Q. My constipation is so bad that I have to evacuate the stools with my fingers. Please help.

Answered by Dr. Noushif M and medically reviewed by iCliniq medical review team.

 

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Hello doctor,

I have an anal fissure, internal hemorrhoid, SRUS, and constipation. One year ago, I was suffering from a hard stool that was difficult to pass. I went to a gastroenterologist, who did a colonoscopy and found that I had an anal fissure and internal hemorrhoid. He prescribed Sitcom Forte, Eldicet, Velgut, and Pankreoflat. He also gave me Sucralcoat Ano cream. However, every night I was in too much pain. So, early this year, I decided to consult an Ayurveda doctor who gave me some Kashayams and tablets. However, my pain did not subside. I used to evacuate the stools using my fingers. That eliminated the stools, but there was so much mucus released and extreme pain after motion. Two months ago, I went to a GP who gave me some antibiotics and painkillers for five days. During this time, I was always sleepy. I took leave from work and was always tired and fatigued. Earlier this month, I went to another GI specialist who did a sigmoidoscopy and said that it is SRUS. He said that I should not finger evacuate the stools and gave me liquid paraffin and LoX cream.

Now, my current situation is that it has been three days and I am very constipated and fatigued. The pain has subsided a little. However, I am not passing stools as I used to before. After I drink water or eat something, I get a vomiting sensation. I get anxiety and panic attacks as I am scared about my condition and do not know which doctor I should consult and what I should do. Is this condition serious and life-long? Will I ever be cured? Please advise on the correct medications (allopathy or ayurveda), lifestyle changes and other things to take care.


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Dr. Noushif M
MBBS., MS (GENERAL SURGERY)., MCH (SURGICAL GASTROENTEROLOGY)., FELLOWSHIP IN LIVER TRANSPLANT AND HEPATO-
General Surgery, Medical Gastroenterology, Surgical Gastroenterology

Hello,

Welcome to icliniq.com.

I have gone through the files uploaded by you. (attachment removed to protect patient identity).

  • The endoscopy report you have shown does not show any evidence of SRUS (solitary rectal ulcer syndrome). All your symptoms can be attributed to underlying constipation.
  • Hard stools lead to an injury of the anal region leading to a fissure. SRUS if present also results from constipation.
  • My suggestions would be:
  1. Avoid hard stools at any cost. Drink around 3 liters of water in various forms daily.
  2. Avoid or at least reduce the amount of constipating foods like maize-based foods, bakery foods, cakes, chocolates, etc. Add more leafy vegetables and fiber-rich foods like oats into your daily food.
  3. Never attempt straining at stools or manual self-evacuation.
  4. Check your thyroid function test every three months and make sure it is normal. Reduced thyroid levels also result in constipation.
  5. Use stool softeners whenever you feel like there are hard stools or incomplete evacuation. Have a dose at night so that you can have a good bowel movement in the morning. Syrup Looz (Lactulose) or Duphalac (Lactulose) 30 ml will be alright to take. You can take extra 30 ml in the morning if the bowel fails to move well with a soft stool. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Do not make these medicines regular.
  • These small tips will make you better over a period of two to three weeks if you follow them well.

Hope your queries have been cleared. Good luck.

For more information consult a medical gastroenterologist online --> https://icliniq.com./ask-a-doctor-online/medical-gastroenterologist

 

Hello doctor,

Thank you for the advice. Here are additional symptoms that I am facing since last week. Please advise on these as well. I pass a lot of gas. When I sit down to pass the motion, I pass a lot of gas and the stool sprays out along with the gas. The stool is very paste-like. The stool sticks to the inside of the rectum often. So, I have to insert my finger to remove the sticky stool. While doing this, more stool comes out. If I do not strain, the stool remains stuck in the passage. It looks like the passage has become narrow and is not expelling the stool, so I use my finger. Sometimes, I get stool which is narrow and tube-like. In both cases, the quantity of stool passed is very less. Whenever I drink or eat anything, after a minute or so, I make a loud throwing up noise as I feel a vomiting sensation. This goes away after one to two minutes. My stomach constantly makes a rumbling noise. I feel fatigued and tired almost throughout the day. My eyesight gets a little blurry and my head feels heavy and dizzy. I would always be fresh until late at night, but lately, I feel very sleepy by 11 PM. My BP is 140/90. I have lost 6 kg weight in the last month. I was 102 kg and now I am 96. I feel constantly anxious and frequently get a panic attack in the form of nervousness, fear and racing heartbeat. Please help me with the above symptoms. Kindly tell me if my condition is curable and that I will start to lead a normal life again. What should I do to cure my problem?

 

Dr. Noushif M
MBBS., MS (GENERAL SURGERY)., MCH (SURGICAL GASTROENTEROLOGY)., FELLOWSHIP IN LIVER TRANSPLANT AND HEPATO-
General Surgery, Medical Gastroenterology, Surgical Gastroenterology

Hello,

Welcome back to icliniq.com.

  • Your symptoms are mainly from constipation. The abdominal problems will definitely improve once it is dealt with.
  • Thyroid medications should not be stopped unless adviced by the physician after checking the reports.
  • Try to have regular physical exercises and maintain a BMI of less than 30. 
  • The rest of the concerns you raised looks of not much significance. You will be alright.

Good luck.

For more information consult a medical gastroenterologist online --> https://icliniq.com./ask-a-doctor-online/medical-gastroenterologist

 
 
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