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Julia Kizhner
Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience:  7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
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Highpertension(controlled),Pacemaker, and currently healthy and semi

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GASTROENTEROLOGY)Folks, I am 69 yr old male. Highpertension(controlled),Pacemaker, and currently healthy and semi-active. After quite a few combinations of medications, all seems fantastic except I am contantly constipated. I do not have a BM except every 5 - 6 days and considerable straining at that, and stool softeners have no or very little effect, which induced me to begin administering enemas avg twice weekly. Prior to this, my flatulations were mostly silent. Now they sound like a buzz saw, which indicates my anus has shrunk or tightened.
BTW, I only eat 1 or 2 small meals a day (mostly bran cereal and fruit) to keep my weight down. And Yes, I have tried Prunes, Prune Juice with no success.
MY EMBARRASSING QUESTION: Would it be advisable to purchase an "Anal Trainer" to enlarge my rectum, somewhat, that would possibly make my defecations more frequent and easier?

Thanks, James

Hello and thank you for your question,


Could you please tell me which stool softeners you have already tried?

Colace? Miralax? Have you ever tried a prescription medication called Amitiza?

Have constipation problems started after you started "dieting" or did you have constipation prior to that?




Customer: replied 5 years ago.
Ms Kizhner, I tried researching my records and cannot locate the names of med's I have tried. I know some were OTC. The Colace sounds familiar, but I don't think I have tried it, nor the Miralax. I have never tried Amitiza. Any drug I take has just about got to be generic or OTC. To answer your last question, I had periods of constipation prior to cutting down on meals. Within the last year I have lost about 45 lbs on my cardiologist's advice (from 215 down to 170 +/-) . I can remember my mother having to give me enemas when I was 8 - 10 years old, and that's why I started trying that. I know this is not much help, but I appreciate you trying to answer so far. Thanks, Jimmy

Thank you for your reply, Jimmy.


Well, before you go and invest in anal trainer, I think there are a few things you can try to help.

The problem that most people do not realize is that laxatives and enemas when used over a long period of time cause "bowel dependency". What that means is that your bowel will not want to move without having to take a laxative. This is why we do not recommend laxatives on regular basis.


You most likely tried Colace (also called Docusate). Its the most frequently used stool softener available over the counter. If you haven't tried it, I would start with Colace - each pill is 100 mg - start with taking 2 daily and may increase to 4 daily if necessary.

At the same time as Colace, try Miralax (get generic Polyethlene Glycol - much cheaper). Its a powder which you dissolve in 8 oz of any NON-carbonated beverage - tea, coffee, water, juice. It takes about 72 hours before it starts to work so don't give up after the first couple of days. Usually you use 1 tablespoon but the dose can also be increased (or decreased if you get diarrhea) if constipation and/or straining persists.


So you can use Colace and Miralax together and adjust their dose depending on how your bowel movements are moving.


If neither of these medications prove to be effective, you can discuss Amitiza with your GP. Amitiza is a relatively new medication (about 7 years old) and is the only prescription medication approved for chronic constipation. Your doctor may even have samples in his office. It is not a laxative so you do not form dependency to it. It is usually very very effective.


If none of these things help you, I would recommend you get a bowel transit study to see if you have a lazy colon but I think this is really premature at this point.


Congrats on weight loss. That's a great achievement. Most people who are in the process of loosing weight are constipated!!


Hope this is not too confusing and answers your question. Let me know if you have any other questions I can answer for you.

If you are satisfied with the answer, please do click 'Accept' button so that I may get credit for my work.


Best wishes and good luck,


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