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Why do I have constipation despite taking fiber supplements?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I have been experiencing a low WBC count for many years. My constipation started about three years ago, when the help of fiber (Psyllium Husk) to flush out my hard stool. Constipation has gotten progressively worse over the last few months. Presently can only pass after taking Magnesium Oxide.

A recent CT scan with IV contrast might not highlight small bowel blockage (bezoar). I am seeking a review of these images for any conclusive evidence of small bowel abnormalities. I have attached the images. Kindly give your opinion.

Kindly help.

Answered by Dr. Ajeet Kumar

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

Hi,

Welcome to icliniq.com.

Unfortunately, the images file which you uploaded is corrupted and can not be opened. You need to upload it again. And please upload the report of the CT (computed tomography) scan as well since the images and their magnification maybe not suitable to comment on the diagnosis. The radiologist even reporting which looking at the CT scan images on console and on full magnification.

You mentioned bezoar in the small bowel. Have you had a prior history of ingestion of undigestable matter? And do you have abdominal pain with constipation? What about your daily water and fiber intake?

Please answer the above questions so that I can help accordingly.

Thank you.

Patient's Query

Hi doctor,

The hospital gave me CT scan CD. Please advise how you can review the CD images or which files from the CD that I can send you. I am attaching the CT scan file.

With regard to bezoar, I have had no history of it. But it became clear that Psyllium seed powder taken without food could form hard balls in my small bowel. A recent colonoscopy reveals nothing abnormal in the colon. Kindly guide me.

Kindly help.

Answered by Dr. Ajeet Kumar

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome back to icliniq.com.

On CT scan (attachments removed to protect the patient's identity), there is no gross pathology (problem) in your small bowel. The large bowel (colon), however, shows fecal loading. The stools are present only, and this is otherwise a normal finding. I could not appreciate bezoar in your small bowel.

Now your primary concern of progressing constipation can be a functional thing. Meaning, the large bowel is somewhat working slow, and it can occur without any specific disease or reason.

Taking fiber does not cause bezoar formation. I do not think that it is a reason for your worsening constipation. In fact, the lack of fiber intake can worsen your constipation. So my advice is to start fiber supplements and take plenty of water in a day, such as eight glasses of water or even more.

Please let me know if you have any concerns. I suggest you upload the CT scan report from the radiologist as well, this would further confirm my findings, and this will ensure we are on the right track.

Thank you.

I hope this was helpful.

Medically reviewed by Dr. Sushrutha M.
Published At August 6, 2021
Reviewed At August 11, 2025

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Sushrutha M. is an ambitious Dentist who completed her BDS degree from JSS Dental College and Hospital. In 2019, she pursued a Postgraduate Certification course in Esthetic Dentistry from M.S. Ramaiah Dental College. Fluent in English, she possesses six years of clinical experience.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

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