Managing Severe Constipation and Bowel Impactation
At 30 years old, I am a woman currently taking Gabapentin, Vyvanse, Seroquel, and Lamictal. Constipation has been an ongoing issue for as long as I can remember, and I currently weigh 138 pounds. Additionally, I vape but do not smoke cigarettes. For the past year, I have not had a solid bowel movement. Recently, the situation escalated, leading to discomfort in my lower back characterized by a burning sensation that comes and goes, alongside pain in my inner thighs and a persistent feeling of pressure in my abdomen. Just yesterday, I awoke feeling a strong urge to relieve myself, and I sensed that a movement was imminent. However, when I tried to go, I encountered an intense obstruction that felt as if I had run into a wall. Immediately, I felt a sensation as though something was lodged in my vaginal area. With work obligations that prevent me from taking time off—living paycheck to paycheck—I had to push through my day. However, after my shift, I decided to go to the emergency room, where I was informed that I was experiencing severe constipation to the brink of bowel impaction. I also mentioned a new symptom: the presence of blood, to which the doctor remarked that it could be a normal response in this situation. I’m not convinced it’s normal, though. I inquired about the possibility of receiving an enema, but the doctor advised against it, expressing concern that it might worsen my condition rather than alleviate it. Instead, I was instructed to follow a cleanse involving Gatorade and Miralax, supplemented with magnesium citrate. Is this the standard procedure? Should I have pushed harder for a different solution? While I understand that an enema might be painful, I find the caution regarding magnesium citrate puzzling. I completed the suggested Gatorade and Miralax regimen and finished it around midnight, but all I have experienced since then is an output of liquid. Even now, I can still feel an uncomfortable pressure, like a "baseball" lodged in my rectum, and despite the liquid output, it feels as though stool remains trapped. It’s coming out with the consistency of water, but it’s like it’s being expelled through a tiny straw. I’m feeling frightened and extremely nauseous. Although it’s only been a couple of hours since I completed the liquid cleanse, I could have never imagined this would be the result so quickly after ingestion.
Answers (1)
2/14/2026, 7:40:39 PM
OpenHealth AI
It sounds like you're experiencing a very challenging situation with severe constipation and discomfort. Your symptoms, including the feeling of obstruction and blood, can understandably be concerning. Let's break down your situation and what you can do next.
Key Points
- You are dealing with severe constipation, potentially leading to bowel impaction.
- The presence of liquid stool and the feeling of obstruction indicate that there may still be stool remaining in your rectum.
- The advice you received from the ER regarding the use of Miralax, magnesium citrate, and hydration is aligned with standard practices for managing constipation.
Explanation
Severe constipation can lead to impaction, which occurs when stool becomes hard and stuck in the rectum. This situation can cause pain, pressure, and discomfort, like what you're experiencing. Liquid stool may pass around the impaction, which can give you a sensation of relief but does not address the underlying issue.
The medical team likely advised against an enema given your situation, as it can sometimes lead to further complications if the impaction isn't resolved properly. Miralax and magnesium citrate are often used to soften stool and help with bowel movements, but results can vary, especially given the severity of your blockage.
Prioritized Next Steps
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Continue Staying Hydrated: Drink plenty of fluids, ideally water, to support your system in processing the Miralax and magnesium citrate.
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Monitor Your Symptoms: Keep track of any changes, especially if you notice increasing pain, vomiting, or significant changes in your bowel movements.
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Consider Dietary Adjustments: Once you're feeling a bit more stable, including high-fiber foods like fruits, vegetables, and whole grains may help. Limit processed foods which can exacerbate constipation.
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Follow Up: If you have not experienced significant improvement within the next 24-48 hours or if your symptoms worsen, consider consulting with a healthcare provider. This can include seeking a gastroenterologist for a more tailored approach to your constipation.
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Gentle Movement: If your back pain allows, engage in gentle physical activity, like walking. Movement can sometimes stimulate bowel function.
Support and Reassurance
It's crucial to recognize that what you're feeling is understandably stressful, and many people face similar challenges with constipation. You are not alone, and there are ways to find relief. By taking these proactive steps, you're working towards better management of your symptoms. If you ever feel unsure, trust your instincts and seek further medical advice. Let me know if you have more specific concerns or need additional information!
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