Constipation and BPH
Posted , 9 users are following.
I am 63, with chronic urinary retention (CUR) due to a streched bladder, currently doing self-cathing to protect my kidneys. I am also taking doxazosin ( alpha blocker) and just started Finasteride (to shrink my prostate hopefully). My PSA for the last 9 years has been about the same, around 3.
I have been noticing for years that my BPH symptoms are related to the occurrences of my constipation and I am easily constipated, especially due to the fact that I have redundant (tortuous - extra long - loopy - twisted) colon, which I was told after my colonoscopy 5 years ago. Every change in diet, every change in daily routine, will make me constipated and gassed bloated and I sufffer BPH symptoms, which is for me means more hesitancy, more urine retention. The harden stool and the gas trapped in the colon will push and/or pinch on the urethra just like an enlarged prostate would. Once I had a very bad constipation and I almost had a complete urine shutdown (AUR). I always find immediate urinary relief once my constipation and bloating subsided. Now I wonder if I have been suffering from constipation more than from enlarged prostate and therefore any prostate surgeries may not do me any good.
Anyone else with similar problem ? Especially with redundant colon ? Please share your story.
Hank
0 likes, 90 replies
oldbuzzard hank1953
Posted
Constipation can definitely impact urinary function. The one time I went into full rentention it was because I was constipated and my urologist told me that was a known association.
JimJames had a good suggestion, but I'd go one further. Have your prostate scoped so you know for sure whether its even a factor. If it isn't, any prodecure won't help and will also be an expense and inconvenience at best. If it is, a successful procedure might help enough to get you off the catheter even when your colon isn't cooperating. But I strongly reccommend against any procedure until you've been scoped and they determine that your prostate is enlarged enough to be a significant contributor to the problem
hank1953 oldbuzzard
Posted
I am glad to know someone else had very bad retention due to constipation. I will talk to a uro about my problem next time. Hank
hank1953 oldbuzzard
Posted
I actually had 2 episodes of near complete full retention due to constipation. The second one was so bad it even caused hemeroids and probalby UTI. It might have caused my kidney problems that was not detected until blood test was done few months later. It was bad. My whole lower section was inflamed. I ended up buying a set of pediatric anal dialators so I can go up and break up the blockage if that happens again. The good thing is I have not have to use them, yet.
It was rough. I wished I had known how to self cath then. Hank
nealpros hank1953
Posted
Hi Hank,
Those of us with BPH sometimes drink less liquid because we think it might decrease the need for problematic urination. In fact, it might not because the concentrated urine might irritate the urinary tract. But what it does do, is cause our stools to become hard, and causes severe constipation. This problem is easily solved. Drink more liquid. You will soon find that your stools are softer.
Also, if you look on the web for a picture of the anatomy involved, you will see that the prostate is located right next to the colon. That's why the doctor can easily feel your prostate by going in through your rectum. So it makes sense that hard stools will irritate your prostate by pressing on it.
Neal
hank1953 nealpros
Posted
Thanks Neal,
I just found out that constipation can also inflame the prostate by spreading toxins over via the linings of the two organs from an article I found and sent to jjjj.
Regarding "drink more liquid", it means more trips to the bathroom, and not so good at night. Hank
nealpros hank1953
Posted
Hi Hank,
More trips to the bathroom may not happen. Please reread my post above about concentrated urine. But even if it did mean more trips to the bathroom, that beats the heck out of a bowel obstruction caused by severe constipation. I had one once. It's about as much fun as a complete urinary obstruction. One of those will leave a lasting unfavorable impression.
Neal
hank1953 nealpros
Posted
Edd52 nealpros
Posted
Drinking more liquid helps, but I found that when you drink may be important. Take a drink for use when you wake up in the night definitely helps. Don't drink 2-3 hours before going to bed and when you wake drink as much as you like. At 3:00 am it does not seem to make much of a difference later on but helps with constipation. I use fruit tea. I noticed this when laxido lost effectiveness at 20:00 but was better at 03:00hrs.
hank1953 Edd52
Posted
JerseyUrology hank1953
Posted
Hello Hank;
Has your urologist performed urodynamic evaluation (testing to determine how the bladder works) and/or ultrasound sizing of the prostate?
Unfortunately, there isn't a "one size fits all" treatment, but some basic testing should be performed before deciding on the best treatment for you.
