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I have had back pain and severe bloating after eating along…

I have had back...

I have had back pain and severe bloating after eating along with constipation for almost 5 years. I had a colonoscopy (some redundant bowel) and back X-rays ( slight disc degeneration). I have tried physiotherapy, cranial sacral therapy, visceral massage, accupuncture, chiropractic therapy with no relief. My doctor had indicated that because the tests showed nothing there was nothing else to be done:/ what could this possibly be? I had some back pain from exercise and running prior to ending up in emergency with a bad case of constipation

Doctor's Assistant: Have you had any recent injuries? What seems to make the pain better or worse?

No injuries identified, just a sore back. Not eating results in no pain thus I have lost almost 20 pounds; now 98 lbs

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have been treated for anxiety and depression and have also been told (years ago) I have Ibs and a hiatal hernia.

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Answered in 16 minutes by:
1/17/2018
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 39,051
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

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Answers here are for education and information.
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What is your age and gender?

Are you on any medications presently?

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Customer reply replied 6 months ago
I am female 53
Customer reply replied 6 months ago
Occasional Ativan and or zopiclone for sleep

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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High fiber intake (lot of vegetable and fruits), exercises, walking and plenty of fluids always are part of the management of the chronic constipation. People who do not respond to this and OTC laxative are advised to take the following medications by prescription;

1) Polyethylene glycol 3350 (Miralax)

2) Lactulose

3) Tegaserod (Zelnorm)

These agents are proven for their effectiveness at improving stool frequency and consistency in patients with chronic constipation.

The other helpful agents are;

a) Lubiprostone

b) Linaclotide

Ideally you should consult a gastroenterologist who can perform the following investigations which are the mainstay of the evaluation and which will give true perspective of the cause;

1) Blood investigations do give the clue. A complete blood count, biochemical profile, serum calcium, blood glucose, and thyroid function tests are routinely recommended in the evaluation of patients with constipation.

2) Depending on these blood results further blood work is done; serum protein electrophoresis, urine porphyrins, serum parathyroid hormone, and serum cortisol levels, may be done to identify or rule out myeloma, porphyria, hyperparathyroidism, and Addison's disease.

3) Barium enema or barium meal with follow through study

4) Colonic transit time; it can provide a better understanding of the rate of stool movement through the colon.

5) Other investigations like Anorectal manometry, balloon expulsion test, Defecography etc.

6) Colonoscopy / sigmoidoscopy

Following measures can be helpful;

1) Increased fluids

2) Prune juice and dried plums

3) Increased fiber; preparation like Benfiber can be tried.

4) An herbal tea, "Smooth Move," have been found to have good result in moving the bowel.

5) Toilet after meals; Toileting 15 to 30 minutes after eating makes use of the gastrocolic reflex. The gastrocolic reflex results in propagating spikes in the colon and rectum within a half an hour after a meal. When we eat, our stomach distends and this sends reflex signals to the large intestines (colon) facilitating for their movements. If one utilizes next half hour of meal, for toilet, the stool elimination time is decreased.

6) Increase in exercise

7) Stimulant laxatives stimulate intestinal motility and increase intestinal secretion. They are anthraquinones (cascara, aloe, and senna) and diphenylmethanes (bisacodyl, sodium picosulfate, phenolphthalein).

8) Avoidance of stress

9) Wheat bran, 20 gms per day can decrease the rectal transit time

10) Vegetables,

11) Fruits (especially dried fruits)

12) Cereals like whole wheat, bran or oatmeal

13) Celery

14) Grainy breads, such as whole wheat, rye or pumpernickel

15) Legumes, such as chickpeas, baked beans and lima beans

16) You can try ground flaxseed sprinkled on salads, cooked vegetables, and cereals.

Food which cause constipation and should be avoided are;

Ice cream

Cheese

Meat / Red meat

Chips, cookies and pizza

Pastries

Foods that contain white flour

Pastas

Junk food or fast food

Banana.

For back pain, you need an MRI for the evaluation.

Physical therapy, acupuncture and deep electrotherapy would be mainstay of the treatment.

Meanwhile following would be helpful;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

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Customer reply replied 6 months ago
Could the digestive issues be caused by a back injury?

Yes, digestive issues, colon and rectum inertial, intestinal motility disorders may be responsible for the back pain. Body symptoms need to be seen collectively in a patient.

It is privilege assisting you.

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Customer reply replied 6 months ago
I know digestive disorders can cause back pain but can injury to the back cause digestive disorders

A back injury causing nerve issues related to pelvic floor may cause large bowel problems. This can be identified by pelvic floor;

1) Electromyography

2) Nerve conduction velocity study.

Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 39,051
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified
Dr. Arun Phophalia and 87 other Medical Specialists are ready to help you
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Customer reply replied 6 months ago
Thank you for all of the information

You are very welcome.

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