Young, 24 year old woman suffering from chronic constipation
April 16, 2014 5:56 PM   Subscribe

I was wondering if anyone knows what my digestive system/ body is struggling with: I am almost 24 years old. I have a very stressful teaching job, and sometimes I don't eat very well because I don't have access to a supermarket. But, even before I started this job, I began to suffer from constipation. I only experience a bowel movement on average once every four days (often it takes a week.) My father has Crohn's disease, and I have been to see his doctor. His doctor told me that he sees a lot of young women with this problem, and he recommends that I take miralax regularly. I take it about once every other day, and occasionally drink Senna tea. But it doesn't always help. I have trouble particularly the week before my period. Have any other young women experienced this kind of thing? Is it as common as my doctor says? Does anyone have "home remedy" advice that actually works well?
posted by anonymous to Health & Fitness (34 answers total) 7 users marked this as a favorite
Prune juice, eating more fruits and vegetables, and getting some exercise.
posted by hush at 6:02 PM on April 16, 2014 [1 favorite]

This is definitely a pretty normal thing, especially when combined with stress and hormones. As I understand it, the uterus, colon, and bladder walls interact all month long as the uterus is working through ovulation, and the smooth lining of the colon can sometimes become unusually taut (or something), preventing normal BMs from happening. Other times it goes so ridiculously slack that all you get = liquid. Let's be real: being a female human is freaking bizarre sometimes.

So what can you do? Walk a lot, drink way more water, up your intake of fiber-rich fruits and vegetables, and limit your intake of binding substances like bananas, white bread, peanut butter, etc. You could also consider drinking chamomile tea because it can relax your body into becoming more regular again. I'd also go see a gyno of your own and talk to them about it, since your dad's doctor may only be offering one set of solutions and a second opinion is always good if you're still having problems.
posted by Hermione Granger at 6:06 PM on April 16, 2014 [3 favorites]

I definitely have gotten the constipation before my period thing. While some of this can just be "bad genes" there is a lot you can do to help move things along

1. stay hydrated
2. fiber (fresh fruits and veg or miralax type stuff, again, with water)
3. exercise

And keep a little track, if you can, what works well and what doesn't. My innards run at their best when I've had at least some fruit/veg, where I'm drinking water and when I'm eating some of that high fiber breakfast cereal (Kashi nonsense). If you can insert even one of those things into your routine and see if it works or not, then try another, repeat. And as long as you're not otherwise feeling crummy, a bowel movement every few days is on the outside of the bell curve but if it's not causing you other problems it's not a medical issue in and of itself.
posted by jessamyn at 6:06 PM on April 16, 2014 [3 favorites]

Judging by my recent experience, eat an avocado
posted by thelonius at 6:15 PM on April 16, 2014

Is the GI that you've been to on the older side, by any chance? Something about the "a lot of young women" comment rubbed me the wrong way and harkens back to the 60s/early 70s when much of gastroenterology was about diagnosing psychiatric problems that manifested in the GI tract. For example, my mother suffered with untreated Crohn's disease for over a year while she was forced into arguably unnecessary psychiatric treatment -- ultimately all of her symptoms resolved when she was actually, you know, treated for the disease itself.

If you're dealing with a really old school GI, I might push for more actual testing or even consider seeing someone else. I know you posted anonymously, but ask yourself this: did you receive a physical examination, including a digital rectal exam? Did he palpate your abdomen? This is standard for a chief complaint of constipation.

