Colon & Rectal Surgeon Questions Gastroenterologist

“Bowel movements?”

I have difficulty finishing bowel movements. I know some of it is due to the fact I have severe OCD. However, I'm wondering if something else is wrong. I only have to push a little bit for more stool to come out. I can do this for hours and still have some keep coming out. Is that normal? Am I just pushing too much? When should I stop pushing and move on? P.S. I already had colon surgery last October to remove a foot of my colon because of prolapse. I really don't want to have that happen again.

Female | 43 years old
Complaint duration: 20 years
Medications: Azelastine, Ceterizine, Citrucel, Clonazepam, Emgality, Esomeprazole, Famotodine, Fluticasone, Levothyroxine, Miralax, Guafinesen, Simethicone, Venlafaxine, supplements
Conditions: GERD, IBS, OCD, Anorexia, Hypothyroid, Migraines

2 Answers

Start taking Magnesium citrate softgel about 800-1,200 mg daily. Vitamin D softgel 50,000 IU daily. Start green Mediterranean diet. Only spend 30 minutes for each bowel movement episode then move on.
You probably have slow transit constipation, and I suspect the sigmoid portion of the colon was resected to aid in BMs. You may have a desensitized rectum, which can be evaluated with a test called anorectal manometry. In general, only strain when you feel the need to evacuate stool. Keep the stool soft, with use of laxatives as needed to achieve daily BMs. If you have a defecation disorder, then physical therapy with biofeedback can help. A GI doc familiar with defecation disorders should be sought.
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