Desperate! This is about severe constipation

This post is long as I had to include some history. And it does get a little gross near the end. But I desperately need help.

I know it's been quite a while since I've been on the site. I apologize for that. But I really need everyone to think real hard about what I'm about to post. Yes it's a lot of info. Any info, no matter how insignificant you may think it is, would be appreciated. 

I had my RNY February 2, 2015. I've had complications from the surgery ever since. I started with uncontrollable pain (and yes I will say right now that I know that any narcotics that I have taken over this period are only working against me but I have only taken them when absolutely necessary), and the inability to pass gas and pee. I ended up two days extra in hospital. I also have the issue of IBS that I was diagnosed with when I was 17. This was under control at the time.

When I finally went home I relied on the dilauted that I was given and actually ended up being given a second prescription for it. I was passing gas and stool as I was on Senokot (literally for 20 years, I did not realize this was not good until my new GP pointed it out this past August). However, I had started vomiting. Drinking has been an issue since my surgery. If I drink too much or too quickly I vomit. I have been vomiting over this whole period of time. At first it wasn't too bad but it became an every day issue. It's not every day any more, but it is a very frequent occurrence.

Since then I have had pain in my stomach and vomiting off and on. Fast forward to February of this year. I got my 1 year blood work done and it was all over the place. Bang. I'm My hemoglobin is low. I'm anemic. I had scopes done in both ends and they found nothing. Now I've been vomiting and in pain off and on this whole time. Needing to go to ER at least 1-2 times per month for IV fluids and Pain control. I had to go on iron pill (300mg which I know is against me as well) and I ended up having a series of 3 iron infusions. My new GP took me off the Senikot and trouble with constipation was there but not that bad. I saw my surgeon and he did a laparoscopy this past September 1, 2016 and repaired some mesenteric defects. This did not solve the problem. Oh ya. I still get heartburn. He said he didn't see it but I may still have some stomach attached. Which can cause an RNY patient to still have heartburn after surgery. I take the max. dosage of Tecta (stronger version of Pantaloc) every day.

Since then I have had severe constipation and pain. I have had to go to the ER quite a few times. One of the times they gave me 2 soap suds enemas and they did not work. I had to take a bowel prep. On the 8th of December I had another soap suds which did work. I have a very bad habit of letting it get bad. I'm the type of person who is petrified of being called a faker or even an addict (pain meds). So by the time I do go to the hospital I'm beyond a simple solution.

By this time my GP has me taking double the max. dose of Restorlax and 1 TBSP. of Chia seed in the morning in a small glass of apple juice (10g of fiber). Fluids are still an issue and I frequently become dehydrated. I still have issues with vomiting as well. And I know this is also working against me. I have tried Every other laxative I can think of. From lactulose to metamusil, benifiber even taking senokot again. nothing is helping.

This is about to get really gross. So if you get turned easy stop reading now.

About a week and half ago my stool, the little that I was passing, turned black. My GP is on vacation and being in a small town there's no replacement. So I was waiting to make an appointment.

OK. Come Christmas day. I'm at my sisters in Oshawa, 2.5 hours from where I now live, and I feel like "Wow. I think it's going to be a great day! I have to go to the bathroom". An hour of a little straining goes by and nothing. A little while later and another hour of straining and nothing. This happened 5 times. I had so much pain in my abdomen and something new. A shooting pain up my bum right up my back. And I was stuck. I couldn't say anything because it was Christmas day and the whole family, including my children that I only ever see every couple of months, was there and we were about to have dinner. Sitting was excruciating. So the drive home was not pleasant. It was very late when we got home, so I didn't say anything because the hospital was another half hour drive.

The next morning I called telehealth, Ontario's medical advice hotline. The nurse on the phone told me to try a Fleet enema and glycerin suppositories. And I also now have hemorrhoids. So I packed up some Prep. H as well. The enema and suppositories did not work and I became so desperate at the time, I couldn't stand it for one more second, that I dug it out. The stool was there and as I pulled it out more would come down to the entrance, and there was a lot. It was not hard.It was actually soft and it wasn't black anymore. It was light grey. (I know. Gross talk. Sorry). But I could not pass it naturally. Once I got it out I still had some abdominal pain, which I have been used to, but the other pain was much better and tolerable. I then had a couple of small movements naturally. The hemorrhoids were pretty much gone, thanks Prep. H. Then a couple of hours later, around 1 pm I felt what I thought was a big movement. When I wiped I noticed the tissue was covered in blood. The toile****er was dark red. This alarmed me, but I thought OK, hemorrhoids.

Throughout the day I was having some trouble passing gas but there was no more movements or blood. I went to bed and was awoken by a sharp pain in my left lower side, and if you push up the side it hurts down in the same spot, at around 11:30pm. I got up and took some extra strength Tylenol, which did not help. At around 12am, this is now the 28th of December so two days ago now, I felt the urge to go. Nothing but dark red blood came out of me. That coupled with the pain? I woke my parents up(I live with them). It was 1am by the time i got to ER and the pain was at a 9 and I've never had this before. I now had leaking stool with blood in it, it was hard to pass gas and every time I did there was a little ooze of blood and mucus. I ended up with a high dose of morphine, I know this is against the problem, and zofran for the stomach. When he examined me he said it didn't look like I damaged anything but there was one hemorrhoid that was a little higher up. It didn't look like it was the culprit, but he couldn't be sure because he couldn't see the other side.

