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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10341
Experience:  14 years experience in the field of Family Practice
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I am 45 years old and have battled with IBS for more than 20

Customer Question

I am 45 years old and have battled with IBS for more than 20 years. However, I have never had constipation. About 3 years ago I battled with Chronic pelvic pain for about 1 year and the last 2 years have been virtually pain free. One day about 4 weeks ago I had a really bad bout of constipation. This caused my pelvic pain to come back and I have had it ever since. Also my bowel movements have not been the same. I used to go every morning at the same time and now it's unpredictable. In addition when I do have a bowel movement it often doesn't feel like it has completely evactuated. And if I eat, I often feel like I have to have a bowel movement. A doctor has recommended having a colonoscopy. I had a colonoscopy 3 years ago and an endoscopy 1 year ago. They both were normal. Is there anything that could develop in 3 years if my original colonoscopy was fine? I don't want to have one if it's not necessary.
Submitted: 12 months ago.
Category: Medical
Expert:  Anthony Bray, MD replied 12 months ago.


What have you tried so far to help the constipation?

I think to focus on the problems at hand would be first priority and not colonoscopy again ..

If not tried yet you may benefit from Miralax --- over the counter -- one capful powder dissolved in 8 ounces fluid each evening for several days until relief ...

Drink plenty of fluids in general as helpful to prevent constipation ..

Have doctor check thyroid function ( hypothyroidism could be new cause of constipation )

Daily stool softener may help in future to prevent constipation

>> Surfak 260mg once a day

>> COLACE or docusate 100mg capsules 1 or 2 per day may help

>> mineral oil 1 tablespoon a day as an option..

One of the above three may help prevent constipation in long run

Measured as described might be helpful for you but you may need further diagnostic studies ...I can't guarantee that further studies may not be needed in your case ..

If you have more of transition to IBS-C then treatment with Rx for Amitiza or Linzess may help....

An abdominal CT scan may be helpful

A colonoscopy might be needed ..I agree with you that it would not seem automatically needed at this point but may be useful depending on your symptoms / degree of relief you have / results of other studies

I hope that this information is helpful for you

Let me know if you have further questions or concerns

I will be happy to get back with you

If my answer has been helpful and to your satisfaction then please remember to leave positive feedback

Thank you and Best Regards,

Anthony Bray MD

Customer: replied 12 months ago.
Thank you for such a thorough response. To help the constipation, I have been eating as much fiber as possible and been drinking aloe vera juice. It's a weird sensation really. I am going daily, but it's the feeling of having to go - especially when I am sitting down and after eating - the rest of the day that persists. I'm wondering if the muscles around the rectum are hypersensitive and could be creating the same type of feeling as constipation and also in turn affecting my prostate. I think the concern on part of doctor, is the sudden change of bowel movements and feeling of not having emptied are signs of colorectal cancer. Would the tests in the following page be an option do you think before a colonoscopy?
Expert:  Anthony Bray, MD replied 12 months ago.

Hello again,

I think that a prostate check would be appropriate as that could be associated with some sensations that you describe ...

I doubtvcolon cancer as you had a normal colonoscopy 3 years ago ..

The daily BMs would seem to go against classifying you as constipated ..

There are non invasive tests to screen for colon cancer -- yes to that

Checking for occult blood of stool should be done I think ..

I will check your reference next here and get back with you on that ....

Expert:  Anthony Bray, MD replied 12 months ago.

You may ask your doctor about the FIT test or cologuard ...these would be reasonable alternatives

Note however that colon cancer would not be the ONLY possible finding of a colonoscopy....

Inflammatory bowel disease and other issues COULD be detected ( FYI..)

Still with you having had the colonoscopy so recent that would not be at the top of my list to your case I agree with you on that ..

I hope that this is helpful

Best Regards!

Anthony Bray MD

Customer: replied 12 months ago.
Thank you so much for all your help. May I contact you in the future should I have any other questions? I will now close out this question.
Expert:  Anthony Bray, MD replied 12 months ago.

Hello again!

Sure ! absolutely !

You may reach me any time down the road via my profile page on this site ---

Take Care!