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Constipation & Crohn's Disease

Hey all.

So I have had crohns for over 2 years now. and throughout the lead up to my diagnosis and since then, I have literally never had issues with constipation. until about 6 months ago I started getting really bad pains and my bowels werent opening.

I had an xray and it showed that I was really bunged up. so my GI doctor started me on some mild laxative sachets (laxido) which you dissolve in a drink.

now I guess I kinda thought that I would take the laxatives for a few weeks and they'd clear me out and I'd be back to normal. but to this day I am still having to take them multiple times a day otherwise I literally cannot poo. Along with this I am taking 3x 100MG Docusate tablets every day to help soften the stools.

I am in constant pain every single day, sometimes I get more severe sharp pains that come and go. I am nauseous and have no appetite. and I now have blood in my stools. sometimes i will get so bunged up that i vomit a lot and cant even keep water down.

so 2 weeks ago I had blood tests and stool tests done and all came back totally normal. so my GI doctor and nurses keep saying, just continue taking the laxatives. I've been taking them for 6 months and had no relief. the tests are showing nothing and literally everyone is now doubting what I'm saying I'm going through because they dont have evidence. I've tried explaining that if my issue is constipation then it wont really show up as inflammation because it's the blockage that is causing the pain!

  • so first of all, is this a normal thing for someone with crohns to experience? I.e. chronic or long term constipation?
  • second of all, any tips on how to help others understand what it's like dealing with this, especially because it's not something they can physically see?
  • and thirdly, who else should I ask for help or what else should I try???
thanks everyone, stay safe xx
 
I experience constipation when my disease is active as well, however not as prolonged as yours. I imagine that it is not an uncommon thing for people with Crohn's to experience.

I think of it like this. If your bowel is inflammed or diseased, it can effect the muscles responsible for peristalsis, which is the process where muscles contract then relax, pushing food along your digestive tract. If there is inflammation, and I think there are some studies for this, this process is disrupted, resulting in food build up. Narrowing of the bowel can also cause this, but it sounds like you don't have this issue.

My guess is that you still have some active inflammation causing this. What kind of tests did you get done? Did they show any kind of active inflammation going on?

Unless I misunderstood your post, I am surprised to hear that your GI is doubting your experience. Knowing you have Crohn's, he must surely see the link between the Crohn's and the constipation?

As for what you can do, I can think of a few things but you have probably heard them before. Fibre and exercise. If you think your gut can handle it, adding some fibre in the form of plant foods could add bulk to your stool, which can help move things along. Be careful not to overdo it though, I ended up in the ER a few years back because I massively increased my fibre intake too quickly lol. Good times. Exercise can also help get things moving along. I try to go for a relatively brisk walk everyday and I do believe it helps. The human body was meant to move.

I have also, in desperation, in the past reached out for some peppermint oil and rubbed 1 drop onto my abdomen and rubbed it in furiously ha. It seemed to help? I looked it up just now and peppermint oil has the ability to relax muscles. Careful with this also, as it can sting if you overdo it, or get the oil in a sensitive area.

Sorry you are suffering, best of luck Pink.
 
Hello thank you for your reply.

Yes I have had blood tests and all aspects were apparently normal. I also had my calprotectin checked which was above the norm of 0-6 but not too high that they were concerned or anything.

Well I guess that they are perhaps confused themselves as I tell them I'm in pain, they do tests and nothing shows. So perhaps they think when I'm saying its severe pain its actually not. I dunno...

Yes my GP recommended the fibre intake a week or two back so I've been increasing that gradually. Also I exercise every day and have done pretty much since I was diagnosed. During lockdown I have been exercising a lot more and do always find that after a good walk or workout the pain does ease. However probably less than 30mins later I'm back to square one!

It's a rather frustrating old journey but I know I will get there. I just hate this part of going from one doctor to another and having them all tell me different things. Been there before and it certainly doesnt make things any easier!

Thanks for your help, I will try the things youve suggested. I am speaking to my GP today so fingers crossed we will get somewhere :)
 
Have you had an intestinal ultrasound done? It is, as far as I know, one of the best diagnostics right behind a colonoscopy (lol behind).
 
Have you had an intestinal ultrasound done? It is, as far as I know, one of the best diagnostics right behind a colonoscopy (lol behind).
Haha love the pun. I had an ultrasound done a while back but dont think it was of my intestines. I will make note of it as another suggestion when speaking to my GI doctor. I am on the waiting list for another colonoscopy but as youd probably know you can be waiting years for those!

Some good news, my GP prescribed me 2 meds this afternoon to help with sickness and tummy pain. Obv just temporary relief but is better than nothing. Fingers crossed it works! :)

Thanks for the advice.
 

crohnsinct

Well-known member
Not an expert but if what you are experiencing is due to scar tissue building up and blocking things then it won't show as inflammation. Where is your disease located? I would think with these symptoms and the prolonged nature, your GI would at least do some imagining to see if there is a narrowing. You could ask him/her if there is any chance that it could be a scar tissue build up as opposed to inflammation, maybe that will prompt further investigation through MRE.
 
