Have had chronic constipation for a few months now. Much backlog. Little relief. I could currently compete with rabbits to see whose poop is more pebble-like. I am desperate for suggestions, from the gentle type to the filthiest laxatives anything goes, because I am not too familiar with the pharmaceutical background in Japan and am therefore a bit lost when it comes to available options. I searched this subreddit but the previous thread like this was 7 years old and many suggestions were links that now seem to be broken (at least on my computer and phone) or stuff that I have now already tried.
Predicting a few questions:
\-Have you seen a doctor? I have, twice in fact (regular 内科 with a focus on digestive/bowel issues). The first time was about three weeks after my constipation started. He ummed and aahed and prescribed me magnesium tablets (マグミット錠), 330mg three times a day, and told me to gradually dial down to 2x and then 1x a day when my poop became soft again. (\*Narrator: It did not, in fact, become soft\*). Which led me to see him a second time a couple of months later. He simply renewed my prescription and told me not to worry too much. Now at about 4-5 months of chronic constipation.
\-Do you eat fiber? Yes, a good deal. Am vegetarian and eat about 6 portions of fruit and veg a day, a portion or two of legumes, and I have oats as my breakfast cereal. I also drink coffee and cook with olive oil (mediterranean upbringing lol)
\-Do you exercise? Yes, I either walk or run between 10 and 12k every day (I think this is grossly between 6.5 and 7.5 miles per day for my imperial-loving friends)
\-If you eat fiber and exercise enough, then do you have any idea what could be causing it?? My endocrinologist added progesterone to my HRT regimen in January, and my constipation started in February. He warned me my metabolism could slow down so that might be the answer. He ended up making me stop taking it when I saw him mid-June, but now I have a bit of a backlog that causes my constipation to self-sustain: the backlog means poop stagnates in my bowels, loses water and dries up and therefore contributes to constipation, and so on. Other than that, I haven’t changed my diet (have been a vegetarian for four and a half years, never had any problems up until now), haven’t changed my exercise regimen, still take the same vitamins and supplements, so am at a bit of a loss.
\-What have you tried to get rid of your constipation so far? My prescribed magnesium tablets, obviously. Tried adding prunes to my breakfast, with little success. Last week, I attempted one of those sea salt bowel cleanse thingies (2tsps of sea salt like Himalayan sea salt in a litre of water, drink in about five minutes, works for about 80% of people) but I appear to be part of the 20% for whom it doesn’t do much apart from bloating me. Used an enema two days ago, it got some of it out but I have a decent amount of backlog so not much came out.
Hence my desperation. Looking forward to your suggestions. Thank you.
27 comments
Have you tried psyllium (husks)? Also known as oobako (オオバコ) in Japanese and often marketed as a [diet aid](https://www.itohkampo.co.jp/products/1148850.html).
I’m not pooptamologist, but psyllium holds water really well. Well enough to stop it all from being absorbed in the gut? Maybe?
I realize it’s just another form of fiber, but *LET’S CHALLENGE!*
2tbsp of mineral oil will let you know when it is done.
How much water do you drink? Dehydration is a ridiculously common cause of constipation. All that fibre isn’t going to help if there isn’t enough water to help to move along!
What you do not seem to mention is your water intake. All of your `cures’ will not work without water.
Hmm…
The general advice is to:
1. Exercise
2. Drink LOTS and LOTS of water
3. Eat fiber rich food
4. Use medication: Laxatives etc.
From your post, you seem to be getting PLENTY of exercise, you seemingly? eat some fiber and you’ve tried some medication too….
If I was you, I’d probably try to drink a SHIT TON of water (like 6+ Liters) mixed with some オリゴ糖 (Kind of a sugar syrup which helps with constipation) AND some fiber source (Such as a bunch of raspberries).
Mix that together drink it over the day as well as **try to avoid** water absorbing/stopping food (Bread, pasta, rice… y’know, stuff which is dry and/or forms a thick paste once processed in your gut).
I don’t know what your usual diet looks like, but I’d recommend trying a one or maybe 2 day “mainly liquid” diet to give your stomach a chance to catch up and hopefully give it time to rehydrate enough to let it pass.
