To my keen sense of observation I am going with bowel obstruction. Looked at the rx and sure enough it was a laxative and pain med combo. The most likely reason: low fiber diet and not enough exercise or water.
Late one night a lady comes in with an emergency room rx for Fiorinal with codeine for migraines. When she checks out I just shake my head and wonder how long she has suffered. She buys 3 Hostess honey buns, 2 bags of Cheetos Puffs, 4 packs of salted sunflower seeds, and 2 Mountain Dews. It doesn't take a genius to see that she eats minimally nutritional things chock full of preservatives, color/flavor additives, and salt. All of these things can contribute to migraines.
She also had no previous history of any other medications except for Fiorinal with codeine to try and prevent migraine episodes so I made some suggestions to make her life easier but she didn't care because Medicaid will give her as many ER visits and Fiorinal with codeine as her little heart desires instead of her actually going to a physician and trying something daily to cut back on her discomfort.
Ugh, some people never learn...