Constipation in Teens & Adults
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Constipation in Teens & Adults
June 2007
Our daughter, 12, has chronic constipation; typically having
a bowel movement only once in three days. She holds her
bowel movements whenever she is away from home. She
recently returned from a 5 day trip in severe pain, having
held herself closed the whole time.
Despite the discomfort, she refuses to use any toilet except
that in our house.
She resists talking about it, but we're worried. She is
very active physically, a bit skinny, and we try to feed her
fiber rich foods, although she's quite the picky eater. Any
suggestions?
Worried parents
Re: chronic constipation. Do not guess as to what may be the
problem. Take your daughter to her pedeatrician and take it
from there. They should run blood tests and so on. It could
stem from emotional stress or it can be biological or in
most cases a bit of both.
mka
Hi Worried Parents, I understand your concern. Hope you're
up for some frank advice from a nurse-mom! A BM every 3
days can be normal, but it should be soft and comfortable
to pass. Since you describe her as chronically
constipated, I assume hers is hard and painful to pass.
For simple constipation, try these measures: 1) make sure
she drinks 64 oz. a day, 2)increase the fiber in her diet
gradually, and 3) give her a stool softener daily. The one
I use with my own family is Colace, which only softens
stool; a version called PeriColace contains a laxative
also. Both are available over-the-counter in any drug
store. (Check this out with your doctor first to make sure
it's suitable advice for her and to find out the MD's
advice on how to approach this problem.) I too am
concerned that she wouldn't go for 5 days and came home in
severe pain. The key to helping her is to find out why she
won't have a BM away from home (embarrassment? aversion to
public bathrooms? etc.) It sounds like the reason is more
than just pain. I think a therapist might be helpful to
explore why she is hurting herself this way and ignoring
her own pain. Work with your doctor on this, and I'm
confident you'll find a solution.
Nancy RN
March 2004
This is totally embarrassing, but I am having a horrible post-
birth pooping problem. Whatever it is that makes poo
cylindrical shaped isn't working! I can feel all my poo
massing up right at the anus, and then it tries to come out in
a huge ball. This means that I end up writhing in pain, when I
finally go it rips my anus so that it's bleeding, and then I
deposit such huge things in the toilet that the toilet clogs.
Seriously, it's almost as bad as giving birth (my first child
was delivered vaginally; this didn't happen then). It's gotten
so bad that I'm afraid to go at anyone's house or in a public
restroom, because it'll clog the toilet. I'm three month post
partum, and had a C-section. I've been exercising and doing
kegals and have regained a lot of core strength, and I've been
drinking lots of water and eating fiber, and nothing's working.
This isn't like constipation, because it's not like I end up
with those little rabbit pellet poos. Help! Am I the only one
this has ever happened to? What can I do?
anon, of course
Hello:
I feel for you. When my first was born, almost twenty years
ago, I had the same problem. It lasted for about 6 months and
then slowly got better over the next 6 months or so. It hurt
badly enough that I had to strip down and do my birthing
exercises in order to go to the bathroom. One of the worst
parts was that as I began to dread going to the bathroom, I
would put it off, which lead to more difficulty.
I hope that someone writes with more information for you, but I
did all things you're doing, and rode it out.
Best of Luck!!
Michelle
This happened to me not only during pregnancy, but also for
about 2 years after, and occasionally even now, 5.5 yrs later.
Several things helped me, Drinking tons of water & herbal
teas, prunes daily, daily mild excercise (20-30 min. hike),
and inserting a finger in my vagina while eliminating &
pushing against the rectal wall to ''guide/push'' the brown
baby out. (ther wall seems to have permanently stretched
enough that a sort of pocket forms rectally bulging into my
vagina & ''trapping'' the feces.I have occasionally had to
resort to rubber gloves and fecal impaction/extraction.
Enemas also, at times.
It has been slowly improving. Good luck!
andrea
You are not alone! I thought I was going to have to go to the
ER one day when I tried to have a postpartum bowel movement. It
was horrifying. I actually had to put on a latex glove and
manually remove the stool little by little . . . very painful,
humiliating and laborious! Another of the aspects of childbirth
that no one ever talks about. I took stool softeners
religiously and it went away in a few weeks. Meanwhile, I kept
the latex gloves at the ready.
anonymous, too
I've never heard of your particular problem, but a few ideas
come to mind....
try a stool softener, which may not clear up your problem but
will make it easier to poop. I used an herbal one years ago when
I had ripped to my rectom after giving birth to my first son. It
made a HUGE difference. The poop just kind of slipped out of me.
