Hi all, I've had problems with constipation ever since I was a child. I'm now in my mid 20s and have been to the doctors countless times regarding my constipation. My latest appointment, the doctor said I have slow bowels because my stools are always on the severely constipated end of the stool chart and because I've always had this problem. They want me to do a ttj blood test and I'm currently doing a food diary too.
Fibre supplements help a little, but I will end up having to take laxido when I feel I'm getting backed up because I never feel empty after having a bowel movement.
I did ask about being referred to a gastroenterologist but the doctor said "what do you think they'll do? There's not much we can do"
I feel I might have ibs-c but no one has actually said I have xyz apart from slow bowels. Is there actually anything the doctors can do for my chronic constipation apart from just prescribing me laxido?
Any advice would be greatly appreciated, thanks!
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Violetskyss
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Have they done a y tests? IBS can only be diagnosed after ruling out everything else. I was told I had IBS for 12 years before finally being diagnosed with celiac disease
I also have chronic constipation since being a child, I was diagnosed with IBS and the GPs just prescribed meds for it like they have for you. You probably won’t get much help from the GP, however I agree that they do need to rule out other conditions like coeliac as if you start making dietary or lifestyle changes to help your constipation they might not detect underlying conditions if you have any.
After years of trial and error I manage my constipation with a combination of different approaches but if I go off the routine, travel or I’m really stressed it can come back. Here is what I find helpful:
1. Probiotics - symprove every morning on an empty stomach for the past 4 years
2. Chia seeds and flax seeds for breakfast every day as they’re full of fibre and draw water into the bowels
3. Kiwis every day - very good for constipation
4. Magnesium supplements - oxide or citrate
5. Exercise - if I’m inactive it gets worse
6. Free soul greens powder in water - it has chlorella and lots of other ingredients that help digestion
7. Avoiding fatty foods that empty the bowel more slowly
8. I don’t eat gluten as it doesn’t agree with me
9. Warm baths help with constipation as they relax your muscles and stimulate peristalsis
10. Peppermint tea in the evenings after dinner
If none of the above is working (it’s not right now for me due to pregnancy hormones) I take fybogel twice a day. I also tried a colonic years ago which I found excellent (do your own research into this as there are risks and you’ll need to find someone you trust) and lymphatic drainage massage. I’ve always wanted to try acupuncture but haven’t yet, I’m sure it could help!
If you have very high progesterone levels it can slow the bowels down so if you notice it’s worse at certain times of the month consider testing your hormones. Hertility do a good at home kit. If you’re on the progesterone only pill consider switching to the combined pill.
Things I tried that I didn’t find helpful were digestive enzymes, aloe vera juices, cheaper probiotics in pill format (most of them are destroyed by stomach acid and don’t reach the gut alive), oats (made me worse)..
It might take a while to figure out your routine but you’ll get there eventually! I was in your position for years and it was very frustrating but don’t give up. Try and get a coeliac blood test done before changing your diet and push for a gastro referral. If your GP is unhelpful get a second opinion from a different GP. There are guidelines that they should be following for investigating your constipation cks.nice.org.uk/topics/cons... so brush up on these and let your GP know you expect them to follow these, if they don’t you can make a complaint!
Thank you so much for that. I was tested for celiac years ago which was negative but I have another blood test for it in a few days. I've also done stool samples and things like ibd were ruled too but I'll push for a referral to a gastroenterologist
Hormones, I do have endo and am currently on depo for that so idk what my progesterone is like. I have considered fybogel tbh. Is it good for long term use?
Endo could definitely be causing constipation if you have endo tissue on your bowel! I think it’s safe enough to use fybogel long term but double check with your GP as I’ve only used it for a few months at a time. If you look at the endospectrum’s Instagram account she has endo and constipation and she shares loads of advice and is training to be a menstrual health coach
To improve constipation in the short term you can try ground flaxseed on your breakfast, starting at 1 teaspoon and increasing at 1 teaspoon every 2-3 days - you'll need to consume extra water with it.
These foods are also high fibre:
8-9 Prunes
2 tablespoon chia seeds (soaked for 10-15 mins in milk or non dairy milk with cereal or water)
Shredded wheat (or if GF: Nutribrex)
60g Quinoa
Wholewheat bread
75g Whole grain pastas (if GF: Buckwheat)
2 Hard pears
5 Dried apricots
90g Raspberries
1 orange (contain a natural laxative)
2 kiwi.
I find that I need to have 1 orange or 2 kiwi a day and then another high fibre fruit later in the day to help with BMs. Introduce new foods and any fibre increases slowly, starting with one new thing at a time, waiting for 2-3 days for a response and keep a food diary. You may not need to consume as much fibre as I do.
For breakfast I make a porridge of 4 tablespoon of oat bran and 4 tablespoon all bran (wheat bran), 2.5 small cups of water and microwave for 10 mins. I then mix in 2 tablespoon of chia seeds and 1 tablespoon ground flaxseed and leave to stand for 15-20 mins since the chia seeds need to form a gel. On top of that I place 8 prunes and eat. The best thing to do is to start with normal oats in similar quantities and, if needed, replace one of the tablespoons of oats with oat bran for a couple of days, carrying on doing this every couple of days until you get to 4 tablespoon of oat bran and 4 tablespoon of oats. Then start replacing with wheat bran in the same manner. You can then add the other ingredients one at a time. You might find you do not need the complete 'recipe' to have a BM. All these individual components are down to tolerance e.g. you may not tolerate wheat (see later about Alflorex), so it is best to keep a food diary (I do this on a spreadsheet) recording symptoms for up to 2-3 days after each change.
