Constipation: What helps you?

Full disclosure, I haven’t skimmed through all the posts so this may have already been mentioned, but have you been evaluated for pelvic floor dysynergia?

I thought of it because you mentioned you’ve tried many medications but haven’t had relief.

With pelvic floor dyssynergia, the problem is a lack of proper coordination with the muscles when you’re trying to have a bowel movement. Instead of relaxing or contracting as they’re supposed to, it does the opposite, literally causing a physical back-up. In that situation, no amount or laxative is going to work because there’s no way for the stool to exit.

I have mild pelvic floor dyssynergia. A GI doctor would know of this, but it’s not top of mind for everyone or they write it off as IBS. There’s a test called pelvic floor manometry but it feels kind of invasive and it’s not good for trauma survivors. Instead, I was evaluated by a pelvic floor physical therapist (which does require a physical exam), but she was able to treat the condition, help me retrain the muscles, and teach me other strategies to help with constipation. My case was mild, so we relied more on the other interventions, but I got much more out of working with her than a doctor.

The other thing that popped into my head was methane-dominant SIBO, which causes constipation. I’ve had that too.

I talked to the colorectal gastroenterologist about the muscle issue and she said she thought I had good muscle control. She’s examined me twice. But, I have no issue being evaluated. I think I have good pelvic floor coordination. Plus, as I mentioned earlier, the constipation hit suddenly. No problem at all for years, the suddenly nothing. Not like a slowing down thing. Plus, I did have 3 perfectly normal BMs in every way a couple of months ago, so I know I’m capable. Muscles worked fine.

I will request them to test me for SIBO. That hasn’t been mentioned by any of the doctors. I feel like it’s up to me to come up with the answers.

Wishing you luck. Unfortunately, with a lot of these chronic conditions, I think you’re right and it comes down to us to sort things out, or at least to keep pressing for answers.

One other thing that has consistently worked for me are magnesium citrate supplements. I started with 150 mg before bed, but it didn’t seem as effective so I added another capsule for 300 mg, and that usually helps.

I talked to the colorectal gastroenterologist about the muscle issue and she said she thought I had good muscle control. She’s examined me twice. But, I have no issue being evaluated. I think I have good pelvic floor coordination. Plus, as I mentioned earlier, the constipation hit suddenly. No problem at all for years, the suddenly nothing. Not like a slowing down thing. Plus, I did have 3 perfectly normal BMs in every way a couple of months ago, so I know I’m capable. Muscles worked fine.

I will request them to test me for SIBO. That hasn’t been mentioned by any of the doctors. I feel like it’s up to me to come up with the answers.

For the past 10 years, I have had severe constipation problems. I tried many medicines, and I have gone through 3 times endoscopy but discovered nothing. From 2015 till now my constipation problem couldn't be solved. To make it worse now I'm having multiple internal haemorrhoids due to this constipation. I don't know why I'm having this constipation problem.Many people suggested many things like changing diets, taking a lot of fibre intake, reducing stress, quit smoking. I burp a lot and do have acid reflux as well but now it is getting better. What is the best solution for my constipation?

Oh, I forgot to add that I also take a probiotic. Doesn’t seem to matter. I hadn’t actually considered that what I have now is as good as it gets…..hmmm…..man, that’s a hard pill to swallow. I think I’m capable of my normal BM, since I had 3 of them a couple of months ago. They happened right after I first took Lubiprostone. Sadly then it did nothing. So, I’m hoping Linzess will help.

I guess I need to make a list and try everything I haven’t tried yet.

What I find striking is that my constipation happened suddenly. All was well and bam! Nothing. Out of no where. So bizarre.

Yes, Celia16, that is super bizarre. I have heard that gluten-free products and dairy-free products, with all that gum of various sorts in them, can be constipating. Also, I know melatonin can be too. Coming on out of "nowhere" makes me think it is a medicine, supplement, or food item. Lack of sleep or stress also doesn't help.

Good luck! You will find what works for you 🙂

I’m going back to the time it happened and preparing a list of everything that occurred at that time, such as meds, diet, stress, etc.

I’m fortunate I recall the first morning I didn’t go. It was after a concert the night before. I was at a friend’s house. I had a light dinner tailgating the night before in the parking lot before the show of low carb fare, because my friend has type 2 diabetes and was taking Ozempic. (Cheese, turkey, olives, celery, etc.) Prior to that evening, my diet was normal. I’m type 1 diabetic and at that time ate normal diet. Not low carb. I had to take laxatives to go after that and it was brutal. I soon got a thrombosed hemorrhoid and that was one of the most painful things I have ever experienced. I mean severe and constant. It eventually burst in the Urgent care office. So, when I sound terrified of constipation, it’s mainly my fear of another thrombosed hemorrhoid. That has to be avoided.

Since I have type 1 diabetes, I have also considered gastroparesis, but my endocrinologist and several gastroenterologists say I don’t have that. Apparently, my muscles do work, because I do go every day, but only with the Metamucil and Miralax. I’m told neither are laxatives. So, it’s actually me that’s making it work.

That "flipping of the switch" change in your gut sounds like a dietary enzyme problem, based on my body doing the exact same thing several times (with different enzymes deficiencies).

It is a case of "all of a sudden, wham"!

It could be protein or fat enzymes (or carbs) and is easy to check by purchasing a relatively inexpensive pancreatic enzyme supplement.

I use the Pure brand Pancreatic Enzyme Formula based on the good Amazon reviews, but a few other brands of the same get good reviews too.

Dealing with protein and fat digestion is the icing on the cake for me, as my largest deficiency is in the carbohydrate area (and I take other enzymes for that).

I would try the pancreatic enzyme route (even if, like me, you don't have the symptoms of pancreatic insufficiency). Even if it helps a bit, that is something to consider and build on.

Also, I am sure you know that Type 1 Diabetes causes constipation for some. There are several studies on it, posted on the NIH website. So just Google "NIH diabetes constipation" and take a read.

Thanks for the info. I have read that my faulty pancreas that no longer produces insulin, also doesn’t produce proper digestive enzymes. So, I’ll bring that up with my doctors and try those enzymes you mention.

I’ve never heard Type 1 causes constipation, but could be. I’ve had type 1 for over 20 years and have dealt with constipation only since June 2022.