While severe gas from long-term constipation can cause chest and back discomfort, difficulty breathing and chest pain are critical symptoms that require immediate medical evaluation to rule out any urgent heart or lung conditions. Please seek medical care right away. Since Kayam Churan and Gerbisa (bisacodyl) have not provided relief, a doctor can safely evaluate your symptoms and prescribe more appropriate treatments, such as osmotic laxatives (like lactulose or polyethylene glycol) or dietary adjustments.

While Kayam Churan can help, long-term use of stimulant laxatives isn't ideal; a gentle osmotic stool softener like lactulose may be safer. To soothe the painful lumps, try taking warm sitz baths (sitting in warm water for 15 minutes) twice daily and applying a mild over-the-counter pain-relief ointment containing lidocaine. Please avoid straining during bowel movements. Since these lumps haven't resolved, I highly recommend consulting a healthcare professional or a general surgeon for a proper physical evaluation to ensure you get the right targeted treatment.

Kayam contains stimulant ingredients like senna, which can cause your bowels to become dependent on them over time. Please don't worry, as this is manageable. I recommend gradually tapering off the tablets rather than stopping suddenly. To help your system transition naturally, try increasing your daily water intake and eating more fiber-rich foods like fruits, vegetables, and whole grains. Regular physical activity also helps naturally stimulate bowel movements. If you need extra support, a gentle, non-habit-forming bulk laxative like psyllium husk can help. Please consult a healthcare professional to guide you safely.

It sounds like you may be experiencing mild constipation, a small anal fissure, or hemorrhoids, which can cause on-and-off pain and gas. Please be reassured that these issues are very common and highly manageable. Continuing with Isabgol (psyllium husk), a gentle bulk-forming fiber, is excellent, but try to limit Kayam Churan to occasional use to avoid dependency. Increasing your daily water intake and eating more fiber-rich foods will naturally soften your stool. Taking warm sitz baths (sitting in warm water for 10-15 minutes) can also greatly soothe the discomfort. If the pain persists, worsens, or you notice bleeding, please consult a doctor for a proper evaluation.

While Nityam tablets and Kayam Churna can offer temporary relief, regular use is not recommended for you. These formulations contain stimulant laxatives like senna and can have high salt content, which may affect your blood pressure, kidney function, and hydration levels, especially alongside your diabetes and insulin. Please consult your doctor. They can recommend safer, gentle alternatives like dietary fiber adjustments or gentle osmotic laxatives that won't interfere with your health conditions or medications.

Since high fiber, hydration, and various Ayurvedic remedies like Kayam Churna and Pet Saffa haven't brought relief, and you rely on Cremaffin Plus, it is time for a targeted medical evaluation. Chronic severe constipation with painful tears (fissures) requires a specialist's care. I highly recommend consulting a gastroenterologist. They can perform diagnostic tests to check your bowel motility and ensure there are no underlying structural issues. Please don't lose hope; identifying the exact cause is the first step to finding a safe, long-term solution that finally brings you comfort.