Q. Does chronic constipation lead to prostatitis?

Answered by
Dr. Gopinath
and medically reviewed by iCliniq medical review team.

Hi doctor,

I am 27 years old. I have been suffering from bladder and lower back pain for about six months now. I have been to the doctor several times and each time the test was negative for infection. I used to get relief from symptoms once I take the antibiotics, but the pain will recur.

I do not have frequent urgency to urinate. My urine is clear, and there is no burning sensation associated with urination. I suffer from chronic constipation, and my primary physician feels it might be from stool backed up in that area and prescribed me Linzess. I have been taking for two days and still have back pain. The pain never gets unbearable, usually a level 2-4 on pain scale.

After all research, I feel it may be prostatitis. I am terrified to see a urologist in fear of rectal exam as I have a phobia of this. I had several blood panels done, kidney and liver function tests everything is perfect. My x-ray indicated lower back spasms and backed up stools. No kidney or bladder problems. I am becoming very upset because I read there is no effective way to treat non-bacterial prostatitis. Is there a way my urologist can test for this without a digital rectal exam? I also have some dull testicle pain from time to time. This is becoming such an annoyance and ruining my daily life. Any help will be thoroughly appreciated.

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Dr. Gopinath

MBBS., MS GEN SURG., DNB GEN SURG., MCH UROLOGY
Urology

Hi,

Welcome to icliniq.com.

As you suspect the symptoms might be due to chronic prostatitis or a similar entity chronic prostatic pain syndrome. It needs a per rectal examination. Per rectal examination is not that painful as you suspect.

Urine culture after a per rectal examination will turn to be positive if it is chronic prostatitis. It needs a 4-week course of Trimethoprim, alpha-blocker drugs, and anti-inflammatory drugs. It has to be treated with Trimethoprim or Levofloxacin.


The Probable causes:

Secondary to UTI (urinary tract infection).

Differential diagnosis:

Chronic prostatic pain syndrome.

Hi doctor,

My urologist after check up suspects prostatitis and prescribed tablet Augmentin XR 1000 mg two tablets twice daily for 14 days. He would like to rule out any potential infection. Should I be worried taking such a large dose of such medication? I feel that 4000 mg a day is very high. I was originally given Cipro but had horrible side effects. Please let me know your professional opinion regarding the prescription given and should I take the tablet as prescribed? Thank you.

Dr. Gopinath

MBBS., MS GEN SURG., DNB GEN SURG., MCH UROLOGY
Urology

Hi,

Welcome back to icliniq.com.

My personal opinion is that you may need Tablet Trimethoprim 100 mg twice a day for six weeks. Only two groups of antibiotics penetrate the prostate well. One is the Ciprofloxacin group of drugs and another is Trimethoprim.

Augmentin may not be helpful for this prostatic infection. Augmentin is a combination of Amoxicillin and Clavulanic acid. It is a chronic infection and keeps recurring sooner or later. Hence a prolonged course has a high chance of eradicating the infection.

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