This question is not asked by me personally. I have been emailing someone back and forth trying to figure out how to fix his problem. His situation is very unique. I hope someone can offer him some advice. If you want or need to know more then let me know and I will see if he will allow this.
I have hesitated to answer this question because it is something so very personal, but admittedly, I've struggled with the same thing and have since (mostly) recovered.
What your friend is suffering from is Lazy Bowel Syndrome. I blame my past laxative abuse for how delicate and sensitive my stomach is now, but with time and gentle treatment, I have resolved most of my issues.
I'll tell you what helped me, though I can't guarantee my experience with resolving my digestive issues will fix his. Everybody is unique, and I'm very fortunate that my body is very resilient. Also, please do not substitute this for actual doctor treatment. I highly advise your friend to see a doctor. He needs treatment for his eating disorder or he may very well die. Laxative abuse is very serious, and can cause heart failure and other permanent, irreparable damage.
First, and I wish I had realized this when I first tried to repair my bowels, eliminate foods that prevent peristalsis. Casein and gluten are proven to prevent peristaltic muscle contractions, as well as some OTC medications that are opioid-based, like pseudoephedrine. Drink plenty of water, eat plenty of fat, and in this case, roughage (vegetables) does help push things along. I also suggest probiotics, since your friend has most likely stripped his gut of all of its flora through his constant purging.
Next, routine is a must. I had to train my body to go to the bathroom on its own. Establishing a set time to "go" is important. The body is smart, and much like how your tummy grumbles when you're hungry, your...uhm, colon will grumble when it's time to go.
Green tea is a gentle stimulant that will help cause your peristaltic muscles to contract, but it is non-habit-forming. (I would avoid coffee, as it is a harsh stimulant that will cause even more diarrhea and dehydration, thus exacerbating the problem.) Eating also helps, since peristalsis begins in the esophagus. I suggest your friend start his morning with a tall glass of cold water, then a reasonably-sized healthful meal (I like to eat a large dish of scrambled eggs and some fruit). With that meal, he'll want to sip a large mug of green tea -- I steep one tea bag in a 16-24 oz mug of hot water. Wait forty-five minutes to an hour-ish, and before long he'll start feeling that familiar pressure. Even if he doesn't, it's time to migrate to the bathroom.
The squat position is optimal. The feet-on-the-floor position crimps the colon and prevents the stool from being eliminated. If he can't do a full squat, propping the feet up on the seat or having a small bench to prop them on will suffice.
Then the waiting game begins. I sit for about ten or so minutes, but I recall it taking me longer at first. Sometimes, massaging the lower abdomen will encourage the digestion to commence.
If it doesn't work after the first meal, try it after lunch. Even then, your body may not let him go. Remember, his body has been stripped of all stool, so it may take time for amble bulk to develop. Don't forget the green tea. I can go without it now, but when I first started to heal my tummy, I absolutely needed it.
Finally, it'll take time. I haven't touched a laxative in three and a half years, and while my digestive system has improved exponentially (and even moreso on Paleo!), it'll never be as good as person's who had never abused theirs. However, the progress I've made from when I first started to recover from my ED to today is remarkable, and I never thought I'd be as healthy as I am after the hell I put my body through.
Again, I stress the urgency that he sees a doctor for treatment for their eating disorder, and possibly some tests to make sure his potassium/electrolyte/other systems are in balance. He is very ill right now, and it's crucial that the laxative abuse stops now, cold turkey.
I wish your friend the best of luck, and hopefully this helps them a bit. :)
Let me know if you have any more questions, since I typed this out in one tiny little burst of courage and may have overlooked something. ^^; Take care!
I had this problem as well. My hope is that by sharing my story, you won't have to look much farther for the answers you are looking for. If you don't care to read the story, scroll down I'll leave some tips at the bottom.
This problem began with me two years ago. Basically I had to use the bathroom one day and none were available so I waited and eventually lost the urge to go. After a week I went out and bought some laxatives and they didn't quite seem to do the trick so after about two months of me thinking the problem would sort itself out, I decided it would be a good idea to go see my doctor. He prescribed me to some medication called Levbid (which I had some pretty unpleasant reactions to) and told me to drink Metamucil with each of my meals. He also had me to see a gastroenterologist to get a colonoscopy.
The colonoscopy was basically to make sure there wasn't blockage or anything that was causing the irregularity. After it was done the doctor told me that everything looked fine and instructed me to take Miralax and Metamucil at the same time every day for a month. I did as told and felt great the whole month. Everything seemed to be going fine until that month was up and I stopped taking them. Within days I noticed something wasn't right and called the gastroenterologist back to schedule a follow up appointment.
When I tried to speak with him about the issue I was having after I stopped taking the Miralax and Metamucil, he basically told me that if they were working, to continue taking them. He told me "You're an adult and you just have to deal with the fact that you will be taking these for the rest of your life." He said all he could do is give me a referral to see someone at the University of Chicago.
