How to manage constipation?

Question

Hello doctor,

I am a 19-year-old male. A year ago I began getting pain, blood, and mucus in my anal area, as well as constipation. As soon as this occurred, I sought medical attention at the emergency room.

I explained to the doctors about my condition and they then told me that I was wasting their time and I should contact my family doctor. Since then, I have seen my family doctor many times, as well as a gastroenterologist, where I have had a sigmoidoscopy, urine and blood test, ultrasound, and swab test.

I had also completed a sexually transmitted disease test at this time. My gastroenterologist said that he saw colitis, but nothing serious. I followed his instructions to take an anti-inflammatory suppository twice a day for two months. This did not clear my symptoms, it only made my life more difficult, aggravating my constipation.

After I gave up on this, I went back to my family doctor and they checked my blood again, and I was told they saw gonorrhea in my DNA, but it did not show up in the swab, or urine sample. I was treated for gonorrhea immediately. Since then, I have been feeling a little better for a few weeks, but the constipation continued.

Now I am currently experiencing pain on and off in my stomach, lower left abdomen, lower right abdomen, and mid-right abdomen. I have had multiple blood tests (they looked at my liver function and blood count, and they looked for auto-immune diseases).

The pain is dull and mild but occurs daily. There is also a lump that comes and goes in my lower right abdomen that I think is food. (I thought for a while I had filled-cecal valve syndrome). Eating more fiber helps the constipation, but does not cure it, and no matter what my diet consists of I still experience pain.

I have recently been prescribed a week test of capsule Constella, a drug for irritable bowel syndrome (IBS) and it gave me bad diarrhea.

Currently, there is blood in my bowel movements and my stool is extremely inconsistent. It is always different consistencies and the colour changes from very dark to very light. There are also white and black specks in my stool and slime. I also have frequent urination and my abdomen feels tender most of the time. It seems like my doctors have no idea what is going on with me, so I am asking for another opinion on this situation that I am currently facing. This is very urgent.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

As your sigmoidoscopy did not show any lesion, then it is most probably due to benign conditions such as colitis, constipation related, and irritable bowel syndrome (IBS). But the best test to confirm your diagnosis would be from biopsy examination of the intestine tissue which will pinpoint the exact diagnosis. IBS is most likely in this scenario. It is due to an alteration in the motility of the intestine or inappropriate reaction to some of the foodstuff consumed.

I would advise you to follow the things that are mentioned below:

Consume a small quantity of meals in liquid form.
Avoid foodstuff that causes or aggravates symptoms.
I suggest you consume plenty of oral fluids, high fiber diet, and avoid a constipation-causing diet.
Ensure adequate water intake.
Do not strain for stool.
Ensure intake of a high-fiber diet in the form of salads, and fruits.
Go for a regular walk.
Can take isabgol husk two teaspoons at night.

I hope this helps.

Please let me know if you need help.

Thank you.