Seeking Urgent Assistance for Severe Constipation
I am experiencing severe slow transit constipation. For the past three years, I relied on senna, but periodically required enemas from the emergency room to stimulate relief. Several months ago, my senna intake ceased to be effective, compelling me to seek another cleansing method. After two consecutive days of enemas that proved ineffective, I was prescribed Motegrity, which initially helped clear some blockage within a week, but its effectiveness diminished quickly by the second week, leading me to discontinue its use. Currently, I have been trying various laxatives including Miralax, Lactulose, and Amitiza, yet I continue to struggle with feeling incompletely emptied. Recently, my symptoms have worsened; I feel increasingly bloated, nauseous, and overall unwell. This sensation of incomplete evacuation has persisted for weeks. Though I was passing small to moderate stools daily while on Lactulose, it was still insufficient. When I attempted a Miralax flush—using three capfuls along with three spoonfuls of Lactulose—I was met with dehydration and only minimal yellow diarrhea. Upon restarting Motegrity, I was able to pass a small amount of stool but mostly expelled green bile, which left me feeling extremely sick. Following this, I went to the ER where a CT scan revealed moderate stool accumulation, periportal edema, and possible hepatomegaly with a Riedel lobe. An attempt was made to administer a soap suds enema (500 ml), which I retained for 40 minutes but resulted in only minimal output. After receiving a Reglan injection, I took Lactulose again that evening and resumed both Motegrity and Lactulose the next morning, resulting only in liquid and tiny, mushy stool. I maintain a solid hydration routine, consuming half a gallon of water each day in addition to an electrolyte pack, while ensuring my caloric intake is around 2000 calories with a focus on healthy eating. Despite visiting a gastroenterologist who continues to prescribe new medications that prove ineffective, the emergency department routinely administers enemas, which return unsuccessful, leaving me without solutions. I am deeply concerned that this could escalate into a sepsis crisis if not managed properly. I am reaching out for guidance on how to obtain a medical clear-out or alternative options for relieving my situation at home. Any assistance would be sincerely appreciated. Thank you.
Answers (1)
12/16/2025, 10:30:47 PM
OpenHealth AI
I understand that you're facing a challenging situation with severe constipation and related symptoms, which can be both physically and emotionally draining. You're seeking effective strategies to relieve this condition, especially given your history and current experiences. Let's break this down into manageable steps.
Main Points
- Current Symptoms and Concerns: You have persistent constipation, bloating, nausea, and feelings of incomplete evacuation. You've tried various medications without lasting results.
- Urgent Action Needed: Your symptoms suggest the risk of complications, so it's critical to find effective home strategies and discuss options for more thorough clearance.
Explanation
Severe constipation with symptoms like yours can be caused by several factors, including slow transit time, dietary habits, and possibly underlying conditions. It’s concerning that despite multiple interventions, you're still experiencing discomfort and bloating, which could lead to complications if not properly managed.
Next Steps
Here are prioritized actions to consider that can help manage your condition at home:
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Daily Fiber Intake: Focus on increasing your dietary fiber to at least 25-30 grams daily (if not already). This can be achieved through fruits, vegetables, whole grains, and psyllium husk supplements. Gradually increase the fiber intake to avoid worsening bloating.
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Stay Hydrated: Continue your hydration routine. Aim for at least 64 ounces (about two liters) of water per day, adjusting based on your body's needs and activities. Electrolytes are helpful, but ensure not to rely solely on them.
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Increased Physical Activity: Incorporate gentle physical activities like walking or stretching to stimulate your digestive system. Aim for at least 20-30 minutes of low-impact exercise most days.
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Medication Review and Structured Plan:
- Consult with your healthcare provider (possibly a different gastroenterologist) about a more structured medication plan. Consider discussing the use of manual disimpaction or a "clean-out" treatment under medical supervision since you've had little response to laxatives.
- Be open about your experience with the medications you've tried, expressing your urgent need for effective relief.
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Track Your Symptoms: Keep a detailed log of your bowel movements, the consistency of stools, medications taken, and any accompanying symptoms. This can help healthcare providers understand your progress and make more informed decisions.
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Consider a Second Opinion: If you feel your needs aren't being met, seeking another gastroenterologist's opinion could provide new insights or alternative treatment options, including possible diagnostic tests to explore underlying causes.
Conclusion
Your symptoms warrant careful attention, and focusing on dietary changes, hydration, activity, and potentially a new treatment plan can help you find relief. Please stay proactive about seeking care, continuing to communicate openly about your struggles, and exploring new medical opinions to ensure thorough management of your condition. If your symptoms escalate or you experience severe pain, fever, or significant changes, it's crucial to seek immediate medical attention.
Take care, and know that you're not alone in navigating this complex situation.
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