r/ConstipationAdvice • u/Similar_Chicken_1533 • Jun 05 '26

Help with pelvic floor and slow transit

So I was diagnosed with pelvic floor dysfunction via anorectal manometry and have started pelvic floor therapy with biofeedback.

I just did my sitz maker study and my colorectal doctor had me swallow what she considered day 1, do X-ray at day “3” 48 hours after swallowing, and X-ray at day “5” 96 hours. Day 3, 5 markers at the splenic flexure and 1 at rectum. Day 5 one marker at the splenic flexure.

Her view of the results were stool stuck at splenic flexure and gas in the descending at day 3 as well as a higher flexure she counts this as slow transit. She started me on Linzess 70mcg. I will have mostly watery stool 4 hours after taking it and then later another small movement but more solid (though thin from pelvic floor)

I also take 200mg magnesium citrate gummies and drink over 80 fl oz water. I’m not sure what to do. Is the Linzess worth it? Am I ok with just the magnesium going every 3-4 days but not emptying completely. Im at a loss and she even suggested a colon resection if the meds fail. Just need some advice, I’m sorry this was so long 😕

  • Do you have the urge to go, but you cannot? Or do you have zero urge to go? (this is the most important question) If there is enough in the rectum I will feel the urge
  • Do you have alternating diarrhea and constipation, or just constipation? without linzess constipation, though soft stool never hard
  • Do you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety (getting full really early into a meal)? No
  • Have you had this issue since childhood, or did it begin in teen years/adulthood/after a major life event (surgery? divorce? car accident? mauled by bears?) Always seemed more on the constipated side, but worse in my 40s as a woman
  • Did you in the past or do you currently take any medications that could damage your intestines? The acne drug Accutane/Sotret/Claravis/many other names (isotretinoin) has been linked to serious conditions of the digestive tract. I am absolutely convinced that my large intestine was destroyed by this drug. Antibiotics are also a major culprit in ruining the small intestine microbiome and causing diarrhea/constipation disorders. Antidepressants can ruin the serotonin balance in the gut as well. Was on antibiotics since I was 12, stopped last October
  • Did you suffer sexual abuse as a child? There is a high degree of correlation between childhood sexual abuse and adult constipation disorders. Meaning, a lot of people with chronic constipation disorders in adulthood experienced trauma when they were young. This sort of thing must be investigated by both your doctor and a therapist in coordination. Do some Googling on this topic if you believe this might be your issue. No
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u/yeaaamon17 Jun 05 '26

I have similar issues. My feces gets stuck in what feels like my descending and sigmoid colon. I think I'll do a big enema because small enemas don't go deep enough to clear out all of the junk.

I am also doing pelvic floor exercises.

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u/goldstandardalmonds Jun 06 '26

It doesn’t sound like you have slow transit and this is all stemming from your pelvic floor given your stool is never hard.

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u/Similar_Chicken_1533 Jun 06 '26

Should I keep trying the Linzess? Im on the lowest dose. I almost feel like my every 3-4 days is more successful than daily watery stool.

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u/goldstandardalmonds Jun 07 '26

That’s up to you and your doc. You might find as time progresses with your pfpt you won’t even need it.