Now this doctor was woken up to see me and after he saw me he went back to bed. He ordered the IV and meds (the nurse did the blood work automatically when I came in) and said to discharge me when I was done 1 L of fluids. The nurse told me my count was low. but not low enough to transfuse. So after 4 hours I went home with no solution. Yes my pain was gone for the time being and I at least wasn't dying, but what was I supposed to do.

Yesterday I learned they were doing a walk in clinic (yesterday and today) where my GP is located. I had to get my B12 anyway, it's a separate clinic at my GP's office, so I signed in to see the on call Dr. This Dr. actually spent about an hour with me. She said the pain may very well be from constipation or impacted stool but the bleeding, which has actually now stopped again, she couldn't explain. They have now put a rush on a GI specialist.

A little more history: I have 2 children, 18 and 16, had a hysterectomy 14 years ago - so no I'm not pregnant, on my period and I'm not on hormone replacement therapy because of a blood clot in my lungs in 2008. And I don't have my appendix or gallbladder.

I know that this is far fetched, but does anyone out there have a similar issue? Or am I alone in this?

What I am asking is for ideas on what I can try.

What are ideas for constipation? How long should I give each solution to work before giving up?

Diet. Different menu ideas. I don't tolerate much and I'm a actually a very picky eater. Sometimes I tolerate a food and the next day I throw it up. I have a not so good relationship with eggs. I can have them "dippy", but not scrambled, or as french toast. I can eat small amounts of cheese, but not large quantities of dairy.

I'm sorry for all the trouble you've had. I can't offer any advice, but hope you find someone here you can offer some support. I hope the New Year will bring you some satisfaction and comfort!!

Dehydration is one of the most common causes of constipation. Please find a way to get your fluids in.

I hope you find relief soon.

Not drinking enough fluids is likely the cause of your constipation.  Even if you use laxatives, those medications require a lot of fluid to be effective.  64 ounces is the MINIMUM amount of fluids you should be drinking.  I have to drink around 120 ounces to keep things "moving".

You need to find ways to drink more.  Set a timer for every 10 minutes and drink just a few ounces at a time.  You need to be drinking ALL DAY LONG.  Try drinks of different temperatures.  Peppermint (or ginger tea) was a great fit for me and it helped with the nausea too.  It does not have to be water.  Experiment until you find something that works.

Dehydration will make you feel like crap.  It's up to you to find a way to up the fluids.

If you are taking fiber and then not taking enough fluids in, then you are setting yourself up for constipation... I have had had some of the worst in my life since surgery. So I take a dose of Miralax daily-Restorlax in CA...sometimes two, and if I still don't go I use liquid glycerin suppositories- like a mini enema almost. I do not let it go more than one day...

I recently started taking Metamucil capsules a couple of times a day. I've heard some people don't tolerate it well, but it's been the most effective thing I've tried. I would say I'm back to pre op regularity.previously,  I was up to two and occasionally 3 doses of restoralax a day and not effective. But as others said, fluids are key!

Sorry you have been through bad times I can relate to. For me, problems started at three months post-op getting in trouble each time I let up on prevention. Activity and water intake were good so not an issue.  Having tried so many things, I think a combination has helped; the top three best guesses would be:  MIRALAX in water, increasing healthy-fat foods and salads, and nearly eliminating cheese.

IDEAS:  1) large glass of warm, Miralax-infused water first thing in the morning 2) daily brisk walk or bend-over housecleaning like vacuuming or scrubbing the bathroom 3) increasing fat intake in your diet like nut butters, olive oil, avocado in addition to more vegetables/salad 4) greatly reduce cheese intake 5) establish a strict routine triggering your digestive system to respond to consistently 6) purchase a swatty-potty to help position your body for better elimination 7) continue prevention to avoid being caught off guard  8) research other suggestions on the internet.

HOW LONG BEFORE GIVING UP:  sorry, I don't have an answer other than to trust your past experiences as a guide.

 

I'll echo NYMom. Ingesting fiber supplements while you are already constipated can cause even worse constipation-and will be even worse for you since you aren't getting your fluids in. 

I had a partial obstruction in my large intestine in 2015. My surgeon told me to stop all fiber in my diet and do a bowel prep to get cleaned out. It took me a 7 ounce bottle of Miralax ( restoralax for you ), plus extra daily doses of 2 caps full and 4 days...but relief came. 

I make sure I get enough fat in my diet, I upped my fluid intake to at least 80 oz a day, and I add a capful of Miralax every morning in my coffee. I won't advise you one way or the other, but that is what worked for me. 

Thank you all so much. I know hydration is the key, but I have a problem with keeping it down. I keep a bottle of water with me at all times, even beside me at bed. I sip and sip but can't seem to drink more than 2 - 3 bottles a day. And it has to be cold or it turns my stomach. Is there any suggestions for fluids?

What have you tried?  Try different temps, different liquids, etc.  Hot tea, hot broth, warm tea, warm lemonade, cold lemonade, etc.  Try using an insulated bottle that will keep your drink cold all the time if you need that.  Try every single thing you can.  

Hydration is your number one job - even if you have to force yourself.  Try using a straw or a sippy cup or sucking on ice cubes.