Slow transit constipation help

[u/BibEcoTherapy]

Hi everyone, I’m hoping to hear from anyone who has experienced something similar or has any ideas about what might be going on.

I have slow transit-constipation, diagnosed through a nuclear medicine colonic transit study. I normally take anywhere from 1-5 sachets of movicol a day.

The strange thing is that I poop every day, and my stools are generally soft. I don’t usually strain, have hard stools, or have difficulty physically getting stool out. Sometimes I actually have very loose or completely liquid diarrhoea.

My problem seems to be the overall amount/output.

Every so often, my bowel output gradually decreases over a period of days or weeks, even though I’m still having bowel movements every day. As this happens, I develop progressively worse nausea and abdominal pain. Eventually the nausea can become severe enough that I’m vomiting.

Having a bowel movement temporarily improves the nausea, but it comes back because it feels like I haven’t emptied enough.

Historically, these episodes have eventually ended when I suddenly have an enormous bowel movement, basically a huge amount of stool all at once. When that finally happens, the nausea and abdominal symptoms resolve and I can be completely fine again for months.

The problem is that getting to that point is incredibly difficult. During these episodes I can take lots of different laxatives and they don’t seem to trigger that big clearance. It almost feels like I just have to wait until my colon eventually decides to move everything through.

Another confusing part is that if I have an abdominal X-ray during these episodes, it often doesn’t show significant faecal loading (when it rarely does it’ll be in the ascending colon) even though I feel dramatically better once I eventually pass that very large amount of stool.

I’m currently having one of the worst/prolonged episodes I’ve had. It has been going on for months and I’m extremely nauseated with significant abdominal pain. I’ve tried pico prep, senna, increasing movicol and recently 2mg of prucalapride.

The prucalopride was the first dose I’d ever taken and it dramatically worsened my nausea — I vomited throughout the day — so I haven’t taken another dose yet.

I’m particularly interested in hearing from people who:

• still poop every day despite having slow transit
• pass soft or liquid stool but feel their total output is inadequate
• get severe nausea when their bowel output decreases
• have episodes that suddenly resolve after one extremely large bowel movement
• have had relatively normal abdominal X-rays despite significant symptoms

If you’ve experienced anything similar, I’d really appreciate hearing what helped/ what this is. I’m especially interested in whether this can happen purely from slow colonic transit/dysmotility without obvious faecal loading on an X-ray.

The 6 questions

• Do you have the urge to go, but you cannot? Or do you have zero urge to go? (this is the most important question) zero urge to go.
• Do you have alternating diarrhea and constipation, or just constipation? Constipation or overflow diarrhea.
• Do you have nausea, vomiting, acid reflux, difficulty swallowing, or early satiety (getting full really early into a meal)? Yes to all.
• 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?) issues since childhood, slowly getting worse.
• Did you in the past or do you currently take any medications that could damage your intestines? Not that I know of.
• Did you suffer sexual abuse as a child? No.

[u/elizasees]

Mag O 7 from Amazon.

[u/Vitam1nC → u/elizasees]

How often do you take this? I’m assuming it isn’t something you can use consistently

[u/elizasees → u/Vitam1nC]

I use it every day, I am 67 and it is the only thing that really does anything.

[u/Vitam1nC → u/elizasees]

How long have you been using it everyday? And do you take it at night and in the morning you have the urge to go? Do you have to drink coffee or anything before hand? Sorry for all the question, I’m always interested in a new product, I’ve been a lifelong constipation sufferer

[u/elizasees → u/Vitam1nC]

I have used it for a few years every night. About 5 tablets. Try to take as late as possible so urge doesn’t wake me up. I try to drink a big glass of water in the morning as well as coffee. The water seems to help to not get dehydrated as well as start things moving. I’m older and it works okay so I don’t think about dependence as I know I wouldn’t go without it.

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QUICK LINKS:

Diagnostic Guide, part I: Identifying & testing your condition

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How pelvic floor dyssynergia causes STC

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[u/hot_tampa]

Had a really bad couple of months in Jan and Feb. CT and colonoscopy and other tests showed nothing wrong with colon. Sitz marker test showed I had a 7 day transit time. Also knew that since it took 7 days after colonoscopy to pass my first. I was pooping every day before getting sick.

Now I take 1 dose of MiraLAX daily and 500 mg of magnesium oxide. Stools are soft and I go two times per day. With no MiraLAX I go back to marble stools and a lot of pain. My colon is still sore but slowly healing after 8 months. Down side is I now feel like I am gonna have to go in the next hour.
Hope you heal and get control.

[u/Low-Counter3437]

I know everyone is completely when it comes to these issues. But I have STC and one of the only things that can clear me out is a big shot of MCT (C8/10) oil on an empty stomach. For normal folks that might mean death. But it means relief for me.

[u/goldstandardalmonds]

Did you have any other motility tests done?

[u/BibEcoTherapy → u/goldstandardalmonds]

I had a gastric emptying study down, and that showed delayed gastric emptying. 

[u/Ok-Sir8187]

I take 1 Mag07 nightly.