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Army man with diarrhoea and costipation

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I have been having stomach and bowel-movement trouble for many years. It started as combinations of diarrhea and constipation and developed mainly as constipation (it would build up until I had stomach pains, and then I would need to use prune juice and the like to get things out and feel better for a while).

I went to a gastroenterologist and he told me to start using "Normalax", which did help. After a while I had to go to a second gastroenterologist (I was in the army) and she told me to stop taking Normalax and start taking a daily dose of Konsyl. This also helped, and I started having bowel movements more often. I'll also mention that I took two tests that came out clean (endoscopy and colonoscopy). However, in the last months things deteriorated (not too much, but still), and even though I do have movements (once every 2-5 days) it feels as though not everything comes out, that things build up a bit after each movement until a day comes (once in a week or two) that I have to have a "long sit-down" and then it's all better.

I was wondering if Konsyl has stopped working as effectively, and if I should do anything else. Also - it says in the directions on the box to mix the powder with 8 oz of fluid. However, in a separate section (not under "directions") it also says "Always follow with 8 oz. of fluids", and I never understood if I must A - take the powder mixed in with 8 oz. of fluids, or B - after the first 8 oz with the powder, I must take ANOTHER 8 oz. of fluids immediately after. I have been doing the latter, but would really like to stop if that's not necessary.

Any advice on my situation would be helpful!

P.S. If there are any good pills/medication to take for when stomach trouble happen (I usually take pepto-bysmol which sometimes helps and sometimes doesn't) - something strong that can really make stomach numb or relax, that would be great (I'd get a doctor here to give me prescription if needed)

Category: Gastroenterologist, Medical

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Category: Hepatologist
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Consult Reply By Dr. Ratnakar Kini. Additional inputs from Dr.Deepu Sebastian


Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

Konsyl is a good remedy for constipation. The right way to take it is to mix with 8 oz of water and drink it immediately. It should be followed by drinking another 8 oz of just plain water.

In addition to it, take high fiber diet, and drink plenty of fluids every day. Continue drinking prune juice. Always try to have bowel movement at a same specified time every day. Never try to ignore the urge to have bowel movements.

Sometimes when these measures are not enough for a good bowel movement, additional medications may have to be taken. One such medication is Lactulose. Polyethylene glycol is also very effective.



In addition to the drug you should make sure that you are following all the general measures to help bowel movements.

*High Fibre Diet - Please do some research on which all high fibre diet you can include in your diet (as dietary habits vary a lot).
*Physical exertion is also recommended, as it stimulates intestinal movement.
*Regular Timings for bowel movements.

You should follow these steps religiously.

The bowel problem appears to have a functional component to it. I would not call it IBS ( Irritable Bowel Disease ) but it sure has functional component to it, as proven by a normal Colonoscopy and Endoscopy. Konsyl is an effective drug and I do not think any other treatment option is needed now. Are you using the Pepto-Bismol for diarrhoea ? Because that itself can cause constipation. I recommend not using it (Dr.DS)

Hope this helps
Please feel free to ask follow up queries.

Patient replied :

Thank you for your answers.

I do try to eat fiber, and I do work out, so I guess I'll just have to make do with what's going on. The gastroenterologist I mentioned in my question actually did think it might be IBS.

If I decide to try "Normalax" again (Polyethylene glycol), should I stop using Konsyl, or is it OK to use both?

Also, I see Dr. Deepu Sebastian suggested not to use Pepto-Bismol. I do not use it for diarrhea, but when I have stomach aches, gas, nausea, etc. Should I stop nonetheless? And if so, is there another similar medication I can take at such times?


Yes, it might be due to IBS.
If you decide to try Normalax again, you can stop Konsyl.
But there is no harm in taking both.


Pepto Bismol should be avoided as might cause constipation as a side effect. You can get a prescription for Bentyl (dicyclomine) for occasional use.

Hope this helps
Thank you

Dr. Ratnakar Kini
Category: Hepatologist
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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