Constipation due to a Traumatic Event/PTSD/Pelvic Floor

I can relate to your situation. I’ve been trying a lot of techniques to help the constipation, including daily exercise and healthy diet. While they have done much to help my health in general, I still have to take daily Miralax in order to go. Oh, I also see a therapist. And, may start Lexapro, though I feel it’s no longer needed. How does biofeedback ?

@45maleamerica Welcome to Mayo Clinic Connect where we can provide you with support.

I’m going to respond to the PTSD that brought about the constipation and pelvic floor problems that you are experiencing.

Are you already seeing a mental health therapist who specializes in trauma/PTSD? You certainly are doing all you can to address your physical health especially with exercise and trying medication. It hasn’t been all that long ago that you experienced the trauma that led to PTSD (1.5 years) and your description of how you are feeling now leads me to believe that it’s going to take some time to treat the PTSD.

Here is a website that explains PTSD and offers recommendations for treatment. The website is from the U.S. Department of Veterans’ Affairs however the information and recommendations are for anyone who wants to know more about PTSD.

PTSD: National Center for PTSD
— https://www.ptsd.va.gov/

If aren’t already seeing a mental health therapist and would like some resources for finding one, would you please let me know?

Hello @45maleamerica

I'd like to join @naturegirl5 in welcoming you to Mayo Connect. I see that you are working with your medical providers to get help for your digestive issues and @naturegirl5 has provided you with some good ideas for working with the emotional trauma that you experienced. Recovering from emotional trauma does take time.

Regarding the constipation problem, it is important to realize that it takes a lot of treatment options to keep this problem under control. Many of us who have issues like this take Miralax (or a different stool softener) on a regular basis as well as a fiber supplement (like Metamucil, Citrucel or Benefiber). In addition, keeping hydrated and exercise is also important. All of these treatments work together to help solve the constipation issues.

On Connect, there are other discussions on this topic. Here are links to some of these discussions:
--Does Anyone Have Chronic Constipation
https://connect.mayoclinic.org/discussion/does-anyone-have-chronic-constipation/
--Problem with Chronic Constipation
https://connect.mayoclinic.org/discussion/problem-with-chronic-constipation/

Will you post again?

Your PTSD has taken a really big toll on your body, I am so sorry for you. But, don't let anyone tell you that cuz of your trauma, your CIC is a psychiatric illness. My PTSD is from two recreational accidents 17 years ago, I am in no way comparing myself to you, just stating it's relevancy to CIC. I have other issues connected to my severe CIC. Mine has just gotten worse with time. I worry constantly about it. After 3 partial small bowel obstructions, one landed me in ER, then ICU, with the ng tube for 3 miserable days. And 4 episodes that required "digital removal ", by my own digits(finger), I keep my poop in constant semi diarrhea to full throttle diarrhea. We are all so very different yet alike from CIC, that we have to use the trial and error methods for any relief. I would say to really up your use of miralax and ask to get X-rays standing up and lying down. Possibly get a set before starting to increase miralax and then after you have been doing the miralax for awhile, possibly even to diarrhea. I have been doing the X-ray thing every 3-6 months for several years, it always shows (translated to physical proof for the idiot drs) that I have a mild to moderate to severe fecal load all the time. New GI is a good idea, but as you said, the drs really don't know what to do. I asked my GI of 17 years, how do they test and treat CIC if it's caused by a faulty ANS(automatic nervous system), his answer was, " if it is, I don't know anything about the ANS." That was a wake up call for me. Also, read about Hyperparathyroidism, it and the elevated calcium levels have many of the manifestations of CIC and mental health like issues. This is probably what has led to my almost zero motility. My colon simply won't contract, therefore it can't push the poop out. Shelley

Hi Celia,

The Lexapro did calm my nervous system but it hasn't had any effect in helping with going to the bathroom. Daily exercise, a healthy diet, (liquid diets) is what I'm operating on. My next step is biofeedback in the bucket list to try. Thank you for your feedback.

Hello Teresa,

Thank you for your insight it's appreciated.

I understand trauma/PTSD takes time and although I feel back to normal again that may not be the case for my nervous system/brain. Hard to say.

My primary physical has me on Linzess along with Miralax. I can't say I see a difference when taking Miralax daily but I'm sticking with it. Eating healthy and exercising is what I'm focus on for now.

Thank you for your feedback and I will take a look at the other threads you provided.

I do have a primary therapist but she doesn't specialize in bio-feedback. She provided a list of therapists that do and have reached out to several that could help. Unfortunately insurance doesn't cover this and a bit costly but feel this is a next step. Interested to know based on a therapist conducting biofeedback what can be gained from it?

** Something important to note I should have listed in the original thread. I am not able to feel when I have to go to the bathroom. After a large meal I should get that feeling like I have to go but I never do. The only indication is my stomach starts to push out causing discomfort which then I take a laxative. My brain isn't signaling to my gut/colon I have to go.**

Thank you!

I can relate to a brain-gut disfunction. I underwent Cognitive Behavior Therapy (CBT) Hypnosis for seven weeks. Gastro Psych in Burke, Virginia via telehealth. I saw Tina. She is experienced and made it work for me.

After seven weeks I can now induce a relaxed state, anytime. That helps my gut function properly as my brain impacts it so much.

The sessions are easy. All you do is relax and listen.

Changed my life -- that, and 150 mcg of melatonin at bedtime and a small dose of magnesium citrate twice a day.

I now have my mild PTSD anxiety under control. The connection is broken and it feels great.

That’s amazing. I’ll explore it for sure.

Possibly double your miralax, all in the morning, or am/pm. I have started adding it to diluted, sugar free OJ, I get tired of chugging it plain. Maybe do a trial when you can stay home, in case you get diarrhea. Good luck