What Causes Severe Constipation Despite Taking Medication?

Posted on Wed, 12 Jul 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 12 Jul 2017 Answered on

Mon, 31 Jul 2017 Last reviewed on

Question : My wife has kidney cancer and a-fib she has been constipated for about 4 days we tried Miralax for two days to no avail. Yesterday at 4 pm she took two Senokot-S Tablets and two more at 10 pm. She just took two more at 2 pm. It may be working but the stool seem either to hard to pass or two large to pass. She has only passed two stools about 1/2 inch in diameter x 1 inch long. The dosage say you can take 4 tablets twice a day should She take another at bed time and if that doesn't work should she start taking 8 tablets in two doses tomorrow? If so how long should we wait before seeing a doctor if that doesn't seem to work. She has hemmoroids . The only pain she has is from the stool waiting to come out.

Answered by Dr. Chobufo Ditah (3 hours later)

Brief Answer:
Maximum of 4 tablets daily. If it fails, get her to the hospital!

Detailed Answer:
Hi,

I have reviewed your information fully. When constipation is long standing, it becomes difficult for laxative to work as the stool is already in the rectum, forming a fecaloma which cannot be influenced much by these laxatives. If there is a blockage and that isn’t responding, the best way is to have it removed mechanically at the hospital.

In all do not exceed 4tablets. If this fails to help, get her evaluated for mechanical removal at the hospital. This should be followed by measures of increased fluids, fruits, vegetables and fiber intake.

I hope this guides and helps. I wish your wife well. Feel free to follow up with me as you please.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Chobufo Ditah (22 hours later)

Just to let you know about 10 minutes after I submitted my question my wife had a bowel movement clearing her rectum. From the size of the feces I can see why she was in pain. She has had one more bowel movement since. Would it be wise to give her two more tablets before bedtime to make sure. She has started taking fiber powder this morning and drinking more water.

Answered by Dr. Chobufo Ditah (12 hours later)

Brief Answer:
Continue with 1tablet daily!

Detailed Answer:
Hi,

This is good news. I will go with one tablet daily. Incorporate the recommended dietary measures we touched on earlier as well. Keep me updated.

I wish you well.

Above answer was peer-reviewed by : Dr. Remy Koshy