Constipation is not unusual and it is completely normal for your menstrual cycle to manifest in changes in GI behavior. However, given your family history of Crohn's disease and the fact that you're having one bowel movement per four days, with regular laxative use, I would investigate this further. Obviously follow all of the lifestyle recommendations and see where that takes you, but if the problem persists, there are many treatable medical issues that can manifest in chronic constipation and you should be proactive in having them investigated adequately.
posted by telegraph at 6:17 PM on April 16, 2014 [15 favorites]

I'd try to work on the nutrition part while also getting some testing done by another GI just to rule those problems out with your family history.
posted by Aranquis at 6:23 PM on April 16, 2014

I sometimes make a huge batch of breakfast burritos to eat throughout the week. You can stock up on the materials on the weekend and then have breakfast all week. The black beans and potatoes are the only items that are essential, here; the potatoes provide filler and keep you full until lunch, and eating a serving of black beans first thing in the morning always gets things working real well for the rest of the the day.

one tube/half a package of Mexian chorizo or veggie soyrizo
1 bell pepper, diced
1 small onion, diced
1 poblano, minced
2-3 potatoes, boiled until soft and cubed (scrape off any gross bits of potato skin, but leave the skin on - you need that fiber)
1 can black beans, all the gross liquid goop rinsed off and drained
1 pack large burrito tortillas

Heat the chorizo, until it's half cooked in a dry pan. Meat chorizo is greasy, you need you add oil for soyrizo.

Fry the onion/pepper/poblano with the chorizo until the veg is soft and the chorizo is cooked. Press this mix into a side of the pan, letting the orange chorizo grease drain away; move the chorizo/pepper mix to a bowl and keep the grease in the pan.

Add oil to the pan if you used Soyrizo or you don't have at least a tablespoon or two of chorizo fat. Add the cubed cooked potatoes to the pan and let them sit there browning for about ten minutes. This is pretty much your only chance to get a golden brown crunch on the potatoes, if you stir them around a lot they're just going to absorb the oil and turn into hot mashed potatoes.

Add the beans, the chorizo/pepper mix, and cook, mixing it together gently until everything's heated through and evenly distributed. Makes like 9 burritos; they freeze perfectly well in sandwich bags for HOLY SHIT THERE'S NO FOOD IN THE HOUSE mornings.
posted by Juliet Banana at 6:29 PM on April 16, 2014 [7 favorites]

I, too, am a big fan of a high-fiber cereal as a way to cram some daily fiber in your diet. Fiber One isn't OMG amazingly tasty but isn't bad with a mixin (Craisins, etc), and just a little bit has a TON of fiber.
posted by ThePinkSuperhero at 6:30 PM on April 16, 2014

Probiotics, an oily supplement like flax seed oil capsules, drinking lots of water, and eating lots of fruits and veggies. I also like chia seed "puddings" for regularity. I soak chia seeds in coconut milk or fruit juice and let them get all puffy and slippery. Then, I either drink them or eat them with a spoon. They're tasty and have lots of fiber. You can also add the soaked chia seeds to cereal. Do not eat them dry - they absorb a lot of water and can make constipation worse. Always pre-soak.

I would not take senna regularly as it can make things worse over time. I would only consider taking a fiber supplement with lots of water. Taking magnesium capsules can also help, though ramp up the dosage as you can initially get cramping and/or diarrhea if you take large doses without being used to it.
posted by quince at 6:35 PM on April 16, 2014

Taking copious amounts of vitamin C will get you moving, and so will Magnesium.

Your crappy diet is likely very Vit C deficient and your doctor erred in not pointing you towards this simple and likely effective cure.

Google for proper dosages. I know Vit C is water soluble and you can't take too much (in fact the sign for "too much" is what puts you in the bathroom- heh) and I know next to nothing about Magnesium except that my Epsom Salts Mineral Bath (basically, pure Magnesium) has directions on it for the bath AND how to take it internally as a laxative.

Hope this info helps!
posted by jbenben at 6:49 PM on April 16, 2014 [1 favorite]

If the not-eating-well means not-eating-much-at-all then I would say this isn't terribly unusual at all. There just isn't enough there to poop. Eating more usually fixes it.

Also the constipation before your period is very normal, even when I was a "perfect" one per day every day, I always had first constipation and then the trots before and during the start of my period. Basically it sucks and there's not much to be done short of hormonal birth control.
posted by anaelith at 7:10 PM on April 16, 2014

Poop is 95% water and non-digestable fiber (the other 5% is assorted stuff like sugar, protiens, etc.)