I also take 30 drops of ginger extract before bedtime to aid motility. You may need to work up the dose to say 7 drop increments each night.
Exercise can help with BMs. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving.
You need to ensure that you are drinking enough fluids (2 litres of fluid per day).
There is some good advice about constipation here:
There are also medications that help IBS-C (constipation dominant IBS). I suffer from IBS-C and have been prescribed Linaclotide for it. I also take Alflorex probiotic which has made me more tolerant to taking in the extra fibre I need for a BM.
Failing dietary measures, you can try Optifibre, which needs to be worked up to a dose according to instructions. You may not need the full dose - watch out for gas and increment to a level that is acceptable for you.
Some people are more prone to constipation due to their intestinal anatomy. Through colonoscopies I have been told that I have a long loopy (redundant) colon. This means that food takes longer to pass through and in the mean time the intestines have more time to suck out water from the stool, drying them out and causing constipation. I have found that I need to consume much more fibre than other people to have regular BMs.
I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly. I also find the larger meals help to push things along better than drip feeding through snacking.
“It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach.”
Is not actually true, I have an ileostomy meaning that my small Intestine empties into a bag instead of the colon but what anyone with an ileostomy will be able to tell you is that every time you eat it causes the small intestines to empty and it’s the same for people without an ileostomy each time you eat it actually stimulates the small intestines and causes them to empty into the colon…….Sorry I just wanted to bring this to your attention as I’ve noticed you have made that comment a couple of times of different posts and it’s not actually true the more you eat the more your small intestines will empty.
The migrating motor complex (MMC) is a cyclic, recurring motility pattern that occurs in the stomach and small bowel during fasting; it is interrupted by feeding.
From this article, there are multiple mechanisms for moving food through the intestines of which the MMC is one. Perhaps I need to rephrase it as:
I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. Additionally, there are a number of mechanisms that help propel food through the intestines. One of these mechanisms is something called the MMC (migrating motor complex) which sets off 'cleaning waves' that sweep food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly and could hinder this 'cleaning' activity. I also find the larger meals help to push things along better than drip feeding through snacking.
Would this cover it? The MMC does exist, it's just a case of correctly wording it to show that it has a specific function. I need to get it right since I am putting together a website regarding IBS and this is a very small part of it.
Oh wow that’s really good that you are putting together a website well done you turning something negative into something positive and yes that does sound better and you are right big meals do really kick it off I just have to be careful not to eat anything even something small before I attempt to change my bag otherwise it’s a 💩 show because it does active it so I would never do it after eating.
Good luck with your website and well done it sounds like you have been doing a lot of research!!!
Thanks so much for your input. I have made a note to update the website with this extra detail. I am trying to get things as accurate as I can including using references everywhere. You feedback has been really helpful.
In addition to all the excellent ideas mentioned here I'd also suggest looking into measures to increase vagal tone/stimulate the vagus nerve. This might be helpful ....
I sympathise with your situation. I developed IBS-C a while ago but my constipation has now resolved. There are some individuals who seem to suffer with longterm, intractable constipation , which appears to defy the usual measures! I agree with the suggestion that you try Alflorex- Japanese studies have shown that the Bifidium strain has helped over 65 years old patients with constipation.
I also agree with suggestion of Linaclotide which comes in two strengths, the lower one for constipation, but the dose might need to be increased.
The usual measures, of which, I am sure you are aware, seem not to be effective.
You could try Magnesium Hydroxide longterm which my consultant suggested but it’s alway better to achieve normal stool frequency more naturally.
You might ask your GP to prescribe Linaclotide, although his prescribing budget, or clinical therapeutic armamentarium, might be constrained, so it would then be appropriate to suggest secondary referral so that the hospital might approve the prescription of this drug.
I’m sure hypothyroidism has been excluded, given the longevity of you suffering this distressing symptom.
Herbal remedies might also work but you need to find a reliable herbalist. I would also include homeopathy as possible avenue of approach. I was converted some four years ago, having thought it was complete quackery!
I've been constipated and had diarrhea for a few years, I have ibs and get constipated mostly. I tried probiotics and found they made a big difference. I also take fybogel husk twice a day. I exercise regularly and eating a lot of fibre. I don't take laxatives much now only occasionally
After many test back and forward to my GP i finally got to see a gastroenterologist . I took an a4 list of what i tried and what worked which was really nothing. I now take linacoltide 1st thing in the morning and 3 tablets of amitripltyine at night. I also only have breakfast and an evening meal and gone lactose free, gluten free. And cut out alcohol completely. This has greatly helped with my constipation i now have a BM every other day. I was also referred to a pelvic floor specialist and she suggest a rectal irrigation i tried it but found it too fiddly . Push to see a gastroenterologist.
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