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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
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Experience:  14 years as clinician in the field of Family Practice
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For about the past 2-3 weeks I have had extreme difficulty

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For about the past 2-3 weeks I have had extreme difficulty having a bowel movement. It feels like I just cannot push anything through even though I regularly feel the urge to do so. I will sit on the toilet for 20 minutes trying to push with nothing coming through. Over the last 2 weeks I have had a few small bm's. Most recently (past 3-4 days) I've been able to get a few small pieces out but that is it. There was also one episode where it come out like diarrhea (4 days ago). The last 3 days though - just a few small thin pieces. And it definitely feels like there is more to go, which is very uncomfortable.
I've also found myself feeling very gassy and sometimes being unable to pass gas (but usually able to do so). I've been having trouble sleeping due to this feeling of needing to go and not being able to. (Though I have anxiety as well so that might be part of the cause there). There has been some discomfort due to my strained attempts to go and feelings of fullness but not really any kind of serious pain. And there has been no bleeding at all.
About a year ago, I had similar problems but they were accompanied by some bright red blood on the TP. That has not been the case this time. At that time I went to the doctor and he said it looked like I had hemmorhoids but all he did was examine the rectum (no colonoscopy or anything of that nature). I am 42 years old - male.
I have tried using medicated wipes, taken a laxative powder for a few days, and added additional fiber to the diet. (I should say I have had a pretty poor diet over the years). I am in a situation now where I am away from home on a summer job, so I am not sure if this situation is serious enough to seek out urgent care or if it is something I should be able to treat on my own. Do you have any advice for what you think might be happening and what I can do in terms of self-care? At what point do I need to go to be seen by urgent care or the like(which would be expensive for me due to being away from home)?
Thank you in advance for your help.
Anthony Bray MD : Hello!

Hello thank you for agreeing to help!

Anthony Bray MD : i would advise that you start with Miralx plus 8 on uncles of water daily for a week...
Anthony Bray MD : ( you may have tried this but perhaps not for long enough time...)

What about food? Should I keep eating extra-fiber and taking supplements? Also, how long should I try to sit on the toilet for?

Anthony Bray MD : I would advise that you push fluids as this tends to help reduce constipation --- 8 ounces every two hours while awake....
Anthony Bray MD : Take a stool softener daily and do this as an ongoing habit---- options would include Surfak, Colace, or docusate one capsule daily or mineral oil one tablespoon daily... One of these would be good to continue daily indefinitely ...
Anthony Bray MD : if you have increasing bloating or abdominal pain --- especially greater than 6/ 10 which interferes with sleep... Then you are advised to seek further medical evaluation.
Anthony Bray MD : I hope that this information helps. Let me know if you have further questions and I will be happy to get back with you!
Anthony Bray MD : if my responses have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated ! Thank you and best regards,
Anthony Bray MD : Anthony Bray MD

OK will do - thanks for the help

Anthony Bray MD : You are very welcome and yes you should continue to eat!
Anthony Bray MD : PS if you have lower abdominal pain discomfort then you may try one to two Fleet's enemas and these may help...
Anthony Bray MD : I would try to avoid extended time string on the toilet and straining -- maybe about ten minutes and then rest and try again later....

Ok - so the feeling of having to go and feeling like i have more stool inside me - is that normal? Just try to ignore it?

Anthony Bray MD : Well it is not a normal feeling. If this persists then discuss this further with your doctor or gastroenterologist.. It may be reason to consider a colonoscopy....

OK then - so it is not an emergency situation at this point, but if these steps that you describe do not work then I should seek medical attention

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