It's real simple: either you too little water in your daily diet or you have too little fiber.

Start eating prunes or similar every day, drink lots of water. I know a female with a similar problem and she eats 6-8 prunes before bed every day.

posted by gnossos at 7:26 PM on April 16, 2014 [1 favorite]

Probiotics helped me more than huge amounts of fiber did. And capsules worked better for me than eating yogurt or kefir.
posted by corey flood at 7:33 PM on April 16, 2014 [1 favorite]

Since you don't always have fresh fruit on hand, try taking four or five Trader Joe's dried apricots (or something similar) and drink a big glass of room temperature water or hot tea. I frigging hate prunes and raisins, so those dried apricots are my best friends when I'm backed up. Works within 30 minutes, in my experience.

You really should try to drink more water though, if at all possible. Get yourself a big ole thermos and sip water and refill that bad boy all day long. Staying hydrated is your best bet for the long haul.
posted by LuckySeven~ at 7:37 PM on April 16, 2014 [2 favorites]

I get constipated in the week before my period every month, it's one of the signs I use to know it's coming. I make sure during those times to drink plenty of water and to go for about a half hour walk a day to get my system kicking along. I normally poop a couple of times a day but I can go three days without one in the run up due to all the fun of hormones in system at that time of the month.

Also Metamucil works wonders and is an easy way to add fibre to your diet.
posted by wwax at 8:03 PM on April 16, 2014

I got the "all young women" advice too. Along with "eat a head of lettuce a day" and "take fiber supplements". None of these worked for me. I would be careful with fiber - there are some kinds of constipation where adding fiber just bulks things up to the point that they become immovable. So fruit and veg = good but I would be wary of adding metamucil / psyllium or too many whole grains.

Up the fat, magnesium and vitamin C in your diet, drink water and go for a walk in the mornings. Cut down on sugar, whole grains and dairy. Coffee helps, a large cup of black coffee at the same time every day might be something to try. Try taking the Miralax every day for a while. Massage your abdomen in a clockwise direction before you get up in the morning.

And one thing that is often overlooked is the psych element: women tend to be (a) busy and (b) shy. For some of us, home is the only place we are comfortable going. For others, we have to remember to make time for going. If this has been a problem for a while, you might have lost the ability to sense when you need to go, or your signals might have become dulled. So making time to sit for a while and relax, about the same time every day, could be key.

Lastly, this might sound weird, but the breathing I learned during prenatal classes has made the biggest difference for me, you know, during. YMMV but you might want to check out a hypnobirthing book and read the breathing section, it can't hurt.

And definitely keep getting checked out but sometimes there really isn't much a doctor can do.
posted by yogalemon at 8:14 PM on April 16, 2014 [6 favorites]

Well, a cup of coffee gets her going but I don't think it's the healthiest in the long run. If you're really bloated/uncomfrotable, though...
posted by stoneandstar at 8:41 PM on April 16, 2014

I have the same poop issue. I can't really contribute anything remedy-wise, since I'm still trying to figure that part out myself, but I can tell you to stay away from FiberOne products. They have an evil ingredient known as chicory root (or inulin) which will, approximately 2 hours post-consumption, make you want curl into a fetal position until the horribly intense pressure and pain of the resultant gas is...expelled. I've never eaten any of their stuff myself, no. Why do you ask?
posted by msbadcrumble at 8:42 PM on April 16, 2014 [1 favorite]

A few prunes (5 or 6) before bed might be worth a try.
posted by rmmcclay at 8:53 PM on April 16, 2014

Coffee may not be the healthiest solution, but it will, indeed, make you poop.
posted by jrochest at 9:06 PM on April 16, 2014 [1 favorite]

I am male and got the "young people" advice: the 2nd opinion doctor said my functional dyspepsia was due to life stressors, and later I saw a GI specialist, who concurred. Basically took one look at me and prescribed an antidepressant, such that at the low doses it would be taken, works by soothing/relaxing the involuntary nerves belonging to the digestive tract. He even said not to worry too much about it, claiming that as long as I didn't mind the chronic discomfort it's not a big deal. Hope this info helps.
posted by polymodus at 9:26 PM on April 16, 2014 [1 favorite]

I have trouble particularly the week before my period.

