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:
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
Related Questions
Throat Pain Radiating to Chest
At 24 years old, I've been grappling with a peculiar situation for several years now, though I can't pinpoint exactly when it started. I frequently experience sudden bouts of throat discomfort, which then escalates as I feel the sensation travel down into my chest. This transition brings about a dull yet pronounced pain that lasts for several minutes. Additionally, I notice that just before the chest pain kicks in, I tend to have very minor burps. The discomfort isn't characterized by a burning sensation, and it doesn’t consistently follow meals, leading me to doubt that it’s simply acid reflux, though I acknowledge I could be mistaken. I am not currently taking any medication. A few years ago, I was diagnosed with severe anxiety, depression, and PTSD, conditions that I suspect have been affecting me throughout my life, stemming from a tumultuous childhood. I find myself puzzled about the nature of this issue—whether it's a manifestation of my ongoing anxiety causing physical symptoms or something as straightforward as heartburn. I've tried acetaminophen, but it hasn’t provided any relief. Recently, these episodes seem to be occurring with greater frequency, and it's becoming increasingly frustrating. I would appreciate any insights or advice on this matter.
Do My Urine Results Suggest a UTI?
I’m a 27-year-old female currently taking 150mg of Venlafaxine. A couple of days ago, I visited my doctor due to severe discomfort and a burning sensation in my urinary tract and lower abdomen, which started three days after sexual intercourse. Now, five days have passed, and despite being prescribed Macrobid 100mg, I haven’t experienced any relief. Additionally, I've developed a fever of 100.3°F and am feeling extremely fatigued, with my vision becoming slightly blurry. The doctor informed me it would take five days to receive the urine culture results, but I’m curious about what my current results indicate. I’m beginning to suspect that I may require a different antibiotic. I also found out that Urobilinogen levels relate more to liver function than to urinary issues. I've been taking Azo, but it hasn’t provided substantial relief from the pain. Here are my urine test results: - **Blood:** 10 (Ery/UL, Normal Reference: Negative) - **Urobilinogen:** 8 (Mg/DL, Normal Reference: Normal) - **Bilirubin:** 4 (Mg/DL, Normal Reference: Negative) - **Protein:** Negative (Mg/DL, Normal Reference: Negative) - **Nitrites:** Positive (Reference: Negative) - **Ketones:** Negative (Mg/DL, Normal Reference: Negative) - **Glucose:** Negative (Mg/DL, Normal Reference: Negative) - **pH:** 6 (Reference: 5.0-7.0) - **Specific Gravity:** 1.000 (Reference: 1.010-1.030) - **Leukocytes:** 25 (Leu/DL, Normal Reference: Negative)
Could This Be Hypoglycemia? Hunger That Won't Leave
Height: 5'4" | Age: 28 | Sex: Female | Weight: 255 lbs Currently, I'm managing treatment for ankylosing spondylitis with Hadlima and take Vyvanse every morning. Although I'm in remission from atypical anorexia, I've noticed a disturbing trend where I’m eating irregularly—often only one substantial meal per day on challenging days, while striving to reach at least 1000 calories daily. For some time, this wasn’t an issue, but recently, a persistent sensation of starvation has settled in, regardless of my food intake. Accompanying this discomfort are feelings of fatigue and an unsettling sense of dread, which could hint at an underlying health concern. I've been informed that these experiences might align with episodes of low blood sugar, a possibility considering my erratic eating habits over the past months and my tendency to avoid sugary foods altogether. These symptoms have persisted for roughly a week now. Interestingly, I find myself craving beans intensely, which may be linked to my menstrual cycle. I also notice that I feel the urge to sleep continuously. This morning, I struggled to focus on my laptop at work, and my usual coffee didn't provide its typical boost. My wife and cat are both becoming increasingly concerned about my well-being, so I would appreciate insights from anyone who might have an understanding of this situation. Thank you!
Unexpected Armpit Irritation This Morning Despite No Changes
Hello everyone, I genuinely appreciate you taking a moment to read this. This morning started off like any other for me. After completing my usual morning routine—brushing my teeth and taking my daily dose of Duoloxetine (20 mg twice daily)—I applied my deodorant, slipped on my T-shirt, and headed downstairs for breakfast. While I was finishing my meal, I began to feel some discomfort in my armpits. As I moved around, the irritation intensified significantly. Upon glancing in the mirror, I noticed the early signs of a light rash forming in the folds of my armpits. To remedy the situation, I decided to take a shower and opted for more comfortable, loose-fitting attire afterwards. At this point, my armpits are still quite irritated, though I’m not overly concerned. At worst, it seems I might need to switch my deodorant, clothing, or detergent brand. What puzzles me, however, is the fact that this irritation occurred simultaneously on both sides without any new factors influencing this sudden change. I've been wearing the same brand and type of t-shirt almost daily for three years now, and the deodorant stick I used has been a regular for about a week, while I’ve been using the same type of deodorant for five years. Similarly, I’ve stuck with Arm & Hammer laundry detergent for the last eight years. If only one side were affected, I might shrug it off, but the fact that both armpits are irritated at the same time has me curious about the underlying biological reasons. I would greatly value any insights you might have. Thank you immensely!
Increased Urination: Seeking Insights on a Mysterious Change
Over the past year, I’ve experienced a noticeable rise in my need to urinate, and I'm at a loss to explain it. The only symptom I have is this heightened urge; there’s no pain or any unusual signs like discoloration, strong smells, burning sensations, or bleeding. Each time I use the restroom, I feel completely empty. My drinking habits haven't altered, so this change is puzzling. In January, I consulted my doctor about this issue. They conducted tests to check for a urinary tract infection. Despite being uncertain about the cause of my symptoms, I was confident it wasn’t a UTI, and the results confirmed that. When I saw my doctor again during my physical in October, I raised my concerns about the frequent urination once more. Other than a slightly elevated glucose level of 101, all my lab results were normal. In previous years, my glucose levels ranged from 90 to 99. I insisted on undergoing a PSA blood test, even though my doctor mentioned that such testing is rarely done for men my age. Fortunately, the results were within the normal range, posing no issues. After being tested for a UTI, having the PSA exam, and undergoing comprehensive lab work during my physical, I still find myself without clear answers. However, the frequent urination continues. In the past, during a typical 9-hour work shift, I would usually go to the restroom once or twice. Now, it’s increased to 5-6 times, even though I’m not consuming excessive amounts of water. Previously, night trips to the bathroom were uncommon unless I drank a lot before bed. Now, I find myself waking up to use the restroom once or twice a night quite regularly. I’ve never consumed alcohol at all and have never smoked. The only supplement I take is a daily probiotic, which is nothing new for me. I’m curious if anyone else has any theories or suggestions for this situation. My family tends to brush it off as simply a part of aging, but I have my doubts about that.