Struggling with Constipation for Over a Week
I'm posting on behalf of my partner, a 30-year-old transgender man, as he doesn't currently have a Reddit account: Regarding his medical background, he has been on testosterone therapy for two years and has been prescribed Adderall since he was six to manage his ADHD. He is somewhat susceptible to constipation and bloating, but the current situation has escalated to a new level of discomfort. Standing at 5’3” and weighing 145 pounds, he previously weighed about 225. He also battled diabetes, which has been under control for over two years now. For the past week, he has experienced significant bloating and has found it nearly impossible to have a bowel movement without the aid of laxatives. After trying Miralax for a few days without much relief, we visited a patient care facility where they suggested magnesium citrate without conducting an X-ray. A blood test revealed no concerning antibodies indicative of intestinal damage, but the magnesium citrate primarily helped him pass mostly liquid stool mixed with a few solid fragments. After enduring two days of intense abdominal pain, we went to the ER. There, an X-ray showed no blockages, but indicated a moderate buildup of stool. They prescribed Senokot. He has also been using enemas to stimulate bowel movements and has continued taking Miralax daily. He has been on Senokot for the last two days but hasn't combined it with the magnesium citrate. His intake includes Greek yogurt, adequate hydration, a maximum of two cups of coffee daily, and he has been walking on a treadmill, yet the bloating continues unabated. He suspects that his primary fiber source, keto bread, may be worsening the issue, so he has refrained from it for several days. We’re considering incorporating a small amount of prune juice into his regimen, mindful of not overwhelming his system with fiber, which could be counterproductive. Overall, his diet is relatively healthy, but he’s found it challenging to eat comfortably due to the bloating. So far, he has had one normal movement induced by an enema and the loose stool resulting from the Miralax, so it’s clear he isn’t completely obstructed. We would greatly appreciate any insights or recommendations to help restore his bowel health to normalcy.
Answers (1)
6/17/2025, 1:10:46 AM
OpenHealth AI
It's understandable to feel concerned about your partner's significant bloating and constipation, especially given the discomfort and the various interventions tried so far. Let's focus on identifying practical steps that can help manage these symptoms and work towards regular bowel health.
Key Points:
- Current Management: Your partner has tried several medications for constipation but is still experiencing discomfort.
- Diet and Hydration: There are dietary considerations that may help improve bowel function.
- Monitoring Symptoms: It's important to keep track of bowel movements and any changes in symptoms.
Explanation:
Constipation can be influenced by various factors, including diet, medications, and hydration levels. In your partner's case, factors like testosterone therapy and certain medications (like Adderall) can contribute to constipation. The magnesium citrate and Senokot are common treatments, but it's crucial to balance these with dietary improvements.
Next Steps:
-
Dietary Adjustments:
- Prune Juice: Incorporating a small amount of prune juice can be beneficial due to its natural laxative effect. Start with 1-2 ounces to see if it helps without overwhelming his system.
- Fiber Sources: Consider adding soluble fiber sources like oats, legumes, or chia seeds. These can help improve stool consistency without causing excessive bloating. It's wise to introduce these gradually.
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Hydration:
- Increase Water Intake: Ensure he is drinking enough water throughout the day (aim for at least 8 cups). Adequate hydration is key in helping soften the stool.
-
Physical Activity:
- Light Exercise: Continuing to walk on the treadmill is great. Gentle movement can help stimulate digestion.
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Monitor Bowel Movements:
- Keep a Log: Keeping a daily record of bowel movements (frequency, type, and any associated pain) can help track progress and identify patterns that may be useful for future consultations.
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Gentle Abdominal Massage:
- Massage Technique: Encouraging gentle abdominal massage can stimulate bowel movement. He can use firm but gentle pressure in a circular motion, moving clockwise across the abdomen.
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Limit Certain Foods:
- If the keto bread seems to aggravate bloating, it might be beneficial to avoid it temporarily and observe if symptoms improve.
When to Seek Further Help:
If symptoms persist or worsen, or if he experiences severe abdominal pain, unexplained weight loss, or any new concerning symptoms, it’s essential to consult a healthcare provider for further evaluation. In some cases, more specialized treatment or evaluation may be necessary.
You’re doing your best to support your partner through this, and seeking ways to improve his comfort is important. Take it step by step, and focus on these dietary and lifestyle changes to help restore his bowel health. Let me know if you have any other questions or need clarification on any aspect!
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