This is a classic Irritable Bowel Syndrome symptom for what it's worth.

The best remedy, home or otherwise, is to see a better doctor and get a real diagnosis then treatment. Because your family history puts you at a higher risk for Inflammatory Bowel Disease, you have worrying actually-not-normal symptoms, and you deserve better than the crappy advice you've been given by your doctor so far. What you eat and how you treat this is going to vary widely depending on the cause of the problem so getting the right diagnosis is going to make all the difference.

While you wait it will probably help to keep a diet/symptom diary. Write down everything you eat, all your bowel issues (look up the Bristol stool scale), and any other physical issues (exercise, your period, headaches or other pains, etc). Having it in writing can help show a Dr that you have a real issue going on and can help identify triggers or diagnostically-relevant patterns.

Also, keep in mind that for many GI issues (e.g. IBD, IBS as the most obvious, others too) diet and nutrition is a really important part of treatment and will have a huge effect on your health. To the point that telling you what to eat as many are doing in this thread is giving you unqualified medical advice. Given you don't even have a diagnosis yet this is unwise at best. For example, if you're in the middle of some kind of flare adding a lot of extra fibre to your diet as many here are suggesting here can be actively dangerous (and there is research to back this up). I'm sure no one is trying to put you in the hospital but by giving you this unqualified medical advice that is a potential outcome. So see a better doctor, get diagnosed, then get your medical advice from doctors and you dietary advice from a qualified and registered dietician only.
posted by shelleycat at 11:05 PM on April 16, 2014 [6 favorites]

I am a lady with similar problems. I take a teaspoon of powdered mag citrate mixed into a shot of orange juice at night. Miralax, fiber, prunes, avocados, coffee etc do nothing for me but magnesium just makes things work the way they should. It has been a miracle.

Also I realized as I got older that dairy products not only make me really bloated, they grind my digestion to a halt. If you consume a lot of dairy, that might be something to consider.
posted by hairy terrarium at 12:11 AM on April 17, 2014 [1 favorite]

Just a note to go very easy on the Senna tea. If used regularly it can create problems.
I used to work in a natural foods store and we had a number of customers who had used it so frequently that they couldn't function normally without anymore.
posted by cat_link at 12:56 AM on April 17, 2014

Maybe ask your GI (or another one) about Linzess. It's really helped me (a young woman in similar shoes) when miralax, a healthy diet, and other measures failed. Also seconding a magnesium supplement. However, order some magnesium glycinate. The others (oxide/citrate) can be hard on your tummy.
posted by shrimpsmalls at 3:28 AM on April 17, 2014

I think shelleycat has it -- the best thing, at this point, is to find a better GI and get properly tested.

I know people with Crohns and other forms of inflammatory bowel disease. If that is your diagnosis -- and given that your father has Crohns, you definitely have higher risk factors here -- then you don't want to wait around, adding and removing fiber, and doing potentially permanent damage, before you get this assessed.

IANAD, but I can tell you that my GI would have done a hell of a lot more than marking it up to "some young women get this."
posted by pie ninja at 5:29 AM on April 17, 2014 [1 favorite]

I know it's been said already but I really want to emphasize drinking lots of water. I struggle with this issue too (especially the week before my period) - I was probably averaging a BM every 36-48 hours, and worse during that PMS week. I was struggling with hemorrhoids and pain because my stool was so hard and it sucked a LOT.

Then maybe 4 months ago I bought a big 30-oz water bottle to keep at my desk at work. Just having it there means I drink SO much more water - and the difference for me has been remarkable. So much so that I want to shout to the world "drink more water!"

I never thought of myself as chronically dehydrated, because I do like and drink water. But just drinking when I was thirsty wasn't working for me, because it was really easy to ignore the thirst. My desk is kinda far from the office kitchen and it was too easy to put off getting up to get some water. Now I fill my bottle first thing every morning and sometimes again in the afternoon.