Secondly, I wonder if something was damaged in your intestines
when you had the c-section. They have to move your intestines
aside, I believe. Maybe a muscle was torn, or something else was
damaged. Possibly an MRI would show this(?) I don't really know,
just a thought.
Also, sometimes when people have digestive problems one of the
added factors could be weak abdominal muscles (I'm a massage
therapist). The abs help give structural integrity to the organs.
Is it too soon to start strengthening your abs? If you can,
start with very gentle easy ones (ask your Dr.)
Hope this is helpful. Good luck.
anon
I had problems that may be similar. I suggest two things: 1) see
your OB. I believe these types of problems are more common than
we realize, and OB's are quite familiar with diagnosing and
treating them. Mine was. 2) My midwife recommended I see Linda
Avery on Telegraph in Oakland, across from Whole Foods. I believe
she's a nurse practitioner(????), but her entire practice is with
women with these types of problems. You could call to see if she
addresses your specific problem.
anon
Someone recently recommended Linda Avery to someone with post
partum elimination problems and said she thought she was a nurse
practitioner and that she worked solely with women with
pregnancy and other issues. This is not correct.
Linda Avery is a physical therapist (highly recommended) and she
and the other practitioners in her practice (also highly
recommended) (Ashby and Telegraph....blue building) see women
and men with all kinds of issues.
anon
I believe that what you are describing is severe constipation. I
have had this problem all my life and when I am really
constipated, it is as you describe. The ''rabbit pellet poos'' as
you describe it, is only mild constipation for me.
Try Colace (or the generic equivalent which is cheaper). Get the
one which does NOT have a laxative and is simply a stool
softener. I would use this until any rectal fissue (the tear you
describe) heals, which could take up to 1 month. After that, try
Citracel. If you are taking pre-natal vitamens with Iron, switch
to something with NO iron. You can also use cortizone
suppositories to help heal/sooth any swelling/hemmorhoids which
you may have. Continue to drink lots of water (especially if you
are breastfeeding...drink a full glass before each breastfeeding
session).
Also, what type of fiber are you getting...it has to be insoluble
fiber (not oatmeal, celery etc which is soluble fiber). Raw
carrots, grapes, blueberries, whole grain cereals like Smart
Start, prunes, etc. There is a lot of misleading info out there.
Given that Citracel says it is soluble fiber...I don't know
why...but it does work.
One other thing...try to relax during bowel movements...don't
push too hard. If it's bad, try a water enema (I believe oil
enemas are supposed to help to break up hard stools). I don't
know much about these...you might want to check with your doctor.
But there are things which can help.
Good luck and you are not alone!
anon
I also had these problems, to the extent that I had to
physically remove the poop one time, it just would not come
out. I went to see the Dr, and he said to avoid milk products,
and eat an oat bran muffin daily (making your own is best, so
you can leave out the yucky stuff - feel free to email if you
want the recipe). I did that, plus ate 2 or more prunes, and
often would take a stool softener as well (either peri-colace or
just colace). These things combined seemed to work pretty
effectively, and immediately. After 8ish months, it finally
started getting better (where I could stop some of the extra
interventions, and now (child is 20 months) I am pretty much
back to normal, other than the fact that I just found out I have
a hernia. So, my advice is, try these things, and if they don't
work, go see the Dr. ASAP. Good luck!
Kelly
Embarrassing or not, I would call your doctor right away. They
have seen/heard it all. I also had a c-section and never had
problems with elimination. They might have left something in
there or sewed up somewhere that is blocking your intestines,
bowels, etc.
Call your doctor today!!!
DiAnn
Definitely go see your OB and tell him/her your problem,
embarrasing as it may seem. It's a very common problem. My OB
prescribed me colace and metamucil to help make things come out
easier. She also had me put in suppositories she prescribed to
help heal 'the area'. Both helped a lot and I was back to normal
within a couple of weeks.
been there!