*P.S: If its just a thing of the poop hurting/being hard to pass – You likely already tried, but on the off chance that you didn’t:
You can try to use the washlet water-spray to shoot water into your…. uhm.. hole, to introduce water into your stool artificially. Spray some water in and once you feel that the pressure is increasing (I.E water is being stored inside) Try to hold it there for some time to rehydrate.
Preferably for 10-15 mins and then try to go poop it out.
*P.S 2: If its hard to pass, Some times it helps with having the washlet spray water at your hole **as you push it out**, as it can help reduce friction.
Well…. I wish you happy pooping!
…. Never thought I’d write that in my life… hah!
Eat raw garlic, two or three pieces a day for a few days and see what happens.
How much water are you drinking? I have a toddler and any time his water intake is down his poop turns to rabbit pellets. It’s balls hot now so you have to be especially cautious, especially if you’re running regularly.
Other than that I would go to the clinic again, and if he just brushes you off again try a second opinion elsewhere. Some clinics truly are garbage, but the system also just takes more time and a LOT more visits than some foreigners are used to.
I don’t know how much of this can help you, since you seem to have quite a backlog there, but I would suggest drinking Yakult/ピルクル400. My movements had always been kinda irregular, but after I started drinking one of those everyday, things basically became normal.
Hope you manage to solve your problem soon!
Like other folks, I suggest MOAR WATER.
Also, keep on a schedule. Wake up at the same time, drunk coffee, eat breakfast, move bowels.
Get a squatty potty step stool. They’re great.
Try a suppository the night before to grease the way by morning.
You mentioned fiber, but what does the rest of your diet look like?
How much water do you drink? With the current heat and your running habit, you need to drink a lot more than 2liters a day.
If everything fails, you still have enema as a last resort to provide temporary relief.
https://preview.redd.it/vmv8xvjurncb1.jpeg?width=435&format=pjpg&auto=webp&s=31f0a6ddc6b4a71c7fd8af3acbb0f6f6dd425612
I recommend taking some biofermin pills, or Yakult. Those always help me when I’m having some constipation. Get those good bacteria in there to help you digest. Remember to drink lots of water, especially since it’s so hot now.
To a vegetarian getting constipation, type of food you’re eating, or amount of water are said to be the common cause.
Also, have you tried flushing your colon with laxatives? or had a colonoscopy? I think it’s worth signing up for one if you’re having that much trouble. It requires you to empty your colon with laxatives the day before, so they will usually give you a kit of liquid meals and laxative making set.
Don’t take the laxatives yourself without consulting the doctor because if your constipation is caused by blockage or other serious conditions, it could make things worse.
Everyone is saying it but I will say it also because this is the best way to help your constipation.
Drink water. Lots and lots of water especially its summer right now so it is so easy to get dehydrated which makes it hard for you to poop. Keep yourself hydrated plus exercise will make it easier for you.
I know plenty of japanese people who had the same problem and the main reason is they tend to not drink water enough but more of those canned coffee which made them constipated.
Others mention water but you should also down a nice cup of black coffee. No sugar, no cream, just black coffee.
how about taking Lactic acid bacteria?
You can purchase a “Biofermin”, 「ビオフェルミン」at any drug stores. We (Japanese) take them quite often. The other way to heal a constipation is to take “Nukazuke” japanese pickles that contains a lot of lactic acid bacteria.
Not a doctor, of course, but why not try a specialist bum doctor; maybe their industrial-strength enemas or the pipe-cleaning two litre drink thing before a bum camera session might flush things out, and if combined with an actual camera session they might find a reason for the blockage?
If you’re in Tokyo, I found the Hachioji Onaka Clinic very professional when they stuck a camera up my Khyber.
Man, try to go to a different doctor and tell what you just told here.
4-5 months could be something serious that you will not fix with reddit comments
A nurse at a hospital can “assist” and yes that is as embarrassing and as bad for both of you as you imagine it to be…
It was effective though for a child that was similarly afflicted (after a few visits a couple of days apart and in conjunction with laxatives).
