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Q. I have severe constipation and bloating problem, with slight vaginal bleeding. Please help.

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 04, 2018 and last reviewed on: Sep 10, 2020

Hello doctor,

I am a 22 year old female, and I have been experiencing major constipation from the last month. Every time I eat, I experience bloating, and I am unable to go to the toilet later on. Have tried taking Sennetabs, Metamucil, increasing fiber, and water in the diet. I have this problem approximately five days a week. I have also been getting abdominal pains, and four days ago I had a light vaginal blood discharge for two days. I am taking tablet Estelle from a very long time, I am still taking it, so this would not have been my periods. I do not have any weight issues. I also get quite a bit of walking done in my job, so I am not sitting down all day long.

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome to

I would need a little bit more history,

  1. How many times during a week do you have a bowel movement?
  2. Please go online and type Bristol stool chart, and let me know the consistency and type of the stools you are having in general from a month.
  3. Have you had diarrhea before the given month? Do you have to strain to defecate?
  4. How are your menstrual cycles usually?
  5. Any family history of thyroid disorders or colon cancer? Do you feel very cold, when everyone is comfortable?
  6. Have you lost any weight lately?

Revert with more information to an internal medicine physician online -->

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Hello doctor,

Thank you for your reply. I have bowel movement approximately twice a week, but in the last month, it has not been consistent. And according to the Bristol stool chart, my stool is type 1 and 2. I also have had one day where it was completely different and was type 7. I have not had diarrhea before this, just once during the month where it was type 7. My menstrual cycles are usually fine. Once I get to the nonactive tablets on my sheet of Estelle, I usually get my period within two days. And it always lasts for four days with spotting on the fifth day.

Yes, lately it has been painful trying to defecate, it has never come easy. I often go to the toilet feeling like I need to go, but once I sit down, I, cannot go. No family history that I am aware. Yes, for years I have always felt the cold more than everyone else. When other people say the temperature is nice, I often have goosebumps. I always assumed this was because I do not have good circulation. My hands and feet often are a purple color, and get cramps in arms and legs regularly. My mother has varicose veins and same problem with the cold. I have lost weight lately, but only a couple of kilos. I just get extremely bloated and constipated, and then when I do get to go to the toilet and relieve myself, I feel better.

Dr. Sadaf Mustafa

General Medicine Internal Medicine


Welcome back to

Thank you for answering my questions.

  • There are various types of constipation including functional, pathological, and iatrogenic. Here is what I would suggest.
  • Please get a thyroid function test done, and it seems like you have hypothyroidism, that may cause both cold intolerance and constipation. It can also cause brittle nails, hair abnormalities, and altered menstrual cycle.
  • Other important point is hypercalcemia, get your calcium level checked. If you are consuming antacids, I would recommend that you stop using them.
  • Please avoid laxatives on all cost, as they can cause rebound constipation. Instead, use a bulk-forming agent. I would suggest using one teaspoon of bulk-forming powder in a glass of water in the morning on an empty stomach. Please keep on doing it at least for two weeks.
  • Minimize meat products in your diet and incorporate more fruits.

Please let me know after you obtain these results, if all is well, then we will focus on the functional aspect of your constipation.

For more information consult an internal medicine physician online -->

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