to help alleviate some of your symptoms while you await more specialized care.

Main Points:

1. Digestive issues, including constipation and delayed stomach emptying, are common but can be severely disruptive to daily life.
2. Your current strategies, including hydration and dietary choices, need fine-tuning to manage symptoms better.

Explanation:

The digestive problems you describe, such as slow stomach emptying and difficulty with bowel movements, suggest a combination of gut motility issues and possibly functional gastrointestinal disorders like chronic constipation or IBS. You mention that standard laxatives have been inconsistent for you, which signals a need for potential lifestyle adjustments and non-pharmacological management strategies. It’s also important to acknowledge the emotional toll that these issues can take, especially given your recent loss and ongoing health concerns.

Specific, Prioritized Next Steps:

1. Dietary Adjustments:

   • Consider Low-FODMAP Options: Many people with digestive issues find relief by following a Low-FODMAP diet, which involves limiting certain fermentable carbs that can increase gas, bloating, and discomfort. Foods such as certain fruits (like apples and pears) and grains (like wheat) could be contributing to your symptoms.
   • Focus on Digestible Foods: Since you struggle with raw vegetables and nuts, try soft, cooked options—like steamed vegetables instead of salads—along with low-fiber grains like rice or oats. These could be easier to digest.

2. Incorporate Gentle Physical Activity:

   • If you are not already doing so, consider gentle activities like walking or yoga. Light movement can stimulate digestion and help with bowel movements.

3. Regular Meal Scheduling:

   • Aim for small, frequent meals rather than one large meal daily. Eating regularly, even in small quantities, can help your digestive system function better. This might involve soft foods that are less likely to cause distress.

4. Stay Hydrated:

   • Continue to ensure you’re well-hydrated, aiming for clear urine. You might also consider water-enhanced electrolytes if your sodium and potassium levels are low, but consult your gastroenterologist for specific options.

5. Keep a Symptom Diary:

   • Document your food intake, symptoms, and any laxative use. This will provide valuable data for your gastroenterologist and help identify patterns that may indicate triggers or beneficial approaches.

6. Consider Additional Non-Laxative Supplements:

   • Have you tried magnesium supplements (in forms less likely to cause discomfort) or probiotics? Sometimes, specific strains can help digestion and bowel regularity without the distress of laxatives.

Final Thoughts:

While awaiting your appointment with a gastroenterologist, implementing these stepped approaches can potentially improve your situation. It's great that you're actively seeking to understand and manage your symptoms better. Please remember: your health journey is ongoing, and continuing to communicate openly with your healthcare providers about your experiences and struggles will be crucial to finding effective solutions. If you experience any new or worsening symptoms, keep a close eye on those and be ready to report them during your consultation.