Understanding Chronic Constipation: Seeking Answers
I’m an 18-year-old female, weighing around 130 kg and standing 5'3" tall. My medical history is complicated, as I'm managing several conditions including Narcolepsy, ADHD, ODD, and ASD. Additionally, I battle high cholesterol for which I’m on medication, as well as non-alcoholic fatty liver disease. Constipation has been a persistent issue for me, intensifying over the years to the extent that I've developed anal fissures and hemorrhoids. Recently, I struggled significantly to communicate my symptoms to my doctor. This included experiencing alarming instances of blood clots appearing after bowel movements. Just yesterday, I found myself on the toilet for a solid two hours; the pain was excruciating and I couldn’t immediately leave. Despite feeling a slight urge, it became painfully clear the situation was dire, and after a brief pause, I had to push out what felt like the largest stool I’ve ever encountered. Today, I’m staying home as my rectal area is understandably sore, accompanied by discomfort in both my upper and lower abdomen. In the past, I've undergone ultrasounds that revealed no significant findings. My diet is primarily plant-based, consisting only of oat milk and Nutlex butter, as I avoid dairy altogether. I am eager to understand the underlying reasons for my severe constipation. What steps should I take to address this issue going forward with a new healthcare provider? I welcome any suggestions you might have or potential factors that could be contributing to this problem. Feel free to ask any questions; I’m looking for comprehensive insight into my condition.
Answers (1)
8/14/2025, 6:40:51 AM
OpenHealth AI
Chronic constipation, especially at your age and with your medical history, can be challenging and uncomfortable, and it’s understandable that you are seeking answers and relief. There are several factors that could be contributing to your symptoms, especially as you’re managing multiple health conditions.
Understanding Your Situation:
Constipation can arise from various causes, including dietary habits, medications, and certain health conditions. In your case, potential contributing factors might include:
-
Diet: While a plant-based diet can be healthy, it’s important to ensure that it contains enough fiber, adequate hydration, and regular meals. Insufficient fiber can lead to constipation.
-
Hydration: Not drinking enough water can result in hard stools. Adequate liquid intake is essential for maintaining stool softness.
-
Medications: Some medications you may be taking, such as those for ADHD, can have gastrointestinal side effects, including constipation.
-
Lifestyle Factors: Lack of regular physical activity can also impact bowel function.
Recommended Next Steps:
Here are some actionable steps you can consider to address your constipation:
-
Increase Fiber Intake:
- Aim for a variety of fiber-rich foods such as fruits (berries, apples, bananas), vegetables (leafy greens, broccoli), legumes (beans, lentils), and whole grains (quinoa, oatmeal).
- Gradually increase your fiber intake to avoid bloating.
-
Stay Hydrated:
- Ensure you're drinking plenty of fluids daily, aiming for at least 8 cups of water. You can find hydration apps to help track your intake.
-
Change Bathroom Habits:
- Establish a regular routine for using the bathroom, even if you feel no urge. This can help train your body to have more regular bowel movements.
- Consider using a footstool to elevate your feet while sitting on the toilet, which may help with the natural alignment for easier bowel movements.
-
Incorporate Physical Activity:
- Aim for at least 30 minutes of moderate exercise most days. Activities like walking or gentle stretching can stimulate bowel function.
-
Monitor Symptoms:
- Keep a diary of your diet, hydration, and bowel movements. Note any patterns or triggers that may correlate with your symptoms. This can be valuable information for your healthcare provider.
-
Pain Management:
- For rectal pain, consider a warm bath or applying an over-the-counter topical cream that can help soothe discomfort.
-
Explore Supplements Cautiously:
- If you're not seeing improvement, a fiber supplement (such as psyllium husk) may be helpful. Be sure to increase water intake with this. However, consult with your healthcare provider before starting any new supplements, especially considering your medications and health conditions.
Preparing for Your Healthcare Provider Visit:
When you see your new healthcare provider, bring your symptom diary along. It can help them understand your situation better. Discuss all your concerns openly, including the blood clots after bowel movements, as this should be addressed seriously.
