# Impaction ... AGAIN



## em_t (Jun 8, 2010)

So its happened again ... thought my tummy had calmed down a bit, until the last few days I've had agonising abdominal pain, general aches and pains all over, almost fainting and generally feeling under the weather and if it wasn't for the fact that I've been really badly constipated for the past few days I'd have thought I'd had flu ... but no I've a complete blockage again!This is at least the fifth or sixth time this has happened in a year and can't believe that a gastroenterologist can do nothing about it! After having numerous investigations done, colonoscopies, gastroscopes, small bowel series, etc my gastroenterologist gave me the great wisdom of eat more fibre, drink more water and do some exerise, then signed me off back to my GP! Well if I'm doing all those things and getting so constipated on a regular basis, to the point of impaction is there not definitely something wrong? Blooming NHS, I know its not as serious as IBD but even still this is starting to seriously affect my life ... taking far too much time off work and even on a good day feel lethargic and have complete brain fog and just to be dismissed as another annoying IBS patient! Even when I went private for colonoscopy, ultrasound and a whole battery of other test the gastroenterologist there told me come back in 6 months time and see if you've improved any ... well I hadn't!I just wonder if there's anyone this happens to on such a regular basis, I take laxatives, eat as healthily as possible and try to get enought sleep and I still constantly feel ill!Sorry for the rant, its just been a very bad IBS day! Just wondering if anyone else has any new ideas I can try - getting very desperate here!


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## sonnygarcia (Jun 3, 2009)

when you get an impaction is it when you haven't gone in something like 2 weeks or so? I go once every 4-5 days and don't really deal with impactions so I'm curious to understand how they develop. Did the Dr. do a sitz marker test on you?


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## BQ (May 22, 2000)

Also try to treat the constipation daily to perhaps avoid impaction.


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## em_t (Jun 8, 2010)

It can happen if I haven't been in only 3-4 days ... over the weekend had horrible diarrhoea so never even saw it coming ... have now been told it was probably bypass diarrhoea, very common in elderly people appararently, although that doesn't apply to me as I'm only 24 lol! I always know when I'm getting an impaction because I develop flu like symptoms, aches and pains all over, nausea, fever, just no coughs or sneezes and I feel truly ill, must be my system being totally poisoned! Also nearly collapsed in front of my class when teaching them the other day, also get very dizzy as well! It happens to me about once a month, although it doesn't always develop into an impaction - sometimes I'll just be ill for a few days, vomiting and unrelenting diarrhoea until it passes through my system.Can't do anything more about the constipation, taking all the laxatives I can, my only problem is when I eat fibre my constipation actually gets much worse, from what I've read on the internet this would seem like slow transit constipation because I never even feel the urge to go and feel like its getting stuck somewhere much higher up. My problem is in the past I had anorexia and was very seriously ill with it and ever since I began my recovery have been battling with long standing constipation - I've a healthy BMI of 21 but feel like I'm 80 years old because constantly tired, nauseous and keep getting every cough and cold going!My GP just doesn't seem to care anymore, think they're fed up of dealing with me because they've tried everything, have been for tests, colonoscopies, gastoscope, small bowel series and nothing, and the gastroenterologist I was seeing in hospital has washed his hands of me dismissing me as another IBS case and discharged me back to the care of my GP and its got to the point of I know my GP won't do anything different for me that I won't go. Haven't had a sitz marker test done, with NHS cut backs and not being seen by a gastroenterologist can't see them doing it. Was thinking of private again, but can't afford it myself and don't want to ask my parents to pay for it, especially after the last time it didn't show up anything and not even sure the treatment would change apart from daily laxatives. Its hard because I live in constant fear of this happening to me again and feel like the doctors haven't a clue how to deal with it either and now worried my bowel has lost the push mechanism to work on its own at this point!Sorry to be so down, but sometimes IBS just wears you down, wish I could just have a "normal" life!


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## em_t (Jun 8, 2010)

Ugh so got to the point yesterday that I had to go to A+E, have had no appetite for days, feelin week, dizzy and no amount of laxatives was shifting the mass inside me and now have to take the Movicol treatment (think its called Miralax in the US)







Its horrible, I have to take 8 sachets in 6 hours and depending on how it works I might have to take it for up to 3 days! I'm starting to get really worried because even when I'm not this bad, I have a very poor appetite, I get full very quickly and can't remember the last time I had a proper "meal", I mean I snack during the day so I'm probably eating 6 times a day, but its just not a huge quantity of food, on a regular day I reckon I only get about 1000 - 1200 calories in my diet. I've tried eating more but it just makes the constipation worse and even the thought of eating a big meal makes me feel sick. My GP's attitude is they aren't too worried if my weight isn't dropping, which it isn't, I'm a steady 108 - 110 lbs (which is ok because I'm only 5'1") but I'm just SO tired during the day and I really do think its because I'm not eating enough or getting enough energy from my food - anyone any suggestions I can do get a bit more calories in my diet without making constipation worse? I've already seen a dietician when my weight was much lower but because I put on a bit of weight they signed me off their books, despite the fact I was still struggling with the constipation! I've been on nutritional drinks before called Fortisip to help me put on weight but because they contain next to no fibre I'm very loathe to take them - plus its not really food I'd rather do it naturally!Have all the laxatives destroyed my bowel or has it just stopped working at all now?! Getting really worried, that this will only get worse!


