I am constipated and have stomach cramps after taking laxatives. Why?

Hello,

Welcome to icliniq.com.

The senna is used in treatment for constipation. They are irritant laxatives, meaning they irritate the gut, cause cramps, and thus pass stools. So cramping, diarrhea, bloating are common side effects. However, they usually do not last for more than three days of their last use. Persistent symptoms of constipation and cramping suggest there is probably another problem going on within your bowels. To tell you the seriousness of the situation, I need to know more about the existent information you just shared. Plus, there are specific other questions to establish the primary cause of your constipation.

• Do you have any weight loss?
• Any family history of colon or rectum cancers or abdominal cancers?
• I understand that you started to have this problem this year, but do you have constipation issues from a young age as back as you can recall?
• Do you notice that the pain you describe changes in intensity after you pass gas or stools?
• I understand you had hard stools in the past, and with abdominal cramping, do you still observe hard stools regularly? How many bowel movements you have in a week?
• Do you require to sit for 30 minutes or so before you able to pass stools?
• Do you ever use a finger to impact stools from the rectum manually? or used self enema?

Now in your age, there are some common causes of constipation. Given your history, the highly likely possibility is Irritable bowel syndrome ( IBS). Which is a nonserious condition, does require targeted medicinal treatment, and symptoms often go away. However, this is simply a hypersensitive gut that tends to become constipated and causes pain, which remains and tends to have an on-off course during life.

Lack of fiber in the diet, lack of regular exercise, and decreased water intake are other essential components, common but overlooked. If you have any problem with that, the correction of that will solve your problem.

Lastly, there is a set of another disorder called pelvic outlet obstruction. Or dyssynergic defecation or obstructive defecation (defecation= passage of stools). In this, there is a paradoxical contraction of the anal canal muscles in response to the urge to pass stools. Usually, it should relax and allow stools to pass quickly. With the above set of questions, I would be able to differentiate among these common causes of constipation in you and would be able to suggest you my recommendations specifically. The blood tests and CT (computed tomography) scans often come normal among these conditions and require more targeted investigations to confirm it. However, the tests are not usually needed, and in most part, the diagnosis is easily established based on the answers to the above questions.

Hello,

Welcome to icliniq.com.

Thank you for providing more information.

The pelvic pressure can be due to stored stools within the rectum. The location you describe is entirely consistent with that. We often see some degree of pain with dyssynergic defecation or obstructive defecation, or anismus. Your number of bowel movements seems to be fine. I suggest you some testing and some symptomatic treatment for it. Basically, to soften the stools and relieve your symptoms of unsatisfactory emptying of the rectum. I would give you laxatives. But they are a different medication class that hopefully would not disturb your gut except to cause normal bowel movements regularly. Polyethylene glycol sachet 17 gm. Two sachets twice daily in a glass of water. I expect that you would have bowel movements after six to eight hours of taking this. You should have two bowel movements for now with soft stools.

Take this for a week, and let me know how you feel symptoms.

Find the investigations below.

• Increase your water intake up to two to three liters in a day.
• Increase fiber intakes like whole wheat bran, brown bread, fruits, and green leafy vegetables.
• If not possible, use Fibrocol (Psyllium husk) or Ispagol husk two table spoon full daily in the night with water.