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Gastroenterology/Constipated for 5 years+ (for no reason)

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My case of constipation is extremely weird and it will take a long time for you to go through, but i am happy that you would volunteer to assist people like me. Sorry if there is a lot of grammar mistakes and your reply is very much appreciated. Cheers.

My personal details and history
Gender = Male   Age = 21   Weight = 51 kg    Height = 162 cm
Country of origin/current tenancy = Malaysia (South East Asia)
Malaysia is a tropical area with warm climate
Constipation time frame = 5 years+ (started at the age of 16 or below)
(might be more than that, but because i do not recall much when i was young, so i am not sure)
Stool type = Bristol stool chart, type 2 and 3
(95% of the time it is type 2 and 3, unless i ate contaminated food, it will be diarrhea)
Bowel movement = Almost everyday (6-7 times a week)
Feces diameter = 2.8cm-4.0cm (most often is 3.2cm, average)
Feces length = 10cm-20cm+ (the size is extremely huge when its 20cm)
Diet = Balanced diet, (rice + vegetables + meat) Asian cuisine.
Water consumption = 1.5 Liter, more or less
(most of the time urine color is often nearly white)
Stool color = Yellow (constipated) or dark brown (constipated).
(I have no idea why sometimes its yellow and constipated... even though i eat the same type of food everyday)
Straining required, discomfort felt at anus after defecate, inability to empty bowel (10% chance)

In my family, i am the only person who is facing this problem as i recently went and ask everyone of them how does their poop looks like. I also ask my close friends too and it felt awkward. All of us eat the same type food, so i do not think the food is the cause of it. I also drink adequate amount of water too. I do not eat much food containing gluten and lactose too. Spicy food is rarely taken. I have been going through uncomfortable defecation years. Every time i defecate, my anus always felt uncomfortable till today.

Recently I have been going through online to find the root of my cause and regrettably, no answer were found. But i found this website and hope it could assist me.

Dec, 2011
Went to New Zealand for 2 months holiday trip, diet was the same as i stay with an Asian background culture family. Basically what we had for meal (most of the time) is just rice, vegetables (soluble and insoluble), meat. For unknown reason, stool became type 4 (based on Bristol stool chart). I felt uncomfortable as i thought it was abnormal to have soft smooth stool and got use to it after sometime. On special occasions, i would go out with the New Zealanders for dinner and had steak for dinner, defecation is still the same, soft and smooth. Bowel movement remained the same for the next 2 months as i stay there. When i came back to Malaysia, stool revert back to type 2 and 3...

Mar, 2013
Had varicocele surgery, (type 3 varicocele, highest stage) (bulging veins in the scrotum, left side) found out that the possible cause is constipation (possible cause was found out a few months ago). This is because when i felt the pain in my scrotum, i will feel my lower left side of the stomach for hard lumps (large intestine filled with feces). After defecation, the pain will completely subside (due to less pressure done to the abdomen).

Aug, 2013
Severe rectal bleeding from extreme tear.

Around 2 years back it became an extremely severe problem, when the rectal bleeding continued for 2 months straight.

During the 1st month, i went for a specialist doctor with 25 years+ experience, and he ask which stool does it look like based on the Bristol Stool Chart. I told him that it is type 2 and 3. Then he proceed to check the anal to check for tear and found it. After that he gave me a drug (use to insert into the anus) to ease the pain and lubricate it, thus easier defecation for the next 7 days and meet him again (stool is still type 2 and 3). 7 days later, the bleed was still the same. He recommended that get an anal sphincter surgery, which i do not wish to as there are complications when i get old, such as "anal incontinence" as my grandfather has it. Another reason that i did not proceed for the surgery is because, if the root of the problem, which is unpreventable years of constipation , what is the point of having the surgery. At this point i stop visiting the doctor. I did not told him i have been constipated for years as i do not know having it for years is abnormal, they did not ask me how long do i have this problem too.

I went for the 2nd specialist doctor with 10 years+ of experience on the 2nd month. I told him what the same thing as what i told the previous doctor. Type 2 and 3 stool based on Bristol stool chart and bleeding. He say just eat more insoluble and soluble fiber, add prunes, more water and it would be fine (I have been having a balance diet as my family does, with adequate fiber, carbs and meat). Laxative was recommended, and use after meals (breakfast, lunch, and dinner). The next day, after breakfast i only took it once and it was more than enough as i have bowel movement for 3 times in the next 3 hours. In every bowel movement, the length of the feces is more than 20cm+. The 1st bowel movement was type 2, and for the 2nd bowel it is softer and break into crumbs as some are not digested, and in the 3rd bowel feces break down easily too as it is not digested completely. But the bleeding is still there. Again, I did not told him i have been constipated for years as i do not know having it for years is abnormal, they did not ask me how long do i have this problem too.