While this journey may seem daunting, by taking these steps, you are moving toward a solution. If you have more questions or need clarification on any of these points, feel free to ask. Your comfort and health are important, and it's great that you're advocating for yourself.
Related Questions
Can Eating More Fiber Alleviate Menstrual Cycle-Related Constipation?
Every month, during the week and a half leading up to my menstrual period, I experience constipation. I'm curious if boosting my fiber consumption might ease this issue. I already ensure that I drink plenty of water throughout the day. I am a woman in my mid-20s.
Seeking Relief from Mild Fecal Impaction: Should I Go to the ER?
At 20 years old, I find myself dealing with a frustrating issue: fecal impaction. It's not something I've faced before, or at least I can’t recall, but I’ve had chronic stomach difficulties throughout my childhood, including constipation from ages four to twelve. Recently, I've been experiencing more digestive challenges after a few years of feeling normal. Currently, I’m under the care of a gastroenterologist, and we’re working on diagnosing the underlying problems. For about five days now, I haven't been able to relieve myself. While I’ve had considerable gas, that’s been the only symptom. Today has been particularly difficult; I’ve spent the last 11 hours in the bathroom grappling with severe discomfort and impaction. Each attempt to relieve the situation is excruciating, to the point where my body is resisting the effort—it’s so painful that I find myself in tears. I imagine this is what birth must feel like. I suspect this intense fear and pain are remnants of my past struggles, as for many years I’ve feared using the bathroom due to the agony it causes. Despite trying various remedies like Miralax mixed with coffee, a bullet suppository, and even a manual approach with gloves, nothing is yielding results. I’m genuinely tempted to head to the emergency room and ask them to put me under so they can help me without the pain. My mother suggests they would likely opt for a liquid suppository treatment like they did during my childhood, which was quite traumatic. I’m torn—it feels like the ER might be my last resort, but I'm concerned they won’t take me seriously since my situation doesn’t seem dire. How foolish would it be to bring up wanting sedation? I desperately want to avoid this pain; it’s becoming increasingly difficult, and I’m fighting back tears from the frustration. Can they truly provide sedation for this type of issue even when it isn’t severe? I worry that my parents might react negatively to my quest for relief and think I’m being dramatic. I’m utterly drained and don’t know where to turn. When there’s no painful push against my body, I can’t even sense the severity of the issue, yet, I am experiencing leakage, leaving me unsure. Would it be unreasonable to pose this question to the doctors in the ER? I apologize if this message is jumbled; I’m also dealing with a migraine, making it hard to focus. For context, my daily medications include phentermine, iron supplements, and vitamin D. I stand at 5’4” and currently weigh 204 pounds as part of my ongoing weight loss journey.
Did My Appendectomy Resolve My Digestive Issues?
I’m a 27-year-old non-binary person who had their appendix surgically removed due to appendicitis early last October. Since that procedure, I’m experiencing something I never thought possible: regular bowel movements. Remarkably, this newfound routine hasn’t faded away, contrary to what my doctors predicted. Historically, I have struggled with constipation throughout my life. As a child, I often felt compelled to mislead healthcare professionals about my bowel habits, claiming I had daily movements out of fear that something was amiss. In reality, I would only have a bowel movement every three to five days. I also live with autism, ADHD, dysthymia, and PTSD. Given my history of burnout, it would be logical to attribute my digestive struggles to stress. However, these issues persisted even during holidays and rarely intensified during particularly stressful times. Most of the medications I tried, including SSRIs and various birth control options, had no impact, except for Ritalin, which occasionally provided some relief when not taken consistently. Prior to the appendectomy, I underwent two surgeries: one for a fractured arm and the other a double procedure to remove my uterus and breasts. Unfortunately, neither operation had any effect on my bowel function. Since my surgery, my dietary, hydration, exercise, and substance use habits have remained unchanged. A bit of additional context: My thyroid hormone levels are normal, although I occasionally have low Vitamin D, for which I take supplements. I receive B12 injections to address low levels since dietary sources aren’t effective for me. Additionally, I deal with a persistent mystery of chronic fatigue that shows no signs of improvement post-surgery. This leads to my question: Could my appendix have been the source of my gastrointestinal issues? Alternatively, did the surgery trigger some other change that resolved my long-standing problem? I’m curious if anyone else has encountered similar experiences. What are the chances that I’ll revert back to my past issues with constipation? Any insights on this would be greatly appreciated, mostly out of interest.