At home I have a sodastream and having fizzy water as a drink option helps too. I enjoy it so I want to drink more, vs. it feeling like a chore.

I'm sure I could stand to eat more fiber as well but the water thing has helped me tremendously, no fiber supplements or senna or laxatives needed. Good luck, this is no fun.
posted by misskaz at 5:44 AM on April 17, 2014

I always had pre-menstrual constipation, and I think it's just a hormones-are-weird thing, as I know women who have pre-menstrual diarrhea. So, I had a comment about pooping, in a thread about pooping, and the thread may be useful. Quick answer - try having oatmeal and some dried fruit at breakfast, eat beans, drink an extra 16 oz of water a day, and get more exercise. I also finally realized I don't tolerate lactose well, and eliminated dairy, which has made my digestive system much happier.
posted by theora55 at 6:33 AM on April 17, 2014

I had horrible constipation during a really stressful period in my life. It was awful. I went to a gastroenterologist who ran a bunch of tests and confirmed that it was due to stress.

A couple things that helped me:

1) Citrucel. Might be worth switching from Miralax and seeing if Citrucel works better. I still take it every day.

2) Apriso. It's a medication that helps with inflammation of the GI tract.

3) Fleet enema. I only did it once or twice when I was really blocked up. It sounds awful but it wasn't difficult, and it provided immediate relief.
posted by radioamy at 10:03 AM on April 17, 2014

I can say that I spent a couple of decades alternating mild constipation with dramatic diahrrhea, along with lots of gas. About 2 years ago, for unrelated reasons, I started eating "paleo" (which for me meant cutting out milk, all grains and starches, sugar, and legumes, and eating more veggies, nuts, and healthy fats), and I was totally stunned by the change in my digestive function and overall health. The diet didn't affect what I was hoping for (skin irritation), but it sort of "cured middle age" from my perspective, including getting rid of any indigestion in response to "rich" or "spicy" meals. I think that blogger Dooce, who has described fall-on-the-floor painful poops most of her life, also found the paleo diet a revelation (something like, "wait, 'regularity' really exists??"), and it's not all that different from the "elimination diet" that's often the starting point for diagnosis of gut issues.

Anyway, as others have said, you don't want medical advice from random strangers, but there is plenty of evidence, both anecdotal and scientific, to back up the idea that our guts aren't designed for the way we tend to eat -- especially where the balance of fats to starches is concerned -- and that you can transform your GI function by making changes to how you eat. Initially seemed hard, but really just a matter of changing the things that go into the slots of "staples" and "covenience foods" and all the rest. Worth looking into, anyway.

Good luck! I definitely wouldn't give up before making, ahem, a serious effort!
posted by acm at 11:42 AM on April 17, 2014 [1 favorite]

As for period issues, I used to get premenstrual diarrhea. Things improved (as did the cramps) when I went on the pill. Even better now that I'm on an extended-cycle (Seasonal) pill.
posted by radioamy at 1:53 PM on April 17, 2014

Have you been tested for gluten intolerance/celiac disease? That can cause bowel problems of all types, from constipation to diarrhea. It is not unusual for people to start manifesting symptoms later in life, and is often triggered by added stress. It might we worth getting tested for, even if it's just to cross it off your list as a potential cause.
posted by sam_harms at 7:32 PM on April 17, 2014

If what is going on is related to ibd, fiber and water are only going to get you so far. Ianad but I found that a prebiotic in the form of inulin works. I take this every morning and it works extremely well. You'll have to adjust your amount likely to avoid too much. I also take turmeric in capsule form every day as an anti-inflammatory. Both of these things have some scientific backing (I did a major literature search) for ibd but there are only a handful of studies. They work for me and have made a huge difference. memail me if you have questions.
posted by bluesky43 at 7:59 PM on April 17, 2014

Also, see a good GI doc.
posted by bluesky43 at 8:00 PM on April 17, 2014

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