I went through online and found that the best way to treat it (naturally) is squatting position and warm sit bath will help, i proceeded and it actually stop the bleeding after 2 months of suffering.

Dec, 2014
I have traveled to Thailand before for vacation, and the stool is type 2 and 3...

Recently (1 month ago) i realize that i am actually facing chronic constipation as i thought type 2 and 3 stool are normal. Currently, i am still suffering from constipation but bleeding is very rare (once every few months), squatting position is done when i defecate and warm sit bath is no longer needed (ever since the bleeding stop). But still have discomfort at anus because of minor tear (i can feel it, as it is itchy and felt inflamed). I also rinse my anus with warm water and wipe gently with soft tissue paper after defecate.

If my long term constipation is treated, discomfort at both my anus and scrotum will subside for good.... Besides that, i would be able to run properly (when i was 12 years old till now) as i have side stitches when i did not empty my bowel, light jogging is torturous.
I will be going back to New Zealand as a trip to visit my friends at the end of this year, at the same time i can double confirm on my bowel movement again.... some of my friends say it might be the weather (although i am unable to find any answers online at all), but if that's the answer, it would be hilarious...
Thank you for your time! I hope i can an answer for this...

Answer
Hi Brian

Having constipation can be sign of the various GI and other problems. Possible reasons for your constipation are:
  Candida-yeast overgrow. It is possible if he took antibiotics, changed the water supply (chlorinated water). Constipation/diarrhea may be also symptoms of it.
  Not enough fiber in the diet
  Dehydration
  Not enough magnesium, potassium.
  Low amount of the friendly intestinal bacteria
  Low pancreatic function. Gas, bloating, left upper abdominal pain
  Low amount of the bile. Bile constipation is in people that avoid fatty foods (olive oil, eggs, butter). These products stimulate the releasing of bile. Bile is natural simulator of the intestinal peristaltic  
  Food  allergy, sensitivity
  Low thyroid function. Some areas in Iran where the water supply is from mountains may have low amount of iodine.
  Depression. Combination of constipation and depression is well-known medical fact
  Lack of exercise, sedentary life style
  Some medications
  Changes in life or routine such as travel
  Ignoring the urge to have a bowel movement. This is important point. After sleep and before go to bed, go to the bathroom, sit and think why you are  there
Try to find the medical professional or doctor who verify the right reason for your constipation and non-drug treatment for it.

Have good health.

Peter Melamed. Ph.D.

Gastroenterology

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Peter Melamed, PhD

Expertise

I can answer all questions about digestive health, especially in focus on the non-drug, non-surgery treatment. It includes healing diet, acupuncture, herbal medicine, nutritional supplementation, healing mineral water, abdominal massage, and cleansing techniques. All these practices are widely used by gastroenterologists all over the world.

Experience

This is my everyday job at Biotherapy Alternative Medicine Clinic in San Francisco. I have decades of the experience of working as an MD in ICU, outpatient department and privet practice. I have helped many of my patients with the chronic digestive disorders by using the non-drug, non-knife approach for the 20 years.

Publications
I published many articles on internet about gastrointestinal disorders. 1. Peter Melamed, Ph.D., Felix Melamed, LAc, MSTCM. EBook Healthy Pancreas, Healthy You. Publisher Biotherapy, Inc, September 2014 https://www.smashwords.com/books/view/236176#/longdescr 2. Peter Melamed, Felix Melamed. Chronic Metabolic Acidosis Destroys Pancreas. JOP. J Pancreas (Online) 2014 Nov 28; 15(6): 552-560 http://pancreas.imedpub.com/chronic-metabolic-acidosis-destroys-pancreas.pdf 3. Peter Melamed, Felix Melamed. Short Review of Our Work - "Chronic Metabolic Acidosis Destroys Pancreas" with Focus on the Functional Exocrine Pancreatic Disorders JOP. J Pancreas (Online) 2015 Jul 08; 16(4):365-368 http://pancreas.imedpub.com/short-review-of-our-work--chronic-metabolic-acidosis-destroys-pancreas-with-focus-on-the-functional-exocrine-pancreatic-disorders.pdf 4. Peter Melamed, PhD, and Felix Melamed, MS. Acidity Kills the Pancreas. Townsend Letter, the Examiner of Alternative Medicine. August/September 2015, p. 74-80 http://www.townsendletter.com/AugSept2015/acid0815.html 5. Peter Melamed, Felix Melamed. The Role of the Metabolic Acidosis in the Development of Chronic Pancreatitis. SM Group (USA) Chronic Pancreatitis: Recent Advances. 2015, Aug 10 http://www.smgebooks.com/chronic-pancreatitis/chapters/CP-15-01.pdf

Education/Credentials
MD, Ph.D. in the medical science and also LicAc, RN

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