OpenHealth Q&A

Hoping to Avoid a Medical Crisis - Seeking Guidance

I find myself in a troubling situation that is not yet a critical emergency, but it feels like I am on the brink of one, and I’m utterly lost on how to navigate this period of uncertainty. I’m a 22-year-old female with a healthy body weight. My current medications include: Effexor 10mg, Adderall 10mg, Junel 1.5/30, Propranolol 10mg, Seroquel 50mg, and Suboxone 2mg. For the past two years, following my recovery from an opioid addiction, I have been battling severe constipation, which has resulted in fecal impaction. I have consulted with two gastrointestinal specialists who have diagnosed me with various upper GI issues, including gastroparesis, eosinophilic esophagitis (EoE), and chronic non-ulcerative gastritis. However, the results from two colonoscopies examining my lower GI tract returned normal. Unfortunately, none of the over-the-counter or prescription medications for constipation seem effective for me. The only solutions that provide relief are Suprep and enemas. Currently, I am experiencing a flare-up that has persisted for two months now, leading to a cycle of distressing symptoms: - I struggle significantly to pass stool or gas without resorting to a weekly enema, which often yields just a few small pieces of stool, mucus, and brownish liquid. It requires intense effort to release anything, and I find it nearly impossible to pass gas. - I face frequent and urgent urination, needing to strain with focus to manage it, experiencing the need to urinate every 15 to 30 minutes. - I endure relentless lower abdominal pain and pressure that seems to intensify over time, with occasional spells of severe discomfort. - Upon self-examination, I notice that I cannot detect stool in the upper rectum, and my rectum feels entirely flat. There’s a painful sensation as if a mass is pushing against my uterus – I suspect this blockage is pressing into both my uterus and bladder, preventing any stool from reaching my rectum. I sought emergency care on December 29 when an X-ray confirmed fecal impaction. They administered a soap-suds enema, which mostly cleared the blockage, and a CT scan revealed diffuse colitis. I left the ER with a prescription for antibiotics, toradol, and a referral to a colorectal specialist, although I did not undergo either a rectal or abdominal examination at that time. Despite the treatment, my symptoms did not improve, and the impaction returned quickly. Today, I had an appointment with the colorectal surgeon, who again deemed a rectal or abdominal exam unnecessary. I described my struggles with urination, the inability to expel stool or gas, and chronic abdominal pain, but I was instructed to schedule a defecatory MRI and follow up in seven weeks. The surgeon expressed that he was unlikely concerned about my bowel perforating in that timeframe and advised me to continue my current approach, despite the fact that enemas and bowel preparations no longer provide any significant relief. What should I do now? My quality of life has plummeted. I’ve been experiencing slight nausea over the past two days, reminiscent of what prompted my initial ER visit. I feel as though I am in limbo, waiting for this to escalate into a more serious condition before any resolution is offered. This flare-up feels different from prior experiences, and I am worried that there may be an underlying structural issue affecting my condition. I am currently waiting for supplies to facilitate soap-suds enemas at home, but given that my situation is not dire at the moment, should I just remain at home? Or should I return to the ER tomorrow and insist on further investigation? Any guidance would be greatly appreciated, as I am completely unsure of the next steps to take!

Answers (1)

12/16/2025, 12:01:31 AM

OpenHealth AI

It sounds like you’re experiencing a very challenging situation with your gastrointestinal health that is impacting your quality of life significantly. Given your symptoms of severe constipation, frequent urination, and abdominal pain, it’s crucial to approach this carefully while ensuring you receive the care and relief you need.

Key Points:

1. You have a history of bowel issues and fecal impaction.
2. Current treatments are not providing adequate relief.
3. You are experiencing new symptoms that raise concern about potential underlying structural issues.

Explanation:

Severe constipation, especially when accompanied by pain and urgency, can indicate complications that need to be addressed promptly. The pressure on surrounding organs (like the bladder and uterus) can cause additional symptoms and complications.

While your recent imaging and examinations may not have shown significant findings, the persistence of your symptoms suggests that further investigation may be warranted.

Next Steps:

1. Monitor Symptoms Closely: Keep a detailed log of your symptoms, including any changes in bowel movements, pain levels, and urination frequency. Note any new sensations or symptoms, such as nausea and changes in ability to pass gas or stool. This will be helpful in discussions with healthcare providers.

2. Consider Returning to the ER: Given the changes you mentioned, including slight nausea and worsening symptoms, it may be wise to return to the ER. Explain your history and current symptoms in detail. Emphasize the urgency of your situation and the lack of significant relief from current treatments.

3. Request Specific Investigations: If you return to the ER, request further evaluation for potential structural issues. You might consider asking for:

   • A physical examination focused on the abdominal and rectal area to assess for any abnormalities.
   • Additional imaging if necessary, such as an abdominal ultrasound or a different type of CT scan.

4. Inquire About Referral Options: If you get little satisfaction in the ER, consider reaching out to your colorectal specialist's office again for any guidance on expediting the MRI or further evaluations. You might also explore whether a second opinion from another colorectal specialist is feasible.

5. Self-Care and Diet Adjustments: While you navigate this situation:

   • Maintain hydration and consider dietary adjustments to include more fiber if your digestive system allows it (consult your GI specialist regarding this).
   • Be mindful of any dietary triggers or foods that you may have identified exacerbate your symptoms.

Conclusion:

Your situation is difficult and understandably distressing. Taking steps to advocate for your health, including returning to the ER if your symptoms escalate or change, is important. Also, closely monitoring your symptoms and seeking further evaluation will help in finding a resolution to your ongoing issues. Remember, it’s okay to seek help and insist on the necessary investigations to understand what’s happening with your health.