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## sonnygarcia (Jun 3, 2009)

have you had a sitz marker test before, if so what were the results?


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## em_t (Jun 8, 2010)

No, they don't routinely do it here in the UK on the NHS. Thinking of maybe going private again see if they will do it, but even the gastroenterologist I went to see privately dismissed me as another IBS patient and said I'd most likely feel better in 6 months, well that was a year ago and I feel worse! Spoke to a very sympathetic doctor today who suggested more anatomical testing, so going to go back to my GP and talk about it


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## Mary5 (Apr 17, 2006)

I think you really really have to get the sitz marker test. You swallow a capsule with markers in it and on the 5th day they take an xray and see where they are. The reason it is important to get this test is that it will allow for a definitive diagnosis and to specific treatments. For example, if colonic inertia is established then you might be a good candidate for surgery. Or not. But it is important to get this issue established because how you are treated depends on it. After 8 years of suffering, under the generic "IBS umbrella", my gastro sent me to a colo-rectal surgeon who ordered the the sitz marker test and a defecography (test how your pelvic floor muscles are functioning) and finally got a clear diagnosis. In my case I have slow transit, a stage one rectocele, and pelvic floor outlet problems. If it was just the slow transit surgery was an option but because of the pelvic floor disfunction it is not. He sent me to therapy and I have to say that I am so much better, not totally, but much better.So I urge you to try and see a colo-rectal surgeon, and/or get the sitz marker test at least.And don't eat too much fibre, it only becomes a ball that sticks in there. My recomendations>Lots of water, vegetable soup, carrots, peas, spinach/-all well cooked. Applesause. NO starch, no white stuff (cakes etc)....Hope this helps.


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## em_t (Jun 8, 2010)

Thanks Mary, problem is even the private gastroenterologists work for the NHS here, they just do a bit of private work on the side to earn more money, so its not like you're even getting a different viewpoint! Have been back onto my GP about a referral, problem is it takes so long! I'm so sorry you've been suffering for 8 years ... I've only had this problem for 18 months and its getting too much for me! Have only ascertained that its fibre that really upsets me ... all the things I've been told to eat have been making me worse! On Sunday ate beans, lentils, veg, anything and everything high fibre and have been so ill the last few days, I can feel it travelling up the right hand side of my colon over to the middle (slowly and very painfully) But because I have a problem with constipation doctors just won't believe me when I say fibre is making me worse and say its no wonder I'm constipated if I don't eat a lot of fibre!I'm just scared about possibly needing an operation, I'm only 23 and have this fear that things will only get worse, so if I need to get part of my colon out already, how much will I need taken out in future? Problem was I NEVER had a problem with constipation until I had a stomach bug last year and seems like its killed off my bowel! If there was another way of treating my overly sluggish bowel I'd love to get some advice on it - here's hoping an appointment will come up fairly soon! Thanks for your advice!


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## DDP (Nov 24, 2010)

em_t said:


> Thanks Mary, problem is even the private gastroenterologists work for the NHS here, they just do a bit of private work on the side to earn more money, so its not like you're even getting a different viewpoint! Have been back onto my GP about a referral, problem is it takes so long! I'm so sorry you've been suffering for 8 years ... I've only had this problem for 18 months and its getting too much for me! Have only ascertained that its fibre that really upsets me ... all the things I've been told to eat have been making me worse! On Sunday ate beans, lentils, veg, anything and everything high fibre and have been so ill the last few days, I can feel it travelling up the right hand side of my colon over to the middle (slowly and very painfully) But because I have a problem with constipation doctors just won't believe me when I say fibre is making me worse and say its no wonder I'm constipated if I don't eat a lot of fibre!I'm just scared about possibly needing an operation, I'm only 23 and have this fear that things will only get worse, so if I need to get part of my colon out already, how much will I need taken out in future? Problem was I NEVER had a problem with constipation until I had a stomach bug last year and seems like its killed off my bowel! If there was another way of treating my overly sluggish bowel I'd love to get some advice on it - here's hoping an appointment will come up fairly soon! Thanks for your advice!


What kind of fiber supplements, if any, have you tried? You may be getting the wrong kind of fiber? If I eat any of the fiber-full things you've been eating (and getting sick from) I'd get sick too. I had best results when taking Metamucil daily (1tbsp). It has insoluble fiber, which is the kind of fiber that helps prevent constipation. Soluble fiber is what I stay away from as much as possible, and that's what you find in the things you've been eating.Maybe you know all this, I don't know. I'm new here, and just wanted to share this info...