Interpreting My Gastrointestinal Discomfort
A 26-year-old female, weighing 155 pounds, has a background of experiencing gastroesophageal reflux disease (GERD) and anxiety. She has been using marijuana for several years and is currently taking venlafaxine at a dosage of 150 mg each day. Residing in the Midwest USA, she identifies as white. On January 20th, she experienced what she initially believed to be a low blood sugar episode. Due to being preoccupied and busy, she had not consumed much food throughout the day. Consequently, she felt lightheaded, nauseated, pale, and was sweating. To alleviate these symptoms, she consumed around 60 to 80 grams of carbohydrates once they began, but it took roughly 2.5 hours for her to start feeling better. The following day, she faced additional discomforts including nausea, heartburn, body aches, trembling with chills and sweats, along with diarrhea. These symptoms persisted for a few days. By January 23rd, she consulted urgent care, where the medical team suspected a stomach virus and advised her to let it run its course. Regrettably, her stomach has not returned to its normal state since that incident. She has been experiencing occasional heartburn and indigestion reminiscent of her previous severe GERD episodes. Additionally, she is suffering from lower abdominal cramps, particularly triggered by consuming items like popcorn or spicy foods, which feels akin to irritable bowel syndrome (IBS) symptoms. During the height of her symptoms on January 20th, she ceased smoking. She partook in smoking a few times between January 24th and 28th, without noticing any changes in her symptoms – positive or negative – and has refrained from smoking since then. It is worth noting that she has not experienced any vomiting or severe abdominal pain typically associated with cannabinoid hyperemesis syndrome (CHS). Are her symptoms indicative of CHS? She intends to abstain from smoking yet seeks clarity on the underlying cause of her discomfort. She has read about post-viral IBS and is curious if the suspected stomach virus has reignited her GERD, which had been stable for several years.
Exploring Probiotic Effects and Antibiotic Strategies in Gut Health
Greetings, M30. Is it possible that consuming an excess of probiotics could lead to SIBO or a similar condition? Earlier this summer, I suffered from a campylobacter infection, and in an attempt to remedy that without realizing its full extent, I resorted to high doses of probiotics. This approach, however, only aggravated my situation. I experienced severe bloating, intensified brain fog—especially after consuming carbohydrates—and following a comprehensive examination of possible causes, including an initially misleading negative test for c. jejuni that later revealed IgG antibodies in my blood, I was prescribed rifaximin (200mg four times a day). Unfortunately, after five days of rifaximin treatment, my symptoms escalated dramatically, resulting in excruciating lower abdominal pain and a marked intolerance to carbohydrates. Through my research, I discovered that the probiotic strains I had been using were sensitive to antibiotics, so I requested that my physician switch my medication to amoxicillin, which promptly resolved the issues I was facing. Complicating matters, I later learned that I had been contending with an acute bartonella infection, which likely contributed to my motility problems. As the year progressed, I indulged in kimchi after having been on antibiotics for bartonella treatment for about a month. However, I had to stop the antibiotics over the Christmas holidays when I developed rashes from herpes on my face and required alternative treatment. Following my kimchi overindulgence, I began to experience bloating again, cognitive fog intensified, and I felt a toxin-like sensation after consuming larger amounts of carbohydrates, alongside a newfound intolerance to wheat products. My doctor once again prescribed rifaximin as the primary treatment, but I am starting to notice that familiar acidic sensation in my abdomen returning. Is this reaction indicative of die-off symptoms, or could it mean that rifaximin is targeting competitors of the kimchi bacteria in my gut, resulting in their proliferation and creating a cycle where lactic acid bacteria alter the colon's pH, promoting further growth of lactic acid producers? I suspect this situation mirrors what transpired during the summer months. Would switching back to amoxicillin be advisable, or might I need to consider amoxiclav instead, given that the kimchi contained fish sauce which might be a source of beta-lactamase? Best wishes,