Constipation is certainly a confounding issue; however, in my experience, it often is not the main issue causing urinary retention.
hank1953 JerseyUrology
Posted
My urinary retention may be a result of many things, including years of unknowing bladder abuse (drinking too much and then trying to hold it in, especially overnight), prostate, and constipation. I am not sure which one is the most dominant contributor, but if I have to pick one, it would be the first one. I had my prostate ultrasounded with my kidney, but no one told me the size. Plan to ask more next time. Hank
jimjames JerseyUrology
Posted
Hello Jersey UroGr,
First, welcome to the forum. I'm assuming you're an MD?
I like that fact that you're recommending urodynamics, as far too many urologists seem to skip this very important step, even prior to a prostate reduction procedure or surgery. Does your group do video urodynamics or without video?
I agree that constipation may be contributing but that it's often not the main issue. That said, what I recommended earlier was urodynamic testing after cleaning out the colon for a best result scenario. In fact, if Hank and his doc think the constipation may be signficant, it might be worthwhile to do urodynamics both with a full/constipated colon and an empty one to see the actual impact his constipation has.
Jim
JerseyUrology jimjames
Posted
Hello!
We use the latest laborie equipment and do not use video- I've honestly never found any significant aid with video for this procedure for patients with retention (other than the help to some physicians' wallets, that is!) and our urology journals don't show any improvement either.
Too often, non-prostate causes of retention are missed; we may still recommend prostate treatment for many of these cases, but it's important to have everyone's expectations in line.
jimjames JerseyUrology
Posted
Hi,
Not surprisingly, I've heard it both ways with video! Urodynamics aside, does your office use a real time bladder scanner or one of the commonly used Verathon units that just gives a volume readout?
If you have the former, then you can get a lot of the same information that you can get from video urodyanmics. Ironically, a voiding speicalist I saw who is an advocate of video urodynamics, has a simple 3D Verathon unit with no real time imaging.
Jim
JerseyUrology jimjames
Posted
Yes, do use handheld ultrasound units.
We actually perform full bladder and prostate ultrasonography with the aid of our ultrasound technologists, which assist us in determining the best procedure and treatment for patients in addition to urodynamics.
We've found this additional anatomical information more useful
jimjames JerseyUrology
Posted
I have a used 2D real time Laborie ultrasound unit at home that I intially got to check bladder volumes to help determine my self cathing schedule.
But I also have a large bladder diverticulum and found the scanner very useful in understanding the synergy between bladder and diverticulum during voiding --- something you wouldn't get from a Verathon unit. In fact, with a Verathon unit, you might not even be able to tell if the reading was from my bladder, diverticulum, or some combination. Good to know your office uses real time ultrasonography.
Jim
jjjj57989 JerseyUrology
Posted
I'd like to congratulate you on your participation on this forum. Until now no doctor has seen the value of providing useful Q&A to hundreds of men with BPH problems.
I hope we learn alot from each other and that your business grows as you sucessfully treat members of this forum.
Collectively the members have been treated by many doctors in all parts of the world. But there is one, a Dr. K who does Fla so sucessfully that patients are forming a fan club on this forum. I'm sure he is getting lots of referrals. You might want to search for references to him to see what he is doing thats different.
Good luck.
oldbuzzard hank1953
Posted
It would be helpful to you to have the testing done that will tell you for sure. And those who say constipation isn't a main driver of retention, that's certainly true for people with normal prostates and bladders. But anyone who is doing all the juggling that BPH and/or bum bladders require could well be thrown into full retention by it. I only had that happen to me once and it was due to constipation.
And I encourage anyone who is having trouble with it to try a normal diet with a lot of fruits, vegatables and legumes and a strong probiotic. For many that regimen will do the trick and let you enjoy most or all of the foods you like.
JerseyUrology jjjj57989
Posted
Thank you!
I think it is a great learning opportunity for both physicians and patients!
I am trying to learn about "FLA", as this is the first I have heard of it. Unfortunately, I am coming up a bit short with searches under that as well as the few doctors who perform it; I'm not able to find anything regarding it in either the urologic nor the radiologic literature (other than an old case study where it was used for cancer, rather than benign disease.)
That being said, this is a very exciting field to be in, and it's great that there are so many options available to choose from!
hank1953 oldbuzzard
Posted