While you are already taking lactulose (Duphalac) and ispaghula husk (Fibrogel) to soften stools, the worsening pain means the fissure needs targeted help to heal. I highly recommend seeing your doctor, who can prescribe a topical ointment, such as nitroglycerin or diltiazem, to relax the sphincter muscle and relieve pain. In the meantime, sitting in a warm bath (sitz bath) for 15 minutes a few times a day can greatly soothe the area. Please keep drinking plenty of water to help the fiber work effectively. Relief is possible, and your doctor can help you get there.

Hard straining from constipation does not cause a miscarriage. Your developing baby is very well protected inside your uterus. Since Duphalac and Movicol aren't providing relief, it is best to speak with your doctor. They can safely recommend other options, such as dietary fiber supplements or mild stool softeners. In the meantime, try to increase your daily water intake, eat more fiber-rich foods like fruits and vegetables, and engage in gentle walking.

Please be reassured that Duphalac (lactulose) is generally very safe for long-term use. Because lactulose is an osmotic laxative, it works naturally by drawing water into your bowel rather than stimulating the muscles, meaning your body will not become dependent on it. Since it is not absorbed into your bloodstream, serious long-term side effects are extremely rare, though some people experience mild bloating or gas. I highly recommend chatting with your doctor to ensure we are addressing the root cause of your constipation and keeping you feeling your absolute best.

Passing stool once every two days in a child is not always constipation by itself, especially if the stool is soft, the child is comfortable, and there is no pain or straining. Many children naturally have different bowel patterns, and what matters more is consistency, ease of passing stool, and whether there is discomfort, hard stools, or fear of passing stool. If your son is active, eating well, and not complaining of pain or bloating, this pattern can still be normal. However, if the stool is hard, the child strains a lot, avoids going to the toilet, or complains of pain, then it may be mild constipation. In such cases, increasing water intake, adding fruits like papaya, pear, and fibre-rich foods, and encouraging regular toilet habits often help more than medicines. Sometimes mild stool softeners are used in children, but they should be given only after proper pediatric advice. If the problem is long-standing, worsening, or associated with weight loss, abdominal pain, or blood in stool, it is better to consult a paediatrician to rule out underlying causes and guide safe treatment.

It is understandable to worry about your father?s blood sugar spike. Duphalac (lactulose) is generally safe for the kidneys, but because it is a sugar-based laxative, it can occasionally contribute to increased blood glucose levels, especially in long-term diabetes. Since his blood sugar reached 310 mg/dL, it is important to pause the Duphalac and contact his doctor or nephrologist right away. They can safely adjust his diabetes medications or recommend a sugar-free alternative for his constipation that won't affect his heart or stage 4 kidney disease. Please monitor his blood sugar closely in the meantime.

Chemotherapy-induced constipation is very common, and it is completely understandable to feel frustrated. Lactulose (Duphalac) can sometimes take 24 to 48 hours to take full effect, so it may still help. Please ensure you are drinking plenty of fluids, as this helps the medication work. If you still have no relief, please contact your oncology team. They may safely recommend adding a generic stimulant laxative, like senna, or a stool softener, like docusate sodium. Please do not start new medications or use suppositories without checking with them first, as your blood counts must be considered.