# constipated yet stool is soft, is this possible? Please reply!



## Jen37

Hey Everyone Ok, for the last year I have been having issues with pain, cramping, feeling that I always gotta go etc.... I never really have diarhea( except for when I have my period my stools can be soft)but other wise pain is my biggest issue. About two weeks ago I started eliminating the rice cereal that I ate at breakfast thinking that maybe it was aggravating things. I switched to oatmeal. Well I noticed after four days of eating the oatmeal my stools were harder to pass( like I was not getting that super urge to go)and when I did get a little urge I would have to strain and not much would come out. But yet it was not hard in texture like the typical definition of contipation( hard balls of stool),this was normal in texture. So, after four days of this I stopped the oatmeal, but still persisted to have the issue. I then added more fruits to my diet hoping this would help me to have a decent BM and get that urge back. I have been eating 1 pear, 1 peach, 1 banana, and about 4 ounces of prune juice daily as well as a vergetable at dinner( carrots or green beans). Still I was Not getting that urge. I mean I was going like every other day but I would not get a super urge and what little urge I got I would have to push to get out the BM and it was not a full BM. SO I would be unconfortable all the time with bloating, pain, cramping and feeling like I had to go, but no real urge. Well last night I felt so horrid( cramping pains in the mid-abdomin and just feeling like I had to go in terms of the mid gut cramping, but not the urge you get down lower telling you to find a toilet. Well I decided to drink a cup of coffee as I know it can cause the intestines to contract. Well low and behold a half hour after I drank the coffee I got the urge. I pushed out a foot long poop!! I mean I emptied out. Unfortunately, I cannot really drink coffee as it really upsets my bladder (I have interstitial cystitis). Now my bladder is in agony from the coffee, but it did make my intestines contract to have a decent BM. What can I use that is safe on a daily basis that helps to get that urge to go and that contracts the intestines???? I know laxatives are not the answer as they can cause damage later on if used constantly. What else is there that can help with this??? Also, can you have constipation( where the bowels just do not move well) but your stool is actually soft in texture???? Is this part of the IBS???


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## Kathleen M.

Yes, you can get odd combinations where you can do enough to the diet to force the stools to be soft and still have issues with slower than normal transit times, or have issues with urge and straining.There can be pelvic floor issues where it isn't working right no matter what the stool consistency (so may have to strain as you tighten up the sphincter when you should be releasing it).Pelvic floor issues aren't always a part of IBS, but a lot of people with IBS have them, so it may be worth getting some testing to see if there is something going on that would prevent you from passing normal stools easily. Also if you have transit issues that can be tested for as well.Would you consider something like Amitza or a low dose SSRI antidepressant to keep things moving a bit better (but may not help with pelvic floor issuses).


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## Jen37

Hi Kathleen,Thanks for replying. I am not sure if this pelvic floor related, I really doubt it as this just started. Also, when I drank the coffee, it gave me the urge and I was able to empty out really well. Years back I was working with a gastro doc for upper gut issues with feeling full ater a few bites and severe bloat in the upper gut.( that got better after I went gluten free five years ago). I remember my gastro doc at that time telling me about all the tests they have to check for slow transit in the upper and lower guts, and he said honestly they are not worth doing. He said that if your not moving well, your not moving well, it is better to just try and treat the issue. The tests are uncofortable for one, expensive and not all reliable. And in the end, the treatments will be the same. I called the gastro today and only was able to relay my message to the nurse. She said that IBS can cause slow transit in some people. She mentioned miralax, but I am unfortunately allergic to it, so that is out. I am waiting to hear back, probably tomorrow or the next day.This whole issue with the slow transit and lack of strong urge just started almost two weeks ago. Before all this started I was kind of alternating( soft formed to a bit harder, but not really hard). Main issue is pain all the time. I am not sure about the antidepressants as I do not want to end up with diareaha either. I just want something that will help contract the intestines enough, but not to cause the big D. It is odd that the coffee did such a good job( unfortunately bothers my bladder though). Does fiber like metamucil or flax seed help the intestines to contract if one has slow transit?? I have been eating alot of extra fibers like fruit and also a natural fiber( only half a scoop) that I put in a fruit smoothie. That I just started today. There has to be something else out there besides miralax and coffee, at least I hope.I cannot depend on coffee as it hurts my bladder. I was searching through some of the old posts on here and came across one from a woman who said she had not had a BM in over 70 days!! I could not even imagine this. This scares me that this can happen. I did not even think you would live if you had not had a BM in over two weeks let alone 70 days! Thanks again. I just hate this. I also drink a lot of water( like 2 liters a day or more). Just not sure what else to do..


