# ibs-c chronic pain and constipation



## Stefanie Berrios (Feb 22, 2015)

I'm 26 female and I was diagnosed with ibs c 7 months ago. I always had problems with constipation but never this bad I can no long use the bathroom on my own using linzess and miralax, and when I do only a little comes out in liquid form never gives me a relief and I'm always in pain. Wanted to know if anyone else is dealing with this and how are you handling it, thank you


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## annie7 (Aug 16, 2002)

Hi Stefanie

i'm sorry you're having problems with constipation and having so much pain. i hope you have a good gastroenterologist to help you with all this. have you told him/her about all your pain? if your pain is being caused by spasms, your doc can prescribe an antispasmodic. and sometimes just using a heating pad (not too hot) on your belly can help relieve the pain and relax the spasms.

a couple things about having problems getting stool out--even the liquid stool that linzess and miralax can produce:

elevating your feet on something like a footstool, shoebox etc while sitting on a toilet can help straighten out the anorectal angle and allow for a more complete evacuation. so can using a squatty potty which you can buy in stores or online. elevating your feet like this can really help get stool out. i first tried it with a shoe box and then i bought a squatty potty.

liquid stool can be hard for some people to get out. you might want to try firming up your stool by adjusting your diet or taking a fiber supplement. when adding fiber--especially if you're using a supplement-- start slowly otherwise it can be gas producing. there are a lot of good diet tips over on the constipation board.

or you could try firming up your stool by reducing the amount of miralax you are taking. or taking the lower dose of linzess --145 mcg--if you are on the 290 mcg dose.

another thing about linzess--the closer you take it to eating, the more D you get. if you are currently taking it as prescribed--30 minutes before breakfast--try taking it an hour before eating. or even the night before. you get less D that way and a firmer stool, which might be easier for you to get out.

also--if you have incomplete bowel movements and keep feeling like you need to go all day, you could have pelvic floor dysfunction. have you been tested for that? with pfd, the pelvic floor muscles don't coordinate and/or relax properly to allow easy passage of stool. ineffective pelvic floor muscle coordination results in inadequate relaxation of the pelvic floor while attempting to have a BM. the puborectalis muscle tightens and contracts when it is supposed to relax to allow passage of stool. so you can't get it all out (incomplete) and often have that "have to go " feeling all day.

a defecatory proctogram test will show if you have pfd as well as reveal if you have any other outlet problems like a rectocele, vaginal prolapse, rectal prolapse, etc. an anal manometry also helps diagnose pelvic floor problems.

biofeedback and physical therapy can be effective in correcting pfd. it helped me.

so you might want to mention this to your gastro doctor--that you're having problems getting stool out-- and ask to get tested for it. here is a good link explaining it all:

http://my.clevelandclinic.org/health/diseases_conditions/hic_pelvic_floor_dysfunction

here is a great u-tube video on how to have a bowel movement without straining. the woman in the video is a pelvic floor physical therapist. her instructions are similar to what my biofeedback PT told me to do.






and lastly--some of us have found that taking a stimulant laxative along with linzess or miralax helps push that liquid stool. i have slow transit constipation (colonic inertia) (not ibs) and because of this my gastro docs and surgeons have all advised me to take a stimulant along with an osmotic laxative so i can go. they have told me to take whatever i need to have a BM. but please--it is very important to get your doctor's approval first before starting on stimulants.

there are a lot of us who suffer from chronic constipation over on the constipation board. if you haven't already, take a look over there for helpful tips on dealing with it--diet advice, etc etc.

hope you can find some relief. take care.


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## Stefanie Berrios (Feb 22, 2015)

Thank you so much for this info, I think I may have pfd I do have the feeling to go all day and hurts really bad I will discuss with my gi doc, again thank you


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## annie7 (Aug 16, 2002)

thanks--you're more than welcome







.

yes do discuss all this with your gastro doc. hopefully he/she will schedule you for a defecatory proctogram and/or anal manometry to test for pfd. a defecatory proctogram will also show if you have any other outlet problems like a rectocele, etc or a rectal prolapse--so it's a good test to have.. . some docs will even send you to a biofeedback PT for an evaluation without any testing beforehand.

most good gastro docs are knowledgeable about pfd. if by chance yours is not, then find a better doc. often gastro docs who work at a university hospital are more up-to-date, knowledgeable and proactive about constipation problems.

good luck with everything! wishing you all the best,


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## lonelygirl123 (Mar 25, 2015)

I am so grateful right now.. because I have chronic pain from IBS-C and every since I started Metamucil the pain went away completely (some minor pain at night, but I'll treat myself with an ibuprofen if it gets bad). I hope you find something that works for you. BTW I wanted to suggest you use enemas, they are amazing when there is a "blockage" and the Metamucil isn't strong enough. It doesn't cause me cramps like the other strong laxatives, so I always go for for that... and I usually feel like I totally cleaned out my colon after an enema (it's not a water enema, it has something in it.. I think "saline" or something, it's called Fleet over in Canada). Honestly, the Metamucil isn't a perfect cure for me, because sometimes I get blocked up and bloated and in pain. The enema clears it out and it helps my intestines "start over". I hope this helps.


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