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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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I hadnt had a bowel movement for 5 or 6 days. I felt the urge

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I hadn't had a bowel movement for 5 or 6 days. I felt the urge to go to the bathroom now because I have had minor to moderate abdominal pain for about 6 hours and also felt the urge to go as well. However, when I went to the bathroom, it was very hard and little came out. What should I do now? Does this warrant a trip to the emergency room?

Ken :

Hello

Ken :

I am Dr Ken and I will be helping you today.

Ken :

Are you able to pass gas?

Ken :

Is there distention of abdomen?

Customer:

Not really. I haven't really had to pass gas. I don't think.

Ken :

To be frank -

Ken :

Not having bowel movement for 6 days with

Customer:

I am not sure how to identify distention of the abdomen, but I don't think I have that. But I am not really sure.

Ken :

pain in abdomen and no gas passage {or no gas production} worries me

Ken :

I would like to rule out intestinal obstruction as my first bet {worries me the most}.

Customer:

I thought nothing of constipation for 6 days because I have had a long standing problem with constipation for years.

Ken :

If you were my relative or a close friend than I would recommend a ER visit.

Ken :

Associated pain in abdomen with possible distention worries me

Ken :

If you are having normal food intake than constipation for 6 days need to be evaluated

Customer:

I really don't think I have distention though. I just don't want to say one way or the other because I am not a medical expert.

Ken :

I do understand.

Ken :

Let me put it this way -

Ken :

Few signs should prompt ER visit -

Ken :

Severe pain in abdomen/ inability of pass gas/ loss of consciousness/ distention of abdomen.

Ken :

As I am not able to examine you - Considering the symptoms you described - I would go to ER

Ken :

May be just for peace of mind!

Ken :

Anyways - The cause for constipation also needs to be evaluated.

Customer:

The pain I have is mild to moderate and is off and on. It might even be more like discomfort or indigestion, maybe.

Ken :

Investigations like - stool and blood analysis/ scopy/ ultrasound and x ray for abdomen followed by CT should give us more answers.

Ken :

You are right - Mild pain may be due to irritation or inflammation of thye bowel loops too.

Ken :

Look for the symptoms - If they get worse than go to ER

Customer:

I had a colonoscopy in August 2002 and another colonoscopy on October 27, 2008, and both were normal. Both tests just said that I had hemorrhoids.

Ken :

That relieves me a bit.

Ken :

As of now - Give some time for the laxatives you just too to act.

Ken :

Do not rush for enema as of now.

Ken :

Have balanced diet {more of fiber} and adequate fluid.

Customer:

I guess my only worry was fecal impaction. Since constipation is a problem I have had for years, where sometimes I would even have a bowel movement once every 5 days and other times once every 6 days as well, I wondered what if this problem could be an accumulation of hard and dry stools. The only difference is that this time the bowel movement after 5 or 6 days was harder and less where before the bowel movement appeared more normal and easier to pass, even after 5 or 6 days.

Ken :

This indicates less amount of fluid in the stool. The cause can be less intake or stricture at the lower bowel loops which is causing hard stool.

Ken :

The change in bowel movement needs to be evaluated.

Ken :

Try having more of fluid. This may help.

Customer:

The last time I told my doctor about this problem, he just recommended Metamucil. However, I just sticked with the Colace and Ex-Lax because the instructions on the Metamucil said that choking on it was a possible risk. Since I have an anxiety disorder, I didn't take a chance on this. I would say on an average, I have a bowel movement every 3 or 4 days. But sometimes like today, it can sometimes be every 5 or 6 days.

Ken :

If normal bowel movement habit is once in 3-4 days than once a while it being on 5th or 6th day does not worry me much.

Ken :

However

Ken :

Associated pain/ distention and may be vomiting need too be looked at.

Ken :

If they are seen than it may be intestinal obstruction.

Ken :

As of now - Calm down. Have fluids. Give time for the medicines to act. Keep a watch for any signs of abstruction.

Customer:

Which signs do I pay particular attention to that would warrant a trip to the emergency room or to call an ambulance?

Ken :

Increase in severity of pain/ vomiting and distention of abdomen.

Customer:

What should I do if the laxatives don't work, say by 12 hours from now?

Ken :

If no effect is seen after 8 to 12 hours - Go for fleet enema {considering none of above mentioned signs are seen}

Customer:

If it gets to that, and if the Fleet enema doesn't work, what should I do at that point?

Ken :

You will need to get yourself evaluated than. It will indicate either no stool in the colon OR obstruction due to impacted stool or a stricture.

Ken :

I am sure that the medicines you have just taken will act and you will not need to get the enema or visit your doctor.

Customer:

When you say get evaluated if that should happen, do you mean to the emergency room or to my doctor whenever possible? Additionally, should I try to refrain from eating right now, unless I really am hungry, and even at that point, should I eat little?

Ken :

There is no need to go to ER as of now. You need to see your primary doctor and get it evaluated {repeat scopy/ stool analysis}. As of now - Have adequate fluid {most important}/ have balanced diet {if you are hungry}. No need to stay away from food.

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