Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
You are obviously constipated.
Since there are risk factors or precipitating factors, you probably are having functional constipation.
It can be a normal transit or a slow transit constipation.
To know what type of constipation you have which will help to plan the treatment, you need to undergo a colon transit study.
You can consult a gastroenterologist for this test.
Meanwhile you can take fiber supplements like metamucil.
I hope that answers your question.
Let me know if I can assist you further.
Patient replied :
Dear Dr. R. K. If constipation is defined as “Accumulation of hard feces in the descending colon and all the way down to the rectum”, then I may say “I am not constipated. You may be right if my definition ifor constipation s not correct. I mentioned in my earlier message that the lower part of my stomach is always empty, and shrinking inward. After a prolonged period of no use of laxative, the small amount of feces that comes out is quite soft, and unlike the hardness that characterize constipation.
I found the following defenition on functional constipation, and only item #6 that may apply for my case:
Rome III Diagnostic Criteria for Functional Constipation
Must include two or more of the following:
1. Straining during at least 25 percent of defecations
2. Lumpy or hard stools in at least 25 percent of defecations
3. Sensation of incomplete evacuation for at least 25 percent of defecations
4. Sensation of anorectal obstruction/blockage for at least 25 percent of defecations
5. Manual maneuvers to facilitate at least 25 percent of defecations (e.g., digital evacuation, support of the pelvic floor)
6. Fewer than three defecations per week
7. Loose stools are rarely present without the use of laxatives
8. There are insufficient criteria for irritable bowel syndrome (IBS)
Please let me know if you still believe it is a case of “Functional Constipation”
Thank you, Sir.
Your definition of constipation is not correct. Constipation is not having bowel movements, difficulty in having bowel movements, passing hard stool, straining during defecation, feeling of in complete evacuation, ( Any one of these). Since you have relief with laxative, what you have is constipation. And since you do not have risk factors, what you have is functional constipation.
And suggested earlier, the next step is to get a colon transit study done.
Feel free to discuss further,
Patient replied :
Thank you very much Dr. R. K.
Your advise is truely of great help to me. I will follow your recommendation and I shall see a gastroenterologist for a test, and take forward from there.