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Physically active person with obstinate constipation

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Hi,

I have been having problems with constipation for over two years now.
I am a fairly active person. I bike to and from work every day (15 minutes each direction) and work out (weight lifting) four times a week.

First I tried changing my diet to see if that would solve it. I started eating more fiber via dark rye bread, whh made no difference.

For the last 6 months I have been on the paleo diet which means no flour, no rice, no pasta, no potatoes. This also changed nothing.

I went to the doctor who suggested I should try drinking more water. So I drank up to 5-6 liters per day, also no difference.

I was given laxatives which made the problem easier to manage, but still not ok. I was never able to completely empty my bowels. As soon as I stop taking the laxatives it is back to 0, it can go 4-5 days between my bowel movements.

I went to the doctor again, and they decided to perform a colonoscopy to see if anything was wrong internally, but they could not find anything wrong there either.

So I am running out of ideas. What can I try to get rid of this problem? I don't want to have to go through the rest of my life like this.

Category: Gastroenterologist, Medical

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Category: Hepatologist
 28 Doctors Online

Hello,

Thank you for posting your query at DoctorSpring.

Three things are essential for a good bowel movement in a normal person-
1. Adequate fiber
2. Enough fluids
3. Enough physical activity

You have taking adequate fiber, drinking enough fluids and is fairly active.
In spite of that if your bowel movements are not good, you need a thorough examination.

1. Check your blood glucose levels to rule out diabetes which is one of the common causes of chronic constipation
2. Avoid medications that cause constipation ( for ex. cough medicine).
3. Get a colon transit study done. (This can be reserved for later).

Colon transit study would show whether you have a slow transit constipation or a normal transit constipation. Further work up and treatment depends on whether you have a normal transit or slow transit constipation.


One issue that needs to be addressed is how good the fiber content of your diet it. Paleo Diet will not contain adequate fiber for sure.
Please see this list and calculate for yourself how much fiber you are taking in: http://www.mayoclinic.com/health/high-fiber-foods/NU00582
If not you should find ways to improve the finer content. And do track in grams.

Also make sure you are having a 'regular' toilet time. Avoid unnecessary straining and long periods in the toilet.

Hope this helps
Please feel free to ask followup questions.
Regards,
Dr.Ratnakar Kini


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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