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
Hi Hank,
I have also noticed that constipation can effect BPH/LUTS for the reason you give. Frequently, I my bladder will expel more urine after a bowel movement as further evidence.
It sounds like you've tried the higher fiber diets which can intially cause more gas and bloating but longer term may be the answer. Have you tried a vegetable based diet like DASH? Vegetables tend to be associated with softer stools.
How much relief do you find when you're not constipated? Is it enough to go off self cathererization with acceptable PVR's?
BPH/LUTS can have multiple causes so it's sometimes hard to figure out if you get rid of "x", will "y" work.
If you're trying to figure out if a prostate reduction surgery will work given both a stretched baldder and constipation, you might try urodynamic testing after administering an enema to at least eliminate one variable.
Jim
Thanks Jim,
I have not found the perfect diet yet. However, I found out that vegetables in general are good for my constipation, except for beans which gave me gas. As far as CICs, when I am constipated, I would do it more times during the day. Otherwise, I only do it just before bed and once more around 3,4am because night time retention is usually higher.
I, too, have found a correlation between BPH symptoms and constipation. But slightly different from yours. I was using a fiber (don't remember which) and had no problems. Then a bowel irritation showed up on my colonoscopy. After a trip to Mexico it became inflammed and I had to quit the fiber, dried fruits, etc because they worsened the inflammation. As I searched for something to make my bowels regular, I bounced from diarhea to constipation and each brought on increasing BPH symptoms...frequency, urgency, hesistation, interruptions.
I've asked several doctors who said they didnt know of a connection.
My guess is that pressure on bowels moves the prostate into a bad position.
So you had a bowel irritation as a result of a colonoscopy ?
There is only limited space in our body cavity so organs will affect each other. Hank
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
The colonoscopy merely found the irritation. After that each time I used the fiber the inflammation flared up, making me think that the fiber or roughage like dried fruit, might be the cause.
Without the fiber I bounced from constipation to diarhea, each time
seemed to trigger increased BPH symptoms.
Now one of the ways I reduced my BPH problems is to use a non-abrassive laxative and avoid constipation.
Thanks Buzz,
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
Thank jjjj,
".each time I used the fiber the inflammation flared up, making me think that the fiber or roughage like dried fruit, might be the cause.."
I agree with this. I think dried up fiber can scratch and irritate the linings of the colon. Worse of, it could block your colon. It is why they suggest extra liquid while taking extra fiber. But too much liquid can cause other urination problems. So it is a fine line we have to walk on.
I think I have the same thing from my last colonoscopy. It showed some blisters. Hank
Hi Jim,
Do you know any simple procedure that we can use to empty our colons, that is similar to how we self cath to empty our bladders ? Right now, all I think off is going through a pre-colonoscopy procedure, perhaps taking laxative like MiraLax with only liquid foods for couple of days. Hank
I agree.
So now I am using mineral oil, like my grandparents used. Plus avoiding pepper, strong spices, onions, dried fruit, too many raw vegetables, etc.
It seems like my colon has calmed down and my nocturia has improved. But its only been about a month.
I'm not sure how healthy this is for my colon.
I don't think it's necessary to go through the pre-colonoscopy procedure. On occasion, I've used OTC Fleet Enemas. If the problem is primarily lubrication, the mineral oil Fleet should be tried first. If the stool needs softening due to it being very dry, you might have to use the standard Saline Fleet Enema. You could also just get an enema bag at the drug store and make your own solution.
The problem is you don't want to get into the habit of using enemas, laxatives, etc, because your body can become dependent on them.
Best thing is to find the right diet approach. Diary, for example, is constipating for many people. I still find a diet ample in cooked vegetables seems to work best. 2-3 prunes a day also helps.
Jim
Hank,
You could also research the appropriate Yoga exercises. When I practiced Yoga there was one exercise that gained control of the abdominal muscle where you could sort of give yourself an internal massage. It took time to master but not that difficult. I would think that would be a great help in getting things moving along.
How many bowel movements do you have a week? When I eat low fiber, I'd average every day or every other day. With inactivity sometimes once every three days. When I was on a plant based, low fat diet, I had two bowel movements a day. That means less transit time and less constipation.
Jim
Thanks Jim,
I'll look into Yoga and enemas as you suggested. I like to go at least once a day but when I am constipated, not much comes out and they are hard and dry. I would like to flush my colon at least once just to see how much urinary relief I will get. Hank
Another thing: when I am constipated, it is more difficult to CIC also. I mean it takes more time for the catheter to find the bladder. Hank
How are you using mineral oil ? I add olive oil to my food and it does help. Hank
I also found out that these tend to cause constipation:
1. Too low in salt diet
2. Too low in fat diet
Too high in salt and fat is not good either due to other things.
Hank
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
Have you tried a strong probiotic? Sometimes they work wonders.
I'm currently on a very low sodium, very low fat diet and have not issues with constipation. Not saying that this may or not be an issue with "jjj" but I would balance the benefits of such a diet against any possible risks. Adding salt to one's diet, at our advancing ages, is usually not a very good idea, while the opposite is.
The DASH diet, for example is also low in salt and fat and apparently is good for constipation. The caveat is that you have to drink adequate fluids.
Jim