That happened to me too... I had a vaginal birth, but I tore a
lot, and had a really long recovery period. Seriously, I was
having problems pooping for months afterward. My midwife
recommended a laxative, which I took for months, and which
helped. I think I finally stopped the laxative 4 months after
giving birth, and I was mostly fine after then.
anon
Make an appointment with your doctor. I know several new moms
who had similar issues after C-Section. You may just have a
fissure or even internal hemorroids. YOu won't know until they
do a sigmoidoscopy.
As embarrassing as it is, you need to contact your primary care
physician and discuss with him/her.
familiar with it.
First I want to thank you for posting your question. I felt so alone, terrified and
miserable when I developed similar problems after the birth of my second child last
summer. At my post-partum check-up I described my symptoms and my OB said it
sounded like I had a rectocele. She gave me a brochure about that and the other
more popular ''pelvic support problems'' which I don't have but at least had heard of
before: stress incontinence and prolapsed uterus. She also said to check back in six
months if it hadn't gotten better, which it has, but it may just be that I'm
learning to
live with it because I don't want to have a surgical repair. Anyway, try googling
rectocele and see if that sounds like what you have. I also second the other posters'
advice about calling your doctor and starting to take Metamucil and stool softeners
right away. Lots of water and a high-fiber diet are just not enough when things get
this bad. Last, please give me a call so we can share what we learn about this
condition (which can be a life-long affliction), emotional support and grown-up
poop jokes. I couldn't find anything on the Web except for medical sites, when what
I really wanted to find was personal experiences and a community of other women
who know what it's like. Maybe we can start our own online confidential pelvic-
support-problem support group!
Jen
You are definitely not the only one with this problem. It will
probably resolve itself in the next month or so. My midwife
told me that the problem is a result of not enough water being
retained in the colon due to nursing. She suggested dried
fruit. Prunes were too potent for me but apples worked well. I
also carried little tushies wipes wherever I went for a while.
Sorry you are suffering with this. It will get better!
Anon too
You are describing exactly what I experienced for about 1+ year
after having a baby! I felt so guilty because I thought it was
because I wasn't excercising as much as before I had our baby
(even though I was still relatively active), and just felt I
wasn't trying hard enough. I ''ate an apple every day'', drank
water all day long, still to no avail. I had blood work done
and discovered I have hypothyroidism. Constipation is one of
the symptoms. I simply had no idea I had this condition. The
bm problem cleared up as soon as I started taking the thyroid
replacement medication and after 2 years it's never happened
again!
Okay - If any of you readers don't want to hear about solutions
to big poops, just don't read this entry. I've got this problem
at times, too and have clogged my share of toilets, even before
I had my children. In the interest of keeping you from becoming
housebound, here is the scoop on big poop from my perspective.
Keep up the water and fruit and veggies and don't overdo it on
the serious fiber or meat feasts. And (my secret weapon) keep a
few of those disposable medical gloves in your purse and when
you know the poop that you just put in the toilet ain't gonna
make it through that 100 yr old plumbing, put on the glove and
carefully break up the poop with your discretely and sanitarily
gloved hand. When done, use the clean hand to put a piece of
tissue in the gloved hand. Invert the glove and hide it in the
trash can (don't put it in the toilet). Wash your hands really
well and use that sanitizer stuff if available. And you may
also want to see a doctor who specializes in this stuff. Perhpas
your muscles need a bit more help in healing there. My friend
says Toto brand toilets are really great for folks like us.
(I don't talk about it either)
have you tried a stool softener? It sounds like you are doing
all the ''right'' things to help yourself recover from the c-
section. Maybe it takes awhile for everything to get back into
place.
hope you feel better
I am so sympathetic to your plight - had something similar but
from giving birth vaginally - it was a large anal fissure that
took almost a year to recover from. I would writhe in pain
every bowl movement, there would be blood in the stool,
paper,etc. Then for hours after it would burn. It was horrible
and painful. GO TO a colon rectal specialist because they are
the only ones that know what's going on and how to treat. My OB
and primary doc kept saying it was hemmoroids so it got worse
and took so much longer to heal. There are medicines that can
help - Don't be embarassed! it happens to alot of people but
no one shares this side of birth. SEE A DR! Feel free to
email if you need more info
meri
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