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Trust Your Gut When It Comes To Constipation In Contact Sports Athletes - Page #1
 

Author: Maria Bianchi, MD
Co Author #1: Britt Marcussen, MD
Senior Editor: Michele Lane, ****
Senior Editor: Kevin Gray, MD
Editor: Steven Brown, MD

Patient Presentation:
A 16-year-old male football player presented to sports medicine clinic with two weeks of vague left abdominal pain and constipation.

History:
Patient reports that pain was worse with activity. They denied fever, nausea, vomiting, upper respiratory symptoms, dysuria, incontinence, testicular pain, and swelling. They also noted their last full bowel movement was two weeks prior to their clinic visit with some small bowel movements since. They denied blood in stools. He reported multiple visits to local urgent cares and the emergency department. Previous workup included an abdominal x-ray that revealed moderate stool burden with no obstruction. During these evaluations, he had labs performed that showed a mildly elevated white blood cell count at 10.8. He was also found to have an elevated c reactive program at 4.2 five days prior to clinic visit and 3.1 three days prior. Other labs included normal amylase, lipase, comprehensive metabolic panel, and urinalysis. He reported eating and drinking less than usual. He attempted to treat his constipation with MiraLAX for three days that produced only mild results. He also used Nulytely, but this only resulted in minimal passage of stool. He reported no prior history of constipation or family history of gastrointestinal issues.

Physical Exam:
Vital signs are unremarkable. BMI 34.87 kg/m2. In no acute distress. No scleral icterus. No conjunctival pallor. Moist mucous membranes. Oropharynx clear, no erythema or exudates. No lymphadenopathy. Heart with regular rate and rhythm, S1/S2 present. Lungs clear to auscultation bilaterally. No CVA tenderness. Abdomen with bowel sounds present, soft, non-tender, non-distended, no rebound nor guarding, negative Murphy's sign and McBurney's sign. Skin color, texture, and turgor normal. No obvious rashes or lesions. Awake, alert, oriented x3.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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