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Chronic constipation and fear of using Senna

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I have constipation 6 years before. I am 24 female 40 kgs height 147cm. I eat fruit and vegs and drink water as much as I can and all I get is bloating. Please help. I have no medical history just normal . I use senna laxative I am afraid its harmful. I went to a a physician once he prescribed normacol plus it worked perfectly but I couldn't continue its hard to eat.

Category: Family Physician-GP

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Category: Hepatologist
 27 Doctors Online

Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

You have mentioned that you had constipation 6 years ago. You have not mentioned whether you still have constipation. You can continue eating fruits, vegetables and drink lot of water. If you are still constipated in spite of these, you may consider taking fiber supplements like metamucil.
Bloating can occur due to many different reasons. It can occur due to gut infection, malabsorption, gastroparesis or even as a side effect of increased fiber intake. If bloating is bothersome you may consider taking prokinetic medications like levosulpiride 25 mg three times a day, probiotics, digestive enzymes and decrease the intake of fiber supplements. As gastroparesis also cause bloating , you need to get your blood gluocose level checked , as diabetes is one of the common causes of gastroparesis.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.


Patient replied :

Yes i still have constipation it started 7 or 6 years ago. Family doctor once gave me duspatalin before meals 3 times a day but it only worked for gas problems. It did nothing to the constipation. And one other time I tried magnesium capsules as I read it helps constipation and it did not help at all. I want to know why duspatalin and magnesium didn't help ? If they did not help, will levosulpiride 25 mg three times a day, probiotics and digestive enzymes all together help me? Will I be able to increase levosulpiride to 75 mg three times a day? When should I feeel an improvement? When to stop the plan? Regarding the probiotics and and enzymes what the correct time to take them night/morning/before/after meals?


Hi,

Thanks for the follow-up.

Duspatalin is an antispamodic medication prescribed for abdominal pain. It is also prescribed for irritable bowel syndrome. It is not a medication for treating constipation. That is why you did not get relief.

It is difficult to say why you did not get relief with magnesium.
Levosulpiride, digestive enzymes and probiotics will help to relieve abdominal bloating, The maximum dose of levosulpiride is 75mg. So you cannot increase it to 75 mg three times a day. You will find relief from bloating from day one itself. You can take it for 4 weeks.

For constipation, you can take metamucil or miralax.

I hope that answers your question.
Let me know if I can assist you further.

Regards,
Dr.R.K.


Patient replied :

What about Linzess? Why I can't treat constipation and be normal like everyone else? Normacol,metamucil or miralax are painful , exhausting to body and tastes bad. I just do not need something to make constipation gone day by day I want to go to toilet regularly. The main question how to cure constipation for the rest of my life


Hi,

For a good bowel movement, you need to take adequate amount of fiber and drink lot of water.
Metamucil and miralax do not make bowel movements painful. If bowel movements are painful, then fissure in ano should be ruled out.
Topical diltiact, sitz bath and fiber supplements should be helpful if there is a fissure. Sometimes you may require surgery to treat it.
Good physical activity. lot of fluids, high fiber diet and fiber supplements/laxatives ( metamucil/miralax) is how we treat constipation. If these are not effective, then newer medications like lubiprostone may be taken. You can discuss with your doctor about this medication and for prescription.


Thank you


Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
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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