Why do I have constipation even after having a balanced diet with adequate fluid intake?

Question

Hello doctor,

I have constipation. I drink 2 to 3 liters of water, eat vegetables, fruit, oatmeal, protein, and exercise daily. I am 53 years old, nearing menopause, and suddenly, I feel like I cannot empty my bowels. I have tiny movements throughout the day. I had a routine colonoscopy two years back. It has been happening on and off for the past few months. Is it acceptable to use Miralax daily? Also, I lost a lot of weight on purpose (20 lbs), eating 1200 to 1500 calories a day. I needed to lose weight because I am having knee replacement surgery soon. Currently, I am taking Prozac 40 mg capsule, tablet Klonopin 2 mg, and Trazadone 100 mg.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I have reviewed your case history, and below is my observation.

1) When you start changing your diet to control weight, your bowels take time to get adjusted to new routines. There are certainly other possibilities I will mention in a while.

2) Yes, you can take Miralax powder. It is a very common laxative and generally safe.

3) It is excellent that your recent colonoscopy was regular.

4) Other possibilities in your case are two -

A) Drug-induced constipation. Since how long are you taking the tablet Trazodone?

B) The second possibility is a sensitive gut. I mean, if you are under stress considering your body weight and actively trying to reduce it, there is a well-known type of IBS (irritable bowel syndrome) known as IBS-C (irritation bowel syndrome with constipation), which means whenever you think more about constipation, you will get more constipation.

In the end, keep an eye on alarm signs like there should not be any rectal bleeding. Also, I hope no significant family history related to gut chronic diseases or cancer exists.

Hope this helps.

Thank you and take care.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concerns,

If you have been using the tablet Trazodone (antidepressant) for 16 years, then it is less likely that this is due to the drug since there is no recent change in the drug dose as well. It seems to be related to diet and some extended stress as well.

These are my few suggestions.

1) Try to continue a high-fiber diet and plenty of water.

2) Continue with Miralax powder (polyethelene glycol).

3) Avoid overthinking about constipation.

4) Go for regular walks and exercise.

Wishing you good luck for upcoming knee replacement therapy.

Hope this helps.

Thank you and take care.