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Gastroenterology (Expert Forum)
Sensitivity to Medication causes Paralytic Ileus
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Sensitivity to Medication causes Paralytic Ileus
by CarmelRob, Sep 22, 2005 12:00AM
Hi, I'm a 26 year old male who has been suffering from chronic paralytic ileus for the past year.
It all started when I augmented my Paxil, which I take for OCD, with Anafranil. Keep in mind that I was already maxed out with Paxil and was now on about half the max amount allowed for Anafranil. Some time later I started to notice that my BMs were incomplete leaving me feeling slugglish and bloated. It wasn't too long that my symptoms started to escalate into being absolutely intolerable. To my surprise the symptoms stayed with me after I got off of Anafranil, albeit a tad bit less intensive. Reluctantly, I started to lower my Paxil even though I had never had these sorts of symptoms before on the drug. Unfortunately, with SSRIs you can only lower them so fast until you start to experience discontinuation symtoms. Since I couldn't tolerate the bowel pain, fullness, and disorientation any longer I decided to admit myself into the ER to see what they could do.
In the ER, they simply gave me a rectal and told me that since they couldn't feel anything that I just needed to wait until the fecal matter traveled to the rectum. I was starting to panic now. I had just left the ER with no help whatsoever and I felt like I was going to die. I immediately went to my primary care physician out of desparation. I was now feeling faint, and the odor of feces was on my breath. This was the closest I have ever felt to dying. The doctor, on seeing my condition, sent me back to the ER that same night and ordered an MRI. Back at the ER for reasons unbeknownst to me my symptoms started to abate ever so slowly. I realized later it probably due to my meds wearing off. I tried to go to the bathroom but only released this acidic yellow fluid which burned me on the way out. According to them, my MRI didn't show any problems and they sent me on my way with the suggestion to eat more banannas since my Potassium level was a bit low. On coming home I wised up and took two ex-lax and later that night I finally relieved myself and my body came out of fight or flight mode.
After much research on the Internet I finally self-diagnosed myself with Paralytic Ileus. With ex-lax I was able to get off of Paxil and onto the milder drug Lexapro and my symptoms seemed to go away.
Lately my OCD has been disrupting my life so I decided to raise the Lexapro from 10mg to 15mg. Soon thereafter the paralytic ileus came back and I subsequently had to take ex-lax to have a BM. Thus I lowered the Lexapro.
I believe my having "Chronic Fatigue Syndrome" has alot to do with my newfound sensitivity to medications but I can't explain why.
I exercise and eat healthy and the blood tests comfirm this.
How can I manage my paralytic ileus and OCD at the same time?
What is the connection between ileus and SSRIs?
What is this burning liquid that I pass?
Are there drugs I can take for ileus?
Can a Candida infection cause ileus?
My doctors aren't much help.
Thanks
Robert
It all started when I augmented my Paxil, which I take for OCD, with Anafranil. Keep in mind that I was already maxed out with Paxil and was now on about half the max amount allowed for Anafranil. Some time later I started to notice that my BMs were incomplete leaving me feeling slugglish and bloated. It wasn't too long that my symptoms started to escalate into being absolutely intolerable. To my surprise the symptoms stayed with me after I got off of Anafranil, albeit a tad bit less intensive. Reluctantly, I started to lower my Paxil even though I had never had these sorts of symptoms before on the drug. Unfortunately, with SSRIs you can only lower them so fast until you start to experience discontinuation symtoms. Since I couldn't tolerate the bowel pain, fullness, and disorientation any longer I decided to admit myself into the ER to see what they could do.
In the ER, they simply gave me a rectal and told me that since they couldn't feel anything that I just needed to wait until the fecal matter traveled to the rectum. I was starting to panic now. I had just left the ER with no help whatsoever and I felt like I was going to die. I immediately went to my primary care physician out of desparation. I was now feeling faint, and the odor of feces was on my breath. This was the closest I have ever felt to dying. The doctor, on seeing my condition, sent me back to the ER that same night and ordered an MRI. Back at the ER for reasons unbeknownst to me my symptoms started to abate ever so slowly. I realized later it probably due to my meds wearing off. I tried to go to the bathroom but only released this acidic yellow fluid which burned me on the way out. According to them, my MRI didn't show any problems and they sent me on my way with the suggestion to eat more banannas since my Potassium level was a bit low. On coming home I wised up and took two ex-lax and later that night I finally relieved myself and my body came out of fight or flight mode.
After much research on the Internet I finally self-diagnosed myself with Paralytic Ileus. With ex-lax I was able to get off of Paxil and onto the milder drug Lexapro and my symptoms seemed to go away.
Lately my OCD has been disrupting my life so I decided to raise the Lexapro from 10mg to 15mg. Soon thereafter the paralytic ileus came back and I subsequently had to take ex-lax to have a BM. Thus I lowered the Lexapro.
I believe my having "Chronic Fatigue Syndrome" has alot to do with my newfound sensitivity to medications but I can't explain why.
I exercise and eat healthy and the blood tests comfirm this.
How can I manage my paralytic ileus and OCD at the same time?
What is the connection between ileus and SSRIs?
What is this burning liquid that I pass?
Are there drugs I can take for ileus?
Can a Candida infection cause ileus?
My doctors aren't much help.
Thanks
Robert
Doctor's Answer
by Kevin Pho, MD, Sep 23, 2005 12:00AM
, Sep 23, 2005 12:00AM
To answer your questions:
1) You may want to confirm the diagnosis with a gastroenterology specialist. Constipation unfortunately is a side effect of both SSRIs and anafradil. Considering a good bowel regimen with a prescribed laxative treatment while on SSRIs may be considered.
2) Constipation is a side effect of SSRIs, occuring in approximately 10 percent of patients. I an not aware of ileus specifically being a side effect.
3) Difficult to say without examination. If there is evidence of a partial bowel obstruction, liquid may pass. An endoscopy, such as a colonoscopy, can be considered for further evaluation.
4) You may want to consider motility agents like Reglan - which may be effective in these cases.
5) There are some anecdotal evidence that Candida may be associated with ileus, but there are no large trials that I am aware of suggesting a link.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
1) You may want to confirm the diagnosis with a gastroenterology specialist. Constipation unfortunately is a side effect of both SSRIs and anafradil. Considering a good bowel regimen with a prescribed laxative treatment while on SSRIs may be considered.
2) Constipation is a side effect of SSRIs, occuring in approximately 10 percent of patients. I an not aware of ileus specifically being a side effect.
3) Difficult to say without examination. If there is evidence of a partial bowel obstruction, liquid may pass. An endoscopy, such as a colonoscopy, can be considered for further evaluation.
4) You may want to consider motility agents like Reglan - which may be effective in these cases.
5) There are some anecdotal evidence that Candida may be associated with ileus, but there are no large trials that I am aware of suggesting a link.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
