instruction: hello doctor I did a herbal cleanse which seemed to cause a blockage I worked with suppositories fleet laxative magnesium supplements senna docusate for temporary results my symptoms are straining excessively feeling of rectal blockage digital retrieval to relieve pressure feeling of incomplete evacuation intermittent pressure rectal area and dyschezia feel this can be the case even with soft stool I used miralax for eight days shortly thereafter I took 500 my magnesium capsules and benefiber the next day the stool was bulky good diameter and easy to pass I took the same supplements but for the next day the stool is fairly bulky with some strain I used the restroom four times to empty the rectum with straining later pressure cannot be moved so used suppository I am concerned about impaction but no blood or leakage I had a history of constipation but never like this before I am taking dilantin and levothyearoxine for several years
output: hello from what I could make out from your description is that you have history of constipation but have a recent worsening possibly due to the cleanse you have a background of hypothyearoidism you have used a plethora of laxatives with some partial relief for your immediate relief I would recommend using safer laxatives like peg polyethylene glycol and stool softener under the guidance of a physician or a gastroenterologist you should also get your thyearoid profile checked as uncontrolled hypothyearoidism is a known cause of constipation do not strain excessively and use enema or suppositories if you feel impaction you may require a colonoscopy in case you have not had one recently I hope this helps