[50F] With chronic constipation and urinary incontinence

Patient Description

A 50-year-old female has been experiencing chronic constipation for years, characterized by very hard stools that resemble small balls. Recently, she has had difficulty holding her urine and reports that her stomach appears to have dropped. She also experiences lower back pain. Despite these symptoms, there have been no recent changes in her weight. She has a history of acid reflux and ulcers but is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Chronic Constipation: This is a common condition that can cause hard, lumpy stools, and difficulty passing them. Chronic constipation can lead to complications like hemorrhoids and anal fissures.

    • Treatment typically involves dietary changes such as increasing fiber intake, staying hydrated, and possibly using over-the-counter laxatives. In some cases, prescription medications may be necessary.
  • Pelvic Organ Prolapse: This occurs when the muscles and tissues supporting the pelvic organs weaken, causing one or more of the pelvic organs to drop (prolapse) from their normal position. This can lead to symptoms like difficulty urinating, lower back pain, and a sensation of heaviness or pressure in the pelvic area.

    • Treatment can range from pelvic floor exercises and lifestyle changes to surgical options, depending on the severity.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like cramping, abdominal pain, bloating, gas, and constipation.

    • Treatment often includes dietary changes, stress management, and medications to relieve symptoms.
  • Urinary Incontinence: This is the loss of bladder control and can be caused by various factors including weakened pelvic floor muscles, nerve damage, or other underlying conditions.

    • Treatment options include pelvic floor exercises, medications, and sometimes surgery.

What you can do

Here are some steps you can take to help manage your symptoms:

  1. Increase Fiber Intake: Eating more fruits, vegetables, and whole grains can help soften your stools and make them easier to pass.
  2. Stay Hydrated: Drinking plenty of water can help prevent constipation.
  3. Pelvic Floor Exercises: These exercises can help strengthen the muscles that support your bladder and bowel.
  4. Over-the-Counter Laxatives: These can provide temporary relief from constipation, but should not be used long-term without consulting a doctor.
  5. Avoid Straining: Try to avoid straining during bowel movements, as this can worsen symptoms and lead to complications.

What you should look out for

You should seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or urine
  • Unexplained weight loss
  • Fever or chills
  • Inability to pass stool or gas
  • Severe back pain that does not improve with rest

Please remember that while this information can be helpful, it is not a substitute for professional medical advice. It's important to consult with a healthcare provider to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are some common causes of chronic constipation?

Common causes of chronic constipation include a low-fiber diet, dehydration, lack of physical activity, certain medications, and underlying medical conditions such as irritable bowel syndrome (IBS) or hypothyroidism.


How can pelvic organ prolapse affect daily life?

Pelvic organ prolapse can affect daily life by causing discomfort, difficulty urinating, lower back pain, and a sensation of heaviness or pressure in the pelvic area. It may also impact activities such as exercise and sexual intercourse.


What lifestyle changes can help manage irritable bowel syndrome (IBS)?

Lifestyle changes that can help manage IBS include increasing dietary fiber, staying hydrated, regular physical activity, managing stress through techniques like yoga or meditation, and avoiding trigger foods that worsen symptoms.


What are some non-surgical treatments for urinary incontinence?

Non-surgical treatments for urinary incontinence include pelvic floor exercises (Kegel exercises), bladder training, lifestyle modifications such as reducing caffeine and alcohol intake, and medications that help control bladder function.

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