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## BQ

I think there are meds to increase intestinal transit. Ask your Dr.


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## AIRPLANE

Jen37,I just had my first transit test this week. I don't think that it really provided any useful information. I swallowed the capsule at the clinic first thing when I got there and had to go back for several checks that day and a few more the next two days.Results:Normal gastric emptying at 1 and 2 hours. Accelerated gastric emptying at 4 hours. Delayed small bowel transit time. Colonic transit was delayed at 4 and 48 hours and at the very lower range of normal at 24 hours.1 hour 50% (normal 11-39%)2 hour 72% (normal 40-76%)4 hour 100% (normal 84-98%)6 hour small bowel transit 26% (normal 46-98%)The doctor seemed to think that my loose stools and sometimes watery diarrhea were really constipation masquerading as diarrhea. She said that I was probably constipated and that my colon was somehow adding water to push things along. I've never heard of this before, although on the few occasions when I get urgent diarrhea I wonder if it has anything to do with what feels like a fistula which I doubt will ever get diagnosed. I mentioned the fistula to her but she wasn't interested in that. I have heard of looser stools getting around severe constipation but that's not what I have- with me, everything is loose and seems to be poorly digested and often pencil thin, regardless of how loose or firm it is. I used to have very definite symptoms of a fistula after my hysterectomy but as time goes by they are known to shrink and close but can open intermittently. If I ever got scheduled for a fistulogram to diagnose it with my luck it would probably be closed tight! I also was diagnosed with a small rectocele several years ago but was told that it shouldn't cause any problems. I do know that when I have difficulty emptying it seems like I have to try and get things around a bulge on the left side and I think that there may be some kind of an abscess or other fluid buildup that is in the way but only my massage therapist seems to notice it. It would make sense to have an abscess if I've had fistula symptoms. She also said that my pelvic floor muscles were probably tight and recommended a two-week pelvic floor retraining program. This was recommended to me several years ago but I wasn't able to do it because it was very expensive and my insurance wouldn't cover it. I agree that I'm tight there- and a lot of other places- probably due to adhesions and I'm not convinced that doing biofeedback (that's what they primarily do) alone can help. They did have me go and speak to a physical therapist and I asked her about insurance issues and she said that more insurance plans were now willing to cover it. She gave me the codes so I could check if I would be covered which I will do. If I decide to do it there is a 3-6 month waiting period and I'm not sure if I'd want to sign up at this time because the clinic is a long drive and I wouldn't want to do it once the snow starts (which always seems to happen soon enough, even though few people are probably thinking of winter with all of the 90-100 degree temps lately!) I did tell the doctor that I'd gone to a couple of local physical therapists who immediately said I had a lot of tight adhesions but she insisted that adhesions could only be diagnosed via exploratory surgery and that was the end of that topic.I'm going back in two weeks. The doctor said she was willing to do a SIBO breath test and also schedule me to see a neurologist for my left side sciatica issues. I did have a spinal MRI last year that showed trapped nerves somewhere and I wondered if maybe going that route might possibly lead to what is causing the discomforts in the pelvic/buttock area and also left-sided vulvar issues. I was once given amytriptiline for the vulvar issue because it is supposed to be good for nerve pain but hated the side effects and only took it 3-4 times. If I remember correctly, weren't you also prescribed that but weren't sure if you wanted to take it? I've also wondered about pelvic congestion due to adhesions but have always been refused vascular testing because my ankles didn't appear swollen. If the neurology route doesn't work, I'm hoping they will consider the vascular route but who knows.But yes, I also can have very soft stool- often right in in the rectum- and no urge to go. I know it's there because I frequently use aloe suppositories and ointments and I can feel it when I insert them. I don't totally discount the pelvic floor issue, especially with the adhesions but, if I do have it, I'm not convinced that it is my only issue. And as you can see from my transit test, it was no help in my case but it might be useful to some people. But it made for a couple of very long days at the clinic!


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