Dr. Babu Lal Meena
Medical Gastroenterology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have gas problem and bloating after I eat any normal size meal. I have struggled with constipation for years, but paid very close attention to that issue. Currently, it is not the problem. I have had colonoscopy and stool tests and they were fine. I did have colitis back due to use of antibiotics but have had no problems since then it was clear with medication. Before 16 years, I had ruptured disc L5-S1, which caused me to have emergency surgery and an acute onset of cauda equina syndrome (CES). The CES caused problems with my colon, rectum, bladder and sex organs. All areas have improved over time, but they are not normal, I also had nerve damage. I have tried everything over-the-counter, all kinds of probiotics, supplements, peppermint tea, but nothing helps. Please advice.
Hi,
Welcome to icliniq.com.
These kind of problems are very common due to our dietary habits and sedentary lifestyle. Sometimes it is due to deficiency of enzymes also, this is uncommon and the main factor is lifestyle.
The syndrome of bloating and constipation is known as Irritable Bowel Syndrome (IBS). This is a very common problem and involves around 10-30%of population. Stressful lifestyle also causes such problem. You already have one stress due to chronic illness.
The management is very simple, it includes avoidance of fatty and spicy meal with plenty of water, regular exercise and alleviation of tension.
Treatment of constipation is the key to get rid of these problems. Most of the time it improves after adequate management of constipation. We need to take high fiber diet along with fiber supplement and some laxatives may be needed for short term.
The Probable causes
Investigations to be done
Treatment plan
Patient's Query
Hi doctor,
What is the brand name for Methyl cellulose?
Hi,
Welcome back to icliniq.com.
This is easily available in the name of Citrucel, Citrucel-SF. Kindly take the advised medicines from your doctor and follow the general measures.
Patient's Query
Hello doctor,
I have followed all your directions given for relief of gas and bloating. My bowel movements are good now. However, the stools are coming more frequent, but it is still dry and hard to pass. This is probably the reason for gas and bloating, unless I do not eat. I quit taking charcoal as you said and drinking lots of water. Is there anything I can try to soften the stool? I have tried all kinds of stool softeners, but they just seem to cause more gas. I have normal movement when my period starts and I feel great for a day or two, but it will be back to the same old situation then. The constipation was not so chronic before, but now it is constant. Thank you for your time.
Hi,
Welcome back to icliniq.com.
It is good to know about the improvement of your health status.
Since you said that you have pellet like hard stool, it seems that your bowel is loaded with a lot of pellets like fecal matter. Now, we should change the therapy.
We have to give stool softener in the form of Polyethylene glycol and stop the rest of the medicine.
I said previously also that charcoal cause bloating and excessive gas formation and you should stop it.
The Probable causes
Treatment plan
Patient's Query
Thank you doctor,
Can you tell me where I can get these products?
Hi,
Welcome back to icliniq.com.
This product is easily available on the pharmacy and get it prescribed by your doctor.
Initially, you need to take 0.8 to 1 ounce per day. You can increase it if the response is not good or decrease in case of excessive response according to your doctor's suggestion.
Treatment plan
Patient's Query
Thank you doctor,
The MiraLax worked and you were correct that there was a lot of of dry hard stool. Finally, my stool was normal. So I went off MiraLax about six days ago. The stool became hard and dry again and so I have gone back on the Miralax. Is it fine to stay on the MiraLax? I have heard if people take laxatives for long term, then the laxatives will not work for them. I do not know what I would do if that happen. My hope is that one day this issue would go away. I guess it has something to do with the nerve damage from my back issue. I have had this chronic constipation issue since I got back injury and sudden onset of cauda equina syndrome. I had on and off constipation sometime before the back issue. The gas, bloating and horrible feeling are gone as long as I have the regular bowel movement every day. Shall I stay on MiraLax for the long term?
Hi,
Welcome back to icliniq.com.
Although, there was no doubt about the efficacy and accuracy of treatment, it is good to know that you got benefit from this regimen.
We have discussed previously that this should be continued for a long time and not to be stopped rather than it should be continued to decrease in the dose. It is not true that it will lose effect.
You had loose stools because initially stool was too hard and you need more dose of this substance to clear it. Once stool became softer you need to decrease the drug to avoid loose stools.
Although you have some nerve injuries, the treatment will be the same in this case. You continue with the same treatment and titrate the dose accordingly, but do not stop. After a few months, we will shift to lower degree laxatives.
Treatment plan
Preventive measures
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Medical Gastroenterology
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