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Alopecia, constipation
I am a patient hypothyroidism on 62.5 mcg thyrox
I have constipation from last 2-3 years initially it about passing stool in 2 days not that duration has increased to 3 days.
Because of constipation I have developed anal fissure,sentinel tag
I take adequate fibre vegetables etc and alot of water too still symptoms persist
Can I take lactulose 15 ml everyday
I am attaching thyroid profile report done on 16 april 2026
Answers (21)
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Your TFT is controlled..for constipation try to take more papaya and have more probiotic like curd..during your episode of constipation try to sit in a warm water with turmeric..if you want precise advice you can contact me
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Your thyroid values are well controlled, but needs to focus on your gut health.
Next Steps
Continue taking lactulose syrup and consult a doctor for furthur evaluation.
Health Tips
A glass of warm water 30mins before your every major meal helps you.
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Continue high fibre diet, drinking more water. Take syp lactulose 10m.l. morning and 10 m.l. After dinner.
Take some pappaya regularly in evening.
Drink a glass of hot water or milk after dinner.
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If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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Yes 👍 lactulose 15 ml at night can be taken safely for constipation and can be continued as needed.
Since you have hypothyroidism, also ensure your thyroid levels are well controlled as it can worsen constipation.
Along with this, continue high fibre, water, and add regular bowel habits.
For fissure, stool softening is very important.
If still not improving, better to review reports and adjust treatment ,can book a consultation.
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When you have sentinel tag , it's chronic fissure.
You need to consult a surgeon at your locality for digital rectal examination and proctoscopy
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Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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O yes no problem.
Or add softovac powder two tsf two times for 20 days than once at night natural herbal isabgol flavored with sanuf , non habit forming.
Gut health remain good. Least episode of piles
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You have hypothyroidism, but your attached report shows TSH 1.29 with normal T3/T4, which means your thyroid levels are well controlled on your current dose (62.5 mcg thyroxine).
So your constipation now is not due to uncontrolled thyroid, but more likely chronic functional constipation, which has unfortunately led to anal fissure and sentinel tag.
Yes , you can safely take lactulose 15 ml daily. It is a gentle, non-habit forming stool softener and is commonly used long-term in such cases. You can even adjust the dose (10–20 ml) based on response to achieve soft, daily stools.
Next Steps
1. Continue lactulose daily, preferably at night
2. Aim for soft stool consistency (not hard, not watery)
3. Add osmotic + bulk approach if needed: lactulose + isabgol (psyllium)
4. For fissure:
-Sitz bath (warm water) 10–15 min, 2–3 times/day
-Local application (e.g., lidocaine + nifedipine/diltiazem ointment)
-Maintain regular bowel timing, don’t delay urge
Health Tips
-Even with good diet, some people need long-term stool softeners, that’s okay
-Avoid straining at all costs (this worsens fissure)
-If constipation still persists, consider evaluation for slow transit or pelvic floor dysfunction
-If fissure pain/bleeding continues then consult a surgeon (for medical management, rarely surgery)
You’re already doing most things right, just need consistent stool softening and fissure care, and things usually settle well over time.
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Yes, lactulose syp.15ml after dinner for constipation.
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Chronic constipation is a very common complication of Hypothyroidism, as low thyroid hormones slow down the metabolic rate and gut motility (peristalsis). In your case, despite a high-fiber diet and adequate hydration, the slow gut transit has led to the formation of hard stools, resulting in an Anal Fissure (a small tear in the lining) and a Sentinel Tag (skin growth due to chronic irritation). Managing the constipation is the priority to allow the fissure to heal and prevent further complications."
Next Steps
Yes, you can take Lactulose (15 ml) every day. It is an osmotic laxative that works by drawing water into the colon, making the stool softer and easier to pass. It is generally safe for long-term use and does not cause 'lazy bowel' syndrome like stimulant laxatives. However, since you have a fissure, the goal is to have 'toothpaste-soft' stools to avoid reopening the tear."
Health Tips
To manage the fissure and constipation effectively, I recommend:
Thyroid Review: Since you have a fresh report from 16th April 2026, check if your TSH is within the optimal range (0.5-2.5 mIU/L). If TSH is high, your Thyrox dose (62.5 mcg) may need adjustment.
Sitz Bath: Take a warm water sitz bath for 10-15 minutes after bowel movements. This relaxes the anal sphincter and promotes healing of the fissure.
Topical Relief: Use a local anesthetic/calcium channel blocker cream (like Diltiazem or Lidocaine) as prescribed by a doctor to reduce pain and improve blood flow to the fissure.
Lactulose Timing: Take it at bedtime for best results. You can adjust the dose (15-30 ml) based on your stool consistency.
Avoid Straining: Never force a bowel movement, as it will worsen the sentinel tag and fissure."
Any doubt do connect and consult
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Your TSH profile is fine. That is Good.
Next Steps
Take Lactulose 30ml minimun on regular basis based on your body weight.
Health Tips
try weight reduction
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You can but you should consult a doctor… you may have other cause for constipation like IBS and hypothyroidism may not be only cause
Next Steps
Detailed evaluation
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Hello,
Chronic constipation is quite common in patients with Hypothyroidism, even when thyroid levels are reasonably controlled. It can also lead to complications like Anal fissure and sentinel tags, as in your case.
Regarding your question
Yes, Lactulose 15 ml once daily can be safely used for chronic constipation. It is an osmotic laxative and is safe for long-term use in most patients.
Since you are already taking fiber and fluids, focus on:
• Regular bowel habit training (fixed time daily, preferably after breakfast)
• Avoid straining during defecation
• Warm fluids in the morning (e.g., warm water)
• Consider adding natural stool softeners like soaked raisins or isabgol (psyllium husk)
For fissure care
• Sitz bath (warm water) 2–3 times daily
• Local anesthetic/relaxant ointments if pain persists
• Prevent hard stools (very important for healing)
Thyroid aspect
Ensure your thyroid function tests are within target range while on Thyroxine, as inadequate control can worsen constipation.
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Simranpreet Kaur
General Physician
10 yrs exp
Ludhiana
Your thyroid profile is normal, tsh is under normal range,
So you can reduce the dose from 62.5 mcg to 50 mcg and repeat thyroid profile after every 2 months
Next Steps
If you have bleeding or burning sensation while passing stool, it’s because of anal fissure being formed
So take tab tranexa 500 sos if bleeding occur
Take tab daflon 500 mg once for 5 days to reduce pain while defecation
Use anobliss cream with the help of applicator
Use sitz bath, by adding a betadine solution to warm water and sit in tub for 15-30 minutes daily
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Dr. Marini Vanitha
General Physician
12 yrs exp
Kakinada
Yes.
Avoid oily, spicy and fatty food
Regular physical activity.
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Yes
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