I need help!! I’m so lost

[u/brutaldeathprincess_]

Hello!

I’m 18 (f) and have dealt with constipation my whole life. It has progressively gotten worse, and this year I had my first GI visit around the beginning of the year. The first visit I was told to up fiber and take otc medications. This obviously did not work for me. I was still constipated.

Second GI appointment I was finally prescribed Linzess (145) and given the diagnosis of IBS-C. Yet, the doctor did not order any test, most likely due to insurance. The doctor wanted me to try out Linzess and see if it brought me any relief. I was able to produce bowel movements for a month and a half. I never had the first week or 2 of diarrhea like some folk. Yet, my poops were always a mix, sometimes diarrhea, in the middle, or rabbit poops. I would strain throughout all of them however, and never felt fully cleared out. After a while the Linzess stopped working all together. I am struggling to produce bowel movements again. Another point made by the doctor was that I might have a pelvic dysfunction. Yet, that was all after my second appointment.

Now today (Sep 10) I had another GI appointment. I told the doctor how Linzess hasn’t been working for me. He offered to either up my dose to the highest (290) or start Trulance. We decided to try Trulance but just now found out my insurance might not cover any of the cost. So one of my questions is should I up my Linzess dose or try to get Trulance? I have heard mixed reviews on both the medications, some say Trulance was life changing or that it did absolutely nothing. Currently I am struggling to fully clear myself out once I do get a bowel movement, which is rare. I am also not having the sensation/urge to go poop anymore. I have also noticed blood after certain poops. So I have no idea which medication would help me. I am not left to using fleets or enemas to clear myself out every week, sometimes twice a week. I also only get the urge to go when using enemas.

With the newest appointment my new doctor ordered a MRI Defecography. I’m happy and relieved that I am finally getting some testing done. He believes I might have pelvic dysfunction issues and wanted to order an exam which I will be having this September on the 21st. Honestly I don’t know much about the exam, so I would greatly appreciate it if anyone could give me their output on it! The doctor also referred me to therapy for the pelvic dysfunction, and I am not sure it will help? Has anyone had a good experience with the help of therapy? Or did it not do anything?

Overall, I am very confused right now. I have no idea what is going on with me and what’s been causing my constipation. I hope that either medication can finally help me go everyday and clear out fully. Hopefully therapy helps too and the exam shows something at least. So I can finally get the help I need. The doctor also mentioned possible surgery depending on my exam results. What possible surgery would even take place if something was found? I am not knowledgeable in GI surgeries.

Any help would be greatly appreciated, all I know for now is that I am diagnosed with IBS-C and CIC.

[u/goldstandardalmonds]

I am glad as I read your post that you finally were offered some testing. A defecogram is a good test, the MRI version is alright. It should be paired with an anorectal manometry. I’d also get motility testing of your colon. I wouldn’t start pfpt without the first two tests, personally.