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My son (18) has been dealing with what we assume is

constipation for several months. Having...
My son (18) has been dealing with what we assume is constipation for several months. Having to strain very hard, sometimes having diarrhea, sometimes soft "ribbons", but never feels "done". The past few days he wasnt able to go at all and went through basically 3 colonoscopy preps in 48 hours. Xray shows all liquid in intestines, yet he can not pass anything even with tremendous strain. Why could this be hapening?
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Answered in 9 minutes by:
3/8/2018
Paul Wolfe
Category: Medical
Satisfied Customers: 9
Experience: Pediatrician / Owner at Marion
Verified

I Chronic constipation is a very common problem. When the stool enters into the large intestine, it is pure liquid. As it progresses from the Right lower side, up, across, and down the Left side of the colon - water is pulled out of the stool so that by the time it gets to the rectal area it is a solid stool. Sometimes the rectal area will be stretched out a little, allowing the stool to sit there and get harder and harder. This makes it difficult to pass. The treatment is to increase the amount of fiber in the diet. The goal should be to have a softer stool every day or every other day. Sometimes, taking a small amount of glycolax everyday (1/2 cap to 1 cap) for several weeks will help. If you use the glycolax, it will need to be weaned off (don't just stop it). I hope this was beneficial. If it helped, please rate it with 5 stars. If you have any follow up questions, just let me know

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Customer reply replied 1 month ago
but after the Dr. ordered 64 oz Miralax, mineral oil enema, Dulcolaxand whole bottle of Mag Citrate in 48 hours and a return visit to the ER because he could go only a few tabkespoons worth of liquid, we were told that all of his stool is "pure liquid" per the xray. Why then does he only have significant belly pressure and no urge to "go"? Why when he pushes with all his might does nothing come out if if is already 100% liquid?

The X-ray can not determine if the stool is all (100%) liquid. It can just determine if the colon (large intestine) is full of stool. It is possible that he has some very hard stool in the rectal area that just has not passed. When did he take the miralax (glycolax), mag citrate, and the enemas?

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Customer reply replied 1 month ago
Actually over about 36 hours from Monday to Tuesday late PM.

It may be worth repeating the enema. Did he have much result with the first enema or the other meds yet. Does he have any other underlying medical problems that could contribute to constipation?

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Customer reply replied 1 month ago
He has had constipation problems since his appendectomy 1 year ago, getting progressively worse until it all came to a head a couple days ago. During that year he has taken daily Miralax and even sometimes stool softeners and laxatives. Never has felt like a complete BM and has not had a normal, formed stool in months.
Customer reply replied 1 month ago
Of course we can't get in to a GI until 3/19.
Customer reply replied 1 month ago
His only resu lts with that barrage has been a slight amount of diarrhea on a handful of times.

Miralax will literally work for everyone. If it did not work for him, he was probably on too low of a dose. It is a difficult thing to deal with, with lots of relapses. The first stage is still to clean him out completely. This would probably fill the toilet 2-3 times - a lot of stool. If you have not seen that yet, its because he has not been 'cleaned out' completely. I would do enemas a couple times a day and maybe double the miralax until you know he has passed all the stool. Mg Citrate could be used, but it tends to cause more cramping.

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Customer reply replied 1 month ago
Ok thank you. Not sure how much more of this he can handle physically or psychologically.

It is NOT a fun process. He will feel better once he is cleaned out. With the enemas - try to get him to hold the enema in as long as he can before trying to pass the stool. The other (less invasive) medicine you can try is Dulcolax Suppositories - again have him hold it in as long as he can so that it will soften the stool. Once the hard stool plug is passed - I am sure you will see a lot of results. Good luck! Let me know if you need any addition help.

Paul Wolfe
Category: Medical
Satisfied Customers: 9
Experience: Pediatrician / Owner at Marion
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