Hi Ally
I am sorry that your sister has difficult symptoms. I can perhaps direct you to information so you can learn more and support your sister if she wishes you to help.
Please see Guts UK symptoms page here
https://gutscharity.org.uk/advice-and-i ... /symptoms/ for further information.
It is not uncommon for people with fibromyalgia to have gut problems and if she has been advised to use laxatives then she might also have severe constipation perhaps, (this is not a diagnosis - I am not a doctor - but this perhaps might be helpful for her to ask her doctor.) Constipation as a symptom does vary but it can be chronic (long term) and very severe and also result in reduced quality of life. Faecal impaction happens when constipation is so severe that a person is unable to clear the poo out of the bowel naturally. The information on constipation on Guts UK website
https://gutscharity.org.uk/advice-and-i ... stipation/ states:
"There are three main physical causes of constipation.
One of the causes is where the muscles of the intestine and large bowel stop working properly; this results in slow movement of contents through the bowel down to the rectum (leading to a reduced urge to empty the bowel and hard stools). This is termed
slow transit constipation and patients have an infrequent urge to go to the toilet.
Another type of constipation is called
obstructed defaecation where the movement (transit) of the bowel is normal, but the person experiences symptoms of difficulty with emptying their bowel. Patients may need to strain, and feel they cannot empty. (Think pelvic floor problems here.) There are some patients who have both slow transit and obstructed defaecation.
Finally, there is
constipation-predominant Irritable Bowel Syndrome (IBS-C) when the person has difficulty with bowel opening and abdominal pain associated with not going. This type of constipation can be made worse with stress or depression."
If she wishes, asking the doctors about the different types of constipation might help and if she is on medicine she could ask if that is a cause of the problem, but she should not stop taking any medicine without her doctors advice.
I'm afraid there is unlikely to be a quick lifestyle fix that she can try but there is more information on the link for constipation about treatments. Being unable to eat is likely also to be contributing to the symptoms and I wonder if you sister has had help from a gastroenterology dietitian? She could ask a hospital doctor (or her GP) to refer her and that might help her to find out what foods she can tolerate. Although sometimes changes to diet are not always successful in resolving a slow gut, when symptoms are severe, it might help her to eat more.
I realise you feel that laxatives are unsuitable but there are lots of myths around taking laxatives - there is more information on the link. But laxatives can sometimes be challenging to get the dose right and there are a number of new ones that your sister could ask her doctor about and sometimes it can mean trying a few different options till she finds a suitable one with her doctor or pharmacists help. Whilst some people consider that taking laxatives is not ideal it should be recognised that some people do need to take them in the long-term. It is not a failure on their part. There is also a link here to an organisation called Bladder and Bowel UK, they have a nurse's helpline which might be helpful for her to contact if she wants to do that
https://www.bbuk.org.uk/.
If she wishes she could request a referral to a gastroenterologist at a teaching hospital (called tertiary care centre) if she has not seen one to help her. It is also important for her to let her GP know how she is feeling too. Some hospitals have bowel nurses who can also be useful to ask advice from.
I hope that at least gives you some information and if your sister wants to, she can contact Guts UK Charity herself
https://gutscharity.org.uk/contact-us/. I wish you both well. Julie.