# Chronic idiopathic slow transit constipation



## Eleanor91 (May 13, 2015)

Hi All,

I have been diagnosed with chronic idiopathic slow transit constipation and IBS-C. However the I rarely experience pain except for occasionally in the morning when I can feel my bowel trying to move but the pain subsides pretty quickly.

I am 24 years old and have never had a problem with being regular, I would go after every meal. Then whilst I was traveling in the UK my bowels just stopped working, it basically came out of nowhere. I only had one proper bowel movement over my 2 month trip and expected my bowels to return to normal when I returned home but they didn't. Its been 6 months since I returned and my symptoms are exactly the same.

I have tried osmotic and stimulant laxatives but they give little relief and make me bloated and uncomfortable. Fibre is useless and makes me incredibly bloated also. If I don't take laxatives regularly I can only pass the tiniest amounts each day (if I'm lucky) which doesn't provide much relief and makes me feel nauseous, tired and uncomfortable. I've lost about 3-4 kilos since this has all happened.

Things that I think may have contributed:

- Started birth control pill before I left for my trip - made me extremely bloated and constipated. Went off pill a week before trip and symptoms were gone and I was back to normal.

- Family history - father has ulcerative colitis, mother died in forties from small bowel cancer/ovarian cancer (not sure which came first but suspected small bowel) mother and her two sisters all had gallbladder problems removed.

- Every few months I experience a strong dull ache in lower right side of abdomen but this literally only happens about once every six months. Happened just before chronic constipation started whilst overseas, the worst I had ever had it.

- Have always had debilitating period pain - often take time off work and strong pain killers such as mercyndol and nurofen plus often don't take the pain away.

Have had CT scan, blood test (thyroid levels, calcium, RBC & WBC) and faecal test. Moderate loading throughout large bowel from CT scan but nothing sinister. All other tests came back negative. RBC was bordering anaemic but am a vegetarian so doc thinks that is the reason.

I have never met anyone that has had such severe symptoms that have started so suddenly, most people I have spoken with that have constipation have struggled most of their lives. I'm hoping I will meet someone on this forum that was once totally regular and now has trouble going at all without the aid of laxatives.

I realise this is a lot of information, I do not expect an explanation or a cure from anyone but if anything sticks out to anyone, or if there is anyone out there that experienced anything similar and found a diagnosis I would really like to hear from you.

Thanks guys









P.S. Am booked for colonoscopy in a couple of months but Gastro and GP think it will show nothing, that is my expectation too at this stage.


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## annie7 (Aug 16, 2002)

hi Eleanor

welcome to the board. so sorry for your constipation problems. yes, it is hard, struggling to manage chronic constipation.

i have chronic constipation but unlike you, i've had it since childhood. it got much worse in my early 20's. i have read posts like yours, both on this board and on another board i read, about people who suddenly developed problems. either way, it's a tough thing to live with.

i have to take laxatives daily to go and yes, it's by no means a perfect solution because for me they don't always work completely and leave me feeling nauseous and bloated.

have you tried any of the medications that are available for chronic constipation--amitiza, linaclotide (linzess as it's called in the usa. constella is another name for it) , or prucalopride (resolor or restoran) i'm not sure which of these are available in australia.

have you been tested for SIBO (small intestine bacterial overgrowth) ? that can cause constipation as well as many other problems. i've been diagnosed with that. there is a lot of information here on the board about SIBO ( do a search) as well as online.

another possible cause of constipation is an outlet problem such as pelvic floor dysfunction or a rectocele, any other 'cele, or a rectal prolapse (both inner and outer). i have pfd. i also have a rectocele that i wasn't even aware of. outlet problems are diagnosed with a defecatory proctogram (defecogram). biofeedback can help with pfd. sometimes surgery can help with the other problems.

a colonic transit test (sitz marker study--it might go by a different name in australia) will show if you have colonic inertia. it is another very good diagnostic test to have.

if you haven't already done so, take a look around the board. there is a lot of good information and tips about dealing with chronic constipation on here.

good luck with everything. wishing you all the best.


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## annie7 (Aug 16, 2002)

just another thought---a colonoscopy will show if you have a long and/or twisted colon. mine showed that. this can also slow colonic transit quite a bit.


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## Nuffa (Sep 12, 2014)

i am just as u, i was totally regular before my bowels quit working, i was 27 back then and i am 32 now. i have absolutely no clue what happened.


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## Nuffa (Sep 12, 2014)

things that help me, besides osmotic laxatives, are: home made kombucha- a fermented beverage-, a vegetable soup every day, seedless grapes. buttermilk. aloe vera juice-caution:some say it may be habit-forming. starting triphala today. if something else comes to my mind, i will let u know.