Not an expert but if what you are experiencing is due to scar tissue building up and blocking things then it won't show as inflammation. Where is your disease located? I would think with these symptoms and the prolonged nature, your GI would at least do some imagining to see if there is a narrowing. You could ask him/her if there is any chance that it could be a scar tissue build up as opposed to inflammation, maybe that will prompt further investigation through MRE.
Thank you so much for your response. Someone else actually suggested this to me and it does seem like a very high possibility this could be my problem.

I tried to get through to my GI doctor this afternoon but no luck. I will try again tomorrow because it's definitely something I want to rule out.

Thank you so much for your advice and help:)
 
Thanks all for your help and advice. I spoke to my GI doctor this morning and he said I am going to need to go into hospital to have further tests and investigations done. Really hope I get somewhere now:)

Thanks and stay safe everyone!
 
Hey all, trust you've had a good day.

So I'm home from the ER now thankfully. I had a few tests done to rule out certain causes all of which were fine.
I didnt see my GI doctor as he had clinic but the doctor I saw was brilliant. He was really thorough and very helpful. He concluded that he is assuming my problem is scar tissue/crohns stricturing.
The only way to confirm is via colonoscopy which is obviously all on hold at the moment due to covid19. So I'm not sure how long I will be waiting but he has written off to my GI doctor to inform him of his assumptions and has kindly asked him to speed up the investigation process for me :)

So pleased to have finally made some steps in the right direction. Should the colonoscopy show everything being fine I.e. no scar tissue etc, there is some sort of sickness syndrome that he would suspect I could have which can only be diagnosed after ruling out all other possible causes. So either way I should get some sort of treatment (hopefully in the near future)...

Thanks all for your support and advice. Will keep you all updated if I have any further news. Keep well xx
 

crohnsinct

Well-known member
So glad you are getting somewhere. Just knowing they are paying attention would bring me some relief.

My only concern would be if the structure is too high into the small bowel to see via colonoscopy. Did he mention an MRE? I think that might visualize narrowing whether inflammation or scar tissue but not sure.
They are starting elective procedures where I live. Still asking that they be somewhat necessary ie: to investigate chronic conditions, health concerns etc. so no routine colon cancer screenings but I would say you qualify. The last thing they want is you showing up in the ER with a full on obstruction.

Good Luck! Thanks for keeping us posted!
 
So glad you are getting somewhere. Just knowing they are paying attention would bring me some relief.

My only concern would be if the structure is too high into the small bowel to see via colonoscopy. Did he mention an MRE? I think that might visualize narrowing whether inflammation or scar tissue but not sure.
They are starting elective procedures where I live. Still asking that they be somewhat necessary ie: to investigate chronic conditions, health concerns etc. so no routine colon cancer screenings but I would say you qualify. The last thing they want is you showing up in the ER with a full on obstruction.

Good Luck! Thanks for keeping us posted!
Thanks for your kind message. Yes it's been a huge relief to me to know that something is at least being put in place. Shame it couldn't have happened 7months ago but nevermind!

No he didnt actually mention about an MRE/MRI. I will speak to my GI doctor and ask whether it would be a possibility as would most likely be quicker than waiting for a colonoscopy.

Thanks again for your interest and support.
 
Location
San Diego
Where in your gut is Crohn's located?

As a general trend (there are always exceptions to everything), Crohn's with lesions located in the large bowel will produce diarrhea, but Crohn's confined to the small bowel often produces constipation. It certainly does for me, and I have ileal Crohn's. Constipation is ususally my first indication that the disease is becoming more active. It may mor may not be related to build up of scar tissue.
 
Where in your gut is Crohn's located?

As a general trend (there are always exceptions to everything), Crohn's with lesions located in the large bowel will produce diarrhea, but Crohn's confined to the small bowel often produces constipation. It certainly does for me, and I have ileal Crohn's. Constipation is ususally my first indication that the disease is becoming more active. It may mor may not be related to build up of scar tissue.
Hello thanks for your response. As far as I know it's in my large bowel actually. In the beginning I suffered terrible diarrhoea and my large bowel was very inflamed. But then Im now suffering from constipation so it's all a bit baffling!!
 
Yeah I get you, about things not making sense lol.

Mine is mostly located in my ascending colon, which is the start of the large intestine.

I have realised that people can have Crohn's in the same location and even with the same severity, but will have different symptoms.

I think it helps to think of the body as a living organism rather than as a machine. Living organisms are not always so predictable ha. This helps explain the differences we see.

Each body will do the best with the conditions it finds itself in and I imagine no two conditions are identical.

To summarise, it is complicated, but there is always hope :)
 
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