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## em_t (Jun 8, 2010)

I've tried Benefibre and putting flaxseeds on my porridge in the mornings but ANY sort of fibre seems to make my constipation worse! On the Sunday when I was eating all the fibre rich foods I hadn't eaten in a day because I was doing a bowel clearout, I ate all those high fibre foods to prove to my GP that high fibre foods are making the situation worse! The only thing that works for me at the minute is eating small amounts of low fibre food, I can't eat huge amounts of food because I constantly have this feeling of being full, even after a few mouthfulls! Also taking 1000 - 1500 mg vitamin C supplement works really well, especially those soluble tablets, plus lowers your chances of getting a cold!Hopefully, the GP will refer me to a gastroenterologist who can perform some more tests and find out what is wrong. Up until 18 months ago I never had a problem with constipation so think it was definitely linked to a stomach bug I had about that time!


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## DDP (Nov 24, 2010)

Maybe try eating yogurt or taking pills that have the healthy probiotics. I took those and found that feeling of being full all the time went away.And I still don't think you're trying the right kind of fiber. GOod luck


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## ChrissyM816 (Nov 24, 2010)

I have been going through the same thing. This past week I had not gone in about 6 days and my stomach was AWFUL...couldn't do anything b/ the pain was so bad. I went to the dr and she said she didn't hear any movement in my stomach which meant I had a blockage and I need to eat more fiber, drink more liquids, take amitiza, miralax, all the usual comments. Well I went home for the holidays and my niece (who is 6 and also has bowel problems) takes Senakot and she told me to try her belly medicine so I did and it worked wonderfully for me. My sister said she tried the pills which don't work near as good as the liquid. Within hours my gas pain was being relieved and by 12 hours I was going to the bathroom and I feel like a whole new person......Granted it was a little bit of diahrrea but I didn't care!!!I hear it doesn't work as well for some people but it's worth a try if you haven't already. It's a natural vegetable laxative, a bit expensive too but I'm ok spending on whatever helps me!


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## em_t (Jun 8, 2010)

Thanks for the tip Chrissie, I've never tried Senna before, have never needed Senokot until I had all my problems with CC and most of the time sodium picosulphate works quite well for me so would be very loathe to change it at this stage. Chronic constipation's a nightmare, sick of feeling sick and blah all the time! It seems like anything solid is upsetting me at the moment, if I can feel it moving through me its bound to get stuck somewhere! So am just eating lots of soups and casseroles with well cooked vegetables and probiotic yogurts. The probiotics are working quite well but again can't even have any of the Activia with bits of fruit or anything in it, has to be the plain ones otherwise it just leaves me feeling so full and sick!Will maybe discuss with my GP about changing laxatives. DDP I have tried eating all sorts of fibre, wholegrain bread (which just gets stuck in my system), flaxseeds (the same), fruits and veg which just fill me up so much I lose a tremendous amount of weight and don't actually help at all with the constipation! At the moment, have just eaten and so nauseous I can't move!


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## QuiQui (Aug 15, 2010)

I can't tell from your profile...are you female? Your problem might be hormonal and related to your period. I know that I feel feverish and sick about 10 days before my period. It's also around that time of the month when I begin to feel the most constipated. If you notice a pattern like this, you could try taking a daily regular dose of Miralax or something similar BEFORE the time when you expect to get an impaction. I find also that eating a big salad every day helps a little, as does eating plain Activia yogurt with some cereal in it every day. It took about a year before I noticed that the Activia was doing anything, but now I notice the difference when I stop eating it, so it's definitely doing something. I have the same problem as you do, where large doses of fiber just make things worse. The other thing that helps me is to organize my schedule so that I have at least an hour or two in the morning to drink some strong coffee, sit still and relaxed, and wait for a BM to happen. If I can maintain this morning routine, then I don't suffer too badly with constipation. Even if you have to get up at 5 a.m., it might be worth the effort and fatigue.


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## em_t (Jun 8, 2010)

Hey, yeah I am female. Find the problem of constipation is definitely usually worse when I've got my period but its pretty bad all month, just worst then. I wish I had the energy to get up at 5 am but I'm really not a morning person, I have a hectic job as a teacher and need all the sleep I can get - if I have less than 7 hours sleep I'll definitely be bad the next day. My doctor's talked about starting back on the Miralax or Movicol as we call it here in the UK but it just leaves me in so much pain I can't bear it - its like the colonoscopy prep again everytime I have to take it and don't want to be adding another laxative to my repertoire! Scarlett, yeah I'm from the UK, Northern Ireland to be specific. Have gone to most of the hospitals in the Belfast Trust but not on any gastroenterologist's list anymore as I'm just another annoying IBS patient who should be glad there's nothing more serious wrong with me - one of them actually said that to me! There's ulcerative colitis in my family so I'm guessing that's what he was eluding to, but no-one wants to live with IBS either! Instead of carrots maybe try roast peppers, courgettes, salad, green beans instead - less likely to constipate than carrots!


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