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Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4761
Experience:  Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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I have a history of gastritis, dispepsia and sluggish bowel

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I have a history of gastritis, dispepsia and sluggish bowel and have experienced changing bowel habits the last few years, currently (2 mos) afflicted with constipatioon in the form of large sized and hard stools, causing repeated pain or discomfort at the outer point of the rectum. The sort of thing Prep H is normally prescribed for. (Stools are usually on a daily basis and of adequate volume.) Fissures is one affliction it seems to match. I have tried supplements such as Miralax, Senecot,Docusate Sodium, Fiber-con internally and Prep H externally but nothing seems to have a lasting effect. My doctor prescribed Miralax. Three days of relief only. I hesitate to become chronic user of any of these due to warnings on the product. The hardness and size (diameter) of the feces seems to be the main problem. What else can I do to get relief.
Should perhaps mention general problem began two years ago when I experienced multiple, voluminous stools daily accompanied by considerable hunger; this situation begain together with my starting doxyccyclene for a skin issue; gradually eased over time and is now essentially normal (daily stool, usually mornings). My diet is fiber rich and I drink liquids regularly but probably not enough; I also have enlarged prostate which can complicate urination frequency. Question: What else can I do?
Submitted: 2 years ago.
Category: Medical
Expert:  Internist replied 2 years ago.
Hello,

Altho you have tried parts of this regimen, it works for most of my patients. You must try to avoid stimulant laxatives. Give this regimen a chance. It takes time.

I will recommend a regimen for you to try to get you to have one or two normal bowel movements a day. The first approach is to increase fiber and bulk in your stool. If this fails, then you must go on to stimulant laxatives or other agents.

First, to increase the bulk in the stool, you must take fiber every am. ie. bran, bran cereal, bran muffin. Also 2 salads a day and ample fruits and vegetables. (avoid gas forming vegetables such as beans or broccoli, cabbage) Psyllium agents such as Metamucil, Citrocel, Konsyl, Hydrocil, Perdiem 2-4 heaping tablespoons a day should help increase the bulk in your stool. You may instead want to try Fibercon, 6-8 capsules a day.Also try Colace (stool moisturizer). Start slowly and increase the amount every day to avoid side effects of gas or bloating.

Try to train yourself to have one or two movements a day by sitting on the toilet the same time every day.

Probiotics, like Activia, will help.

Make sure you don't have hypothyroidism as this can affect bowel movements.

I have found this works for most of my patients after minor adjustments you must make yourself. Let me know how you make out after a few weeks. This takes time and does not work overnight.

You can use Miralax on a short term basis or an enema if you are really
uncomfortable.

Ask your doctor about Amitiza which is a relatively new drug.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000384

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Customer: replied 2 years ago.

My stools are of substantial volume and generally daily. My problem seems to be hard and large feces matter which harshly irritates the surrounding body material, particularly at the outer points of the rectum. There is a burning sensation as the stool matter passes and the pain at the end can linger, particularly noticeable when I suddently get up or sit down. Do I have symptoms of hemorroids? Should I also utilize sitz baths? Or Prerparation H? I don't feel the need for a stimulant laxative, rather something regarded as a stool softener would seem good.

 

Can you give me any advice on what is the likely cause of the problem? Are the changing bowel habits over time important now? Does it seem like something that should go away with temporary use of a particular supplement? If a supplement seems to be working should it be continued indefinitely? Labels seem to suggest avoiding long-term use or any type of addiction.

 

Appreciate your advice. .

Expert:  Internist replied 2 years ago.
You have either a fissure or internal hemorrhoid. Steroid suppository or cream will work for either. Colace is a benign stool softener which can be used indefinitely.


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Customer: replied 2 years ago.
Helpful. Thank you. I remain curious about the cause(s) of my current problem and whether I cam expect further changes in boiwel habits, voluntary or involuntary. Also remain curious are a periodic sitz-bath or Preparation H useful in gaining relief or cure, and should they be used in conjunction with Colace?
Expert:  Internist replied 2 years ago.
The cause is the hard stool and the Colace can be used. Sitz baths will not be helpful for internal problem.


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Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4761
Experience: Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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