A 41 year old man weighing 104 kg with a BMI of 40 and thus labelled as "morbidly obese" came to the clinic looking irritable and depressed. By the way I notice that patients who are constipated are generally glum and down.
This is his third time of seeing a doctor for colicky abdominal pain and constipation. He claimed everytime he came to see a doctor, all they gave him was stool softener and advice to take more fibre, vegetables, fruits and drink plenty of water. Well, according to him the problem settled after taking the stool softeners but it recurred despite him taking the suggested foods to help reduce his constipation. when asked whether he passed flatus (fart), he replied "hardly now".
I could have given him the same prescription of stool softeners but I thought it would not help him. In fact I was tempted to just do that seeing that the patient was irritable and seemed to think that the world owed him a living. He was also accusatory of the "unhelpful treatment" received so far.
I asked him how long had he been constipated and he replied for the last one month or so. He was not constipated before that neither did he have colicky abdominal pain. He also denied taking any medications which could contribute to his current problem. Then I asked him what was " something new" that he had been taking over the last one month or so.
He paused to think then he said that about six weeks ago he went to see a private doctor for aching pain in his knee joints and the doctor advised him to drink a special high-calcium milk as he (the doctor) thought he had "bone problems". The patient had been taking the milk three times a day and now he realised that his current problem started a few days after his thrice a day milk drink.
Too much calcium in the blood (hypercalcaemia), depending on individual response , could cause constipation with abdominal colic.
I told him to stop taking the high calcium milk and prescribed him stool softeners to tie him over the period before the return to normal calcium level. He came for review after three weeks looking more cheerful as his abdominal pain and constipation had both subsided.
He complained that he spent so much money buying the "special milk" only to throw it away. I advised him to lose weight as he is unhealthily obese (morbid obesity). He is 34 kg overweight and now suffering from knee arthritis causing him aching pain. Taking more calcium is not going to help him, in fact too much of the mineral had adversely affected his bowel movements.
Obesity affects knee joints by placing more force on them, gradually wearing the joints away causing arthritis, pain and inactivity leading to more weight gain and worsening obesity. A vicious cycle.
This is his third time of seeing a doctor for colicky abdominal pain and constipation. He claimed everytime he came to see a doctor, all they gave him was stool softener and advice to take more fibre, vegetables, fruits and drink plenty of water. Well, according to him the problem settled after taking the stool softeners but it recurred despite him taking the suggested foods to help reduce his constipation. when asked whether he passed flatus (fart), he replied "hardly now".
I could have given him the same prescription of stool softeners but I thought it would not help him. In fact I was tempted to just do that seeing that the patient was irritable and seemed to think that the world owed him a living. He was also accusatory of the "unhelpful treatment" received so far.
I asked him how long had he been constipated and he replied for the last one month or so. He was not constipated before that neither did he have colicky abdominal pain. He also denied taking any medications which could contribute to his current problem. Then I asked him what was " something new" that he had been taking over the last one month or so.
He paused to think then he said that about six weeks ago he went to see a private doctor for aching pain in his knee joints and the doctor advised him to drink a special high-calcium milk as he (the doctor) thought he had "bone problems". The patient had been taking the milk three times a day and now he realised that his current problem started a few days after his thrice a day milk drink.
Too much calcium in the blood (hypercalcaemia), depending on individual response , could cause constipation with abdominal colic.
I told him to stop taking the high calcium milk and prescribed him stool softeners to tie him over the period before the return to normal calcium level. He came for review after three weeks looking more cheerful as his abdominal pain and constipation had both subsided.
He complained that he spent so much money buying the "special milk" only to throw it away. I advised him to lose weight as he is unhealthily obese (morbid obesity). He is 34 kg overweight and now suffering from knee arthritis causing him aching pain. Taking more calcium is not going to help him, in fact too much of the mineral had adversely affected his bowel movements.
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| Excess weight strains the knee joint causing arthritis and pain |
Obesity affects knee joints by placing more force on them, gradually wearing the joints away causing arthritis, pain and inactivity leading to more weight gain and worsening obesity. A vicious cycle.
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