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## marleyma (Aug 13, 2014)

How much aloe very juice do you consume daily? That's interesting.. habit forming? Why's that?


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## Nuffa (Sep 12, 2014)

i don't consume it daily, just sporadically. but when i take it, then it's quite a lot. about 80 ml. it usually works in 7 hrs.


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## Eleanor91 (May 13, 2015)

Hi All,

Thanks for your replies! It is indeed a horrible thing to have to deal with.

Annie, I have heard of SIBO yes and suspected that this could perhaps be my problem. I started taking a contraceptive pill a few weeks before my overseas trip (which was when the constipation started) and my body had a really bad reaction to it: massively bloated stomach and the same kind of constipation. I went off the pill after 2 weeks and symtpoms subsided but then left for my trip shortly after and the symptoms started again. I've always thought that the pill played a part in this. Anyway, I've done a lo of research obviously and found that antibiotics AND the contraceptive pill kill the good bacteria in your tummy and can contribute to SIBO. Problem is doctors over here know nothing about it and don't test for it. My gastro doctor refused to believe it was even a possibility. I have an appointment with the centre of digestive diseases here in Sydney which is run by a Professor Borody who specialises in FMT and believes bacteria plays a major role in digestive diseases such as Crohns disease, ulcerative colitis and chronic constipation. They are running clinical trials on FMT at the moment, apparently it has been shown to be a very effective treatment in digestive problems and they do the hydrogen breath test and other tests to check for pathogens/overgrowth in bacteria. If you haven't seen the centres site you should have a look, I find their theories very interesting: http://www.cdd.com.au/pages/disease_info/constipation.html.

I have heard that a long, twisted colon can be part of the problem for many, but doubt it will be the case with me as I have never experienced these problems before in my entire life, but you never know, it very well could be. I'll be interested if the colonoscopy shows anything at all to be honest, my feeling is that its either bacterial or a motility issue (which may be something to do with hormones in my case) but this is all just speculation really.

I also get pains on and off in my lower right abdomen outside of my period, and have been experiencing these pains for about a year now. I have always experienced debilitating period pain (cannot go to work or do anything for a couple of days) so am going to a gynaecologist to get an internal ultrasound and laparoscopy. I'm determined to check absolutely everything before I give up and accept that this is what I have to deal with forever - may as well.

And in answer to your question about the medications for chronic constipation; I have tried Resotran which my gastro doc prescribed and will never touch it again. I only took one pill and it made me as sick as a dog! Migraine started about 45 mins after taking it, felt like a couldn't swallow properly, made me throw up and feel incredibly depressed I couldn't stop crying and then had to take the next day off work - so I am really turned off the medications. Maybe there are better ones out there but I hate feeling like a guinea pig and the side effects usually outweigh any good (IF any) the give. Have you found any particular type to be effective for you?

Thanks Nuffa for the tip on aloe juice - does this cause you and side effects such as bloating? I almost always get bloating from anything that helps. Was there anything triggered the constipation that you can think of? Its frustrating especially when you know what it feels like to have things work normally and then everything just stops.. I console myself by telling myself that there are people out there dealing with worse, but it still sucks 

My doc asked me to stop taking laxatives and get an xray to check for faecal loading (which has already been confirmed by CT scan but anyway..) which I had done this morning so currently haven't been pretty much at all in over a week and feel sick and horrible. Laxatives it'll be tonight! Fun!

Anyway, thanks everyone for your feedback and in the meantime, if I find anything that is very effective for the constipation I will let you know. And I will give updates on my colonoscopy in how I go with the gynaecologist. Fingers crossed something will come to light for me!

Over & out


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## annie7 (Aug 16, 2002)

Hi Eleanor

yes, over the years i've tried all the constipation meds that have been available here in the usa and no, they haven't helped me much. zelnorm (way back in the day) helped a little but the FDA pulled it off the market due to cardiac issues. i use linaclotide (linzess) for cleanouts (by taking it with food, not as prescribed) otherwise it doesn't work for me. prucalopride (resolor or restoran) is not available here in the usa. so sorry it didn't help you and gave such such miserable migraines.

yes, i've read a lot about FMT. i agree that it can be very helpful in some cases. my problems are more structural and muscular--i have pelvic floor dysfunction, rectal hyposensitivity and megarectum and the twisted colon. bacteria cannot help with these problems. a course of antibiotics has reduced my SIBO for now.

i remember reading about that FMT link in this thread on the board re SIBO:

http://www.ibsgroup.org/forums/topic/121611-sibo/

FMT doesn't help with SIBO but, like i said, it can be helpful for some people.

good luck with everything and yes, do keep us posted--thanks.


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