I’ve heard that conversely, *too much* fiber intake can cause constipation…
That said–not as dire as your situation but I often get constipated when traveling/on business trips–[this little concoction](https://www.otsuka.co.jp/en/nutraceutical/products/fibemini/) at most conbinis usually helps.
This time of year when you hydrate make sure you’re getting minerals and sodium as well, not just tons of water, a pocari sweat or similar here and there is good.
It must be done….
https://www.amazon.com/review/R2JGNJ5ZPJT4YC
Do you take a probiotic? Take a probiotic. Also take something like psyllium husk, it helps on both ends of the spectrum (diarrhea or constipation). Increase fermented foods (miso, kimchi, natto, yogurt, yakult, etc) and grab some prune juice. Also, strange but lube your butthole. Squat stool for the toilet. Prune juice.
If all else fails, go to another doc, maybe at a bigger hospital, and get them to release everything at once a la what they do for colonoscopies. I heard it’ll be incredibly unpleasant, but then it’ll be done with.
Signed, someone who has had IBS related diarrhea and constipation for a year now
You need to see a different doctor. Obviously you had tried the self care route. However, the injuries that can be sustained can affect your daily life. Judging by your current eating habits, I would highly doubt a simple change of diet would fix this problem. If you were to sustain injuries, the potential of a colostomy bag, ruptured intestines or severe hemorrhoids are possible. Getting your butt checked sucks, but risk isnt worth it to wait. Youre an adult, try making the best decision
I found that when my toddler had hard poops, feeding him jelly (either agar agar or gelatin) got things moving, with plenty of water. Apples also helped but avoid bananas.
I was told that when agar or gelatin pass through the digestive system, they pull water or retain water in the intestines’ turning everything into a slip and slide.
With all that fiber intake and exercise (loss of water as sweat), you will need extra water to keep your stools hydrated. Magnesium works by preventing the intestinal walls from absorbing water, thereby leaving it in the stool. But if the stool clogging the end of your digestive tract is already rock solid from staying inside too long, I don’t think it will be capable of absorbing the magnesium/water. I am guessing the insoluble fiber (cellulose) intake was too high compared to the soluble fiber intake, and progesterone slowing the metabolism allowed the stool to become totally dehydrated. Coffee is a diuretic, so coffee intake didn’t help either. It’s like you have created hardened cellulose balls in your gut. (It’s called 硬便.)
The basic flow of treatment in Japan for constipation goes like this.
Step 1: Prescribe magnesium.
Step 2: If magnesium is not effective, prescribe ethylene glycol.
Step 3: If polyethylene glycol is not effective, prescribe stimulant laxatives in combination with magnesium/polyethylene glycol.
Step 4: If all of the above fails, refer patient to large hospital.
You are only at Step 1 with your doctor. My advice to you would be to continue seeing your doctor. They will eventually refer you to a large hospital if you do not respond to any of the treatment. At the larger hospital, they will know your condition is serious enough to have been referred to them, so they will probably perform an MRI to assess how much stool you have accumulated, and decide the course of treatment.
Do not abuse stimulant laxatives based on your judgment, even the commercially available ones. Overuse of aloe, senna, and other commonly sold stimulant laxatives can cause life-long constipation, requiring progressively higher doses of the stimulant.
Throwing out random suggestions here.
Maybe it’s your pooping posture. Get one of those leg poop stools (YouTube squatty potty unicorn)
If you’re super desperate, as an absolute last resort, buy and eat a giant gummy bear.
*Gummy bears are Not vegetarian*
Here are the things that have helped me in the past. These are all available OTC at drugstores.
[https://www.kokando.co.jp/products_constipation_medicine.html](https://www.kokando.co.jp/products_constipation_medicine.html)
[https://kanpobenpi.jp/kanpobenpiyaku/](https://kanpobenpi.jp/kanpobenpiyaku/)[https://kanpobenpi.jp/kanpobenpiyaku/](https://kanpobenpi.jp/kanpobenpiyaku/)
[https://www.otsuka.co.jp/en/nutraceutical/products/fibemini/](https://www.otsuka.co.jp/en/nutraceutical/products/fibemini/)
If you’re desperate, try the first one. However, stay home for the day… It really, *really* works.