Patient's Query
Hi doctor,
I have been dealing with this issue for a couple of months. It all began after taking a senna leaf, which is a laxative. I should also want to mention that I had a thin stool for some time, but now it comes and goes. In the beginning, I also had a dark-colored stool, but that is no longer the case. My stool tends to be light-colored now. I plan to visit a GI soon but wonder if the symptoms I describe sound like anything. After a day of taking it, I had stomach cramps and was constipated. This went on for several months, but the stomach cramps disappeared; however, constipation comes and goes. One symptom that has been constant the entire time is pressure, almost like in my pelvic area only when I am lying down. It is hard to distinguish if it is my pelvic area or rectum, to be honest. I recently took a laxative not too long ago, and it once again messed up my stomach but not as bad. I wondered if these symptoms sound like anything serious, as well as any correlation between taking a laxative and messing up my stomach. I went to urgent care a month ago and had a blood test and CT scan of my abdominal region, and it all came back normal.
Hello,
Welcome to icliniq.com.
The senna is used in treatment for constipation. They are irritant laxatives, meaning they irritate the gut, cause cramps, and thus pass stools. So cramping, diarrhea, bloating are common side effects. However, they usually do not last for more than three days of their last use. Persistent symptoms of constipation and cramping suggest there is probably another problem going on within your bowels. To tell you the seriousness of the situation, I need to know more about the existent information you just shared. Plus, there are specific other questions to establish the primary cause of your constipation.
Now in your age, there are some common causes of constipation. Given your history, the highly likely possibility is Irritable bowel syndrome ( IBS). Which is a nonserious condition, does require targeted medicinal treatment, and symptoms often go away. However, this is simply a hypersensitive gut that tends to become constipated and causes pain, which remains and tends to have an on-off course during life.
Lack of fiber in the diet, lack of regular exercise, and decreased water intake are other essential components, common but overlooked. If you have any problem with that, the correction of that will solve your problem.
Lastly, there is a set of another disorder called pelvic outlet obstruction. Or dyssynergic defecation or obstructive defecation (defecation= passage of stools). In this, there is a paradoxical contraction of the anal canal muscles in response to the urge to pass stools. Usually, it should relax and allow stools to pass quickly. With the above set of questions, I would be able to differentiate among these common causes of constipation in you and would be able to suggest you my recommendations specifically. The blood tests and CT (computed tomography) scans often come normal among these conditions and require more targeted investigations to confirm it. However, the tests are not usually needed, and in most part, the diagnosis is easily established based on the answers to the above questions.
The Probable causes
Investigations to be done
Differential diagnosis
Probable diagnosis
Treatment plan
Patient's Query
Hi doctor,
Thank you doctor for your reply.
So I have weight loss, but it has been intentional because when this all started, I was very overweight around 220 pounds, but I went on a diet and exercised regularly. So I believe I lost my weight naturally. I do not have anybody in my family with serious issues other than IBS. I never really had problems beforehand; not to this extent, constipation was horrible. Thin stools come often, but not daily. I will say this though it feels like I can never empty my bowels. My bowel movements typically take around 10 minutes, sometimes a little longer, and I say I have maybe for ten weeks. I never had to use a finger in my rectum to disimpact a stool. The biggest issue I have is the pelvic pressure, it is very uncomfortable when lying down and sitting, but when standing, almost 90% of the time, the pressure is nonexistent. The pressure is hard to describe the exact location because it is not on the surface.
Hello,
Welcome to icliniq.com.
Thank you for providing more information.
The pelvic pressure can be due to stored stools within the rectum. The location you describe is entirely consistent with that. We often see some degree of pain with dyssynergic defecation or obstructive defecation, or anismus. Your number of bowel movements seems to be fine. I suggest you some testing and some symptomatic treatment for it. Basically, to soften the stools and relieve your symptoms of unsatisfactory emptying of the rectum. I would give you laxatives. But they are a different medication class that hopefully would not disturb your gut except to cause normal bowel movements regularly. Polyethylene glycol sachet 17 gm. Two sachets twice daily in a glass of water. I expect that you would have bowel movements after six to eight hours of taking this. You should have two bowel movements for now with soft stools.
Take this for a week, and let me know how you feel symptoms.
Find the investigations below.
Investigations to be done
Regarding follow up
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Answered byDr. Ajeet Kumar
Medically reviewed byDr. Preetha. J
Same symptoms don't mean you have the same problem. Consult a doctor now!
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