Needless to say, I left feeling pretty horrible. I went back to work and all I could think about was how this was going to effect the goals I had set for myself in life. I spent the next couple months feeling very depressed and eventually decided to use that referral to go see the specialist at the University of Chicago.
My first visit was somewhat of a screening where they just asked questions and whatnot. Once they were finished asking questions they told me that what I was dealing with was most likely a dependance to the laxatives I was taking. They also told me the one thing I needed to hear to change my attitude about the whole thing: they told me that they were going to help me get off the laxatives.
First they wanted to make sure that it wasn't actually a problem with the muscles in my colon so they did what is called a Proctogram. Basically they inject a paste into you and you have to push it out while they take xrays (yes, it was horribly embarrassing but I havent seen the dude since so whatever).
When the results were in they called me and said that the muscles were working fine and it was indeed laxative dependency. They had worked out a plan for me to pull off of them slowly while consuming lots of water every day. The plan was to keep taking the Miralax everyday and when I felt comfortable, start taking them every other day. Taking that first step is the hardest part, not knowing if it is going to work and not taking the Miralax for a whole day.
So basically over the next year or so (probably didn't need to take that long) I slowly cut back adding a day in between every dose when I felt comfortable. What I came to notice after awhile was that every time I added another day in between, the bowel movements seem to be more and more normal the longer I wasn't taking the laxatives. In other words, the laxatives seemed to be causing the irregularity.
I got to the point where I was taking the dose once a week and by that point I was going just fine until I took the laxatives. The next couple days after my dose, I would barely go at all. That was the point where I decided it was time for me to try something new, and I just went cold turkey with it.
So that brings me to today, its been about three weeks with no laxatives and quite honestly, I haven't felt this good in years. Everything seems to be going just fine at this point and I know it may not seem like a long time, but for someone that was once taking them everyday it feels like an eternity. Hopefully if you are reading this and have this issue I have been of some help to you, I know I could have used it. Sorry for the horrible grammer.
Here's some tips:
If you are taking powerful laxatives, stop taking them and take Miralax. It's a very gentle laxative and is much easier to pull off of. Take it every day at the same time and do as I did: when you feel comfortable take them every other day, then every two days, then every three days and so on.
Drink a lot of water. I was told by my doctor that water is like lubricant for food passing through you.
Coffee: I was told that drinking coffee regularly can help with having regular bowel movements.
Diet: Eat smaller portions more times a day, this helps your stomach by giving it less to digest at once, this will also make you feel less bloated and overall better. Eat a lot of vegetables (corn, brussle sprouts etc.). Potatoes also help.
Marijuana: Now I'm not telling anyone to go out and start doing anything illegal. I actually don't smoke anymore. As dumb as this may sound, there were days where I thought I wasn't going to have a bowel movement and then I would come home from work and smoke some weed and be running to the toilet.
Exercise: Lift some weights, run, ride a bike. Sweat.
Do not give up: this problem can be extremely taxing on your mind. Hopefully if you are reading this I have given you some kind of hope and hope can go a long way. Just know that the human body is capable of some amazing things and with some hard work and determination, you can fix this.
Apart from the obvious solution that he really should be speaking to a medical professional if it's that bad, has he tried massage.
I took a massage course many years ago and seem to recall being taught how to massage the stomach in a slowish circular motion (3-4 seconds per anticlockwise revolution comes to mind but I may be mistaken so don't quote this) to aid peristalsis. If he doesn't wish to go down the medical route for whatever reason then a visit to a good masseur may help him.
How long has this been going on for? Is this an acute or a chronic condition? +1 for go to a doctor. But assuming that has already been tried or refused, I would say:
Try a combination of some digestive enzyme support (such as Super Enzymes from Now Foods) and fiber. The enzymes should speed digestion and increase absorption, while the fiber should "help things along." If you take a rediculous ammount of fiber, it will give you the runs for a day or so. My wife got some fiber gummies, and mixed them up with some gummy bears. She ate the entire bag, and couldnt get away from the commode for two days. True story.
Also, hit up some probiotics to help return the GI tract to its normal bacterial state.
Is this all his life, or lately? If the former there are various deformations of the colon that can cause this - Hirschsprung's Disease comes to mind, which is a lack of nerves development in the last bit of the colon (so stuff just doesn't move past easily), and may not be obvious at the beginning (I have some family members who have dealt with this). But that is just one wild-hair idea based on almost no info.
The other Answers are correct: go to a doctor or, if you think we - "the internet" - can be helpful, include a lot more detail and history.
I had the same problem, still somewhat struggle with it now and again. ESPECIALLY if I have a cheat day and have portions of bread. My body is so sensitive now from being clean for so long. However, I have found to help me I have to eat lots of RAW veggies, pretty much as my only carbs in fact. I also take "Natural Calm" its a magnesium mixture that is gluten free and all natural so you are adding the dextrose and some of the crap they put in normal laxatives. i take it sometimes before bed and it helps me a lot. But the raw veggies really helped me get moving when i needed to. I used to literally be in hunched over pain from that feeling in my stomach of being so bloated. Magnesium and raw veggies I think would really help.