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Q. I have severe constipation after undergoing cervical spine surgery. How to treat it?

Answered by
Dr. Ana Karen Pulido
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 25, 2018

Hi doctor,

I suffer from severe constipation for the past three years. I have undergone cervical spine surgery before two years back. Post surgery constipation problem still got worsened. Presently, I am taking Baclofen 5 mg three times a day for the spasticity in legs. Please help.

Dr. Ana Karen Pulido

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

The first option for treating constipation is starting with Sennosides tablets. Take two tablets every night. If there is no improvement in two days, you can take two tablets for every 12 hours. This medication can be taken for now and on. Sometimes you may need more fiber to make bulks in the stools.

Psyllium Plantago is a natural laxative, and it helps for maintaining an adequate amount of fiber. You can take one tablespoon in a glass of water every morning and then drink another glass of water. You should take at least 1.5 liters of pure water every day. You can add milk of magnesia 15 to 25 ml for every eight hours until the stool gets soft. It has to be taken when there is bad constipation once in a while (two to three days for every ten days).


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Thank you doctor,

I tried taking PEG fiber, Dulcolax and I am taking three liters of water daily. My ultrasound scan is normal. The doctor advised me to do a colonoscopy. Is it required?

Dr. Ana Karen Pulido

General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

PEG (polyethylene glycol) fiber is an alternative to Psyllium Plantago. Dulcolax (Bisacodyl) has a different mechanism of action from Sennosides. So you can add this to your current medication.


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Thank you doctor,

PEG fiber was not effective in my case. I am having cramps in the abdomen, and I have bloating.

Dr. Ana Karen Pulido

General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

You can change it to Psyllium Plantago. This is a natural fiber that does not cause bloating or cramps. This is a type of treatment for constipation. But in your case, you need to take sennosides, as you take Baclofen, which slows down your bowel movements. Sennosides reduces this secondary effect of Baclofen. You can take two tablets every 12 hours.


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Thank you doctor,

Even after having a good bowel movement, still, I feel bloated. What could be the reason? How to make sure that there is no obstruction in the intestines? How to know it?

Dr. Ana Karen Pulido

General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

Bloating can occur due to a fiber or something in your diet. Obstruction presents differently with vomiting and causes severe abdominal pain. Try to identify the specific food that makes you uncomfortable. Please say when the bloating is worse, after taking food or before taking food, or during a stressful situation.


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