I'll try my best, but. Huge, very important but.
I need to be perfectly clear that the last time I was anything resembling a medical professional in any capacity, was over 10 years ago.
Everything I learned then, should be considered out of date.
I know it sounds paranoid that I am harping on this, but people can easily be too trusting of someone who has claimed to be in a professional capacity when it comes to medicine.
I say "claimed" because this is all I have done. I have never provided documentation for my education nor any information that anyone can use to prove that I am who I say I am. Or did what I say I've done.
I'm a random guy on the Internet. It is super important I make that clear. Ok?
It's not an ego thing for me, I'm on this site because of people who died under my care. I could do real harm if I run my mouth like I'm somehow qualified to assess a person over the internet.
It's very important to me that you never take anything I say over that of a licensed medical practitioner, who actually can physically assess your husband's health.
I do not hold a licence to practice medicine in any capacity. I don't currently even have a first aid certification. Please bear that in mind, first and foremost for everything I write after this.
Now, I'll try to answer as best I can.
1. How much of straining/grunting is actually okay?
Probably fine, right up until it starts to strain muscles or irritate the mucosa of the rectum. In my personal experience, straining too much, has caused me to have the feeling that I'm not empty, even when I am. So I have learned to just get up and sip water until I think I'll make some progress.
2. How much of „bathroom time“ per try is okay and when do you need to see a doctor ASAP?
Preferably before before it starts coming back out the way it went in.
Sounds like a joke, but it's a real thing. Though, it's extremely rare and no normal person could tolerate the pain long enough for fecal vomiting to occur.
I would say that if it's enough time and grunting to make your wife worry about you. That's probably when you should see a doctor.
3. How many days of „only a few rabbit pellets“ are okay?
I have no idea.
I would guess, it depends on how much food is going in, how much is being digested and how quickly that specific person's digestive tract turns stomach contents into poo.
4. Is it normal to feel an extremely strong need to use a bathroom after a bigger meal?
As far as I know, yes.
That doesn't happen to you?
my husband sometimes avoids eating properly on his job when his constitpation is bad. For two reasons one is loss of appetite when constipation is bad and one is the fact that he „cannot“ use the bathroom there for „pooping“.
This I understand.
Where I work, it's not uncommon for people to disappear for excessive periods of time "pooping".
When it happens too often it makes you look like you're just shirking your duties. It's also hard to focus on your work through the cramps.
I don't smoke cigarettes at work when I feel this way either, as nicotine irritates the bowel, as does caffeine.
Why „cannot“ use it? Because there sometimes places he feels very bad about because of ptsd and one is the bathroom they have on his job.
I don't like public toilets either. But that's probably more to do with my primary school years than ptsd. But that's me.
Having to make several trips to the toilet at work in a couple of hours, is not amusing in the least.
Especially when someone notices and asks if I'm ok. It's silly but I find it embarrassing all the same.
I would say that if it's really affecting his quality of life, it would be important for him to see his doctor.
Even if no harm will come to him health wise. It still sounds like it's making him miserable.
A physician could refer him to a dietitian, who could work with him to find a plan that meets his needs, while still appealing to his taste of food.
I would encourage him to go.
As no harm will come to him, aside from a little embarrassment from at least a basic appointment with his physician.