I can understand why your boyfriend's constipation is concerning. It is not possible to determine the cause of his constipation or the best treatment without evaluating him in person. I encourage you to schedule an appointment with a primary care physician
. If needed, he may also need referral to a gastroenterologist.
Many different factors can lead to constipation. The most common factors include changes in diet, general immobility, dehydration, opiate use, and stress. Irritable bowel syndrome
often leads to periods of constipation. In addition, disorders such as hypothyroidism can cause hypothyroidism. An obstruction, either from a benign mass or from a tumor, can rarely cause severe constipation. He will need a thorough evaluation by a physician to determine if any of these disorders are at play.
X-rays cannot always determine whether stool is present, and it is an inadequate study to determine the cause of his constipation.
It is important to address his constipation because severe constipation can lead to a blockage that cannot resolve on its own and could even require surgery
in advanced cases. I cannot tell which laxatives he has tried, but there are additional potent laxatives that are only available with prescription. Very rarely, patients require decompression with endoscopy, which involves passing a tube with a camera on the end into the rectum. I recommend he discuss these possibilities with a primary care physician.