Man I didn't really know what to use for this topic. It has a lot to do with what has been happening to me lately and my trip to the VA hospital today. But after asking Quix privately about this she suggested I post so that this topic could be discussed. This could turn out to be somewhat long, but I hope that it is not too long for all to read.
So I spent 7 hours today at the VA today mostly dealing with a constipation issue, but also a short visit with my friend Dave who is still in the hospital after abdominal surgery on the 14th. While they supposedly have fixed the problem with his intestine, he still is not doing too well and still has not gotten any accurate indication of when he will get to come home. Just shortly before I got to his room he had another vomiting episode and the nurses were in the process of cleaning him up. I kind of suspect that they will be going back inside of him again to try and find out what is going on.
Anyway as I mentioned earlier I have not had a normal BM since the 13th of August. During this period when I have gone it has been mostly clear liquid and gas that has come out of me...NO solid or even semi-solid material at all. After explaining all of this to Quix in a PM she told me that it was constipation even though I don't feel constipated as we don't alway feel this due to the neurological damage in out bodies.
At the VA the use the ER as a walk-in clinic as there is no way to get to see your PCP within any time less than 2 months. So I tell the receptionist that I have not had a BM since the 13th and I am then seen by a tech to have my vitals checked. My BP was 186/98, o2 was 99%, and temp my normal 96.5. The tech didn't tell me my pulse rate.
Next I am seen by a nurse and he has me stand up to take my vitals ( probably because the BP was high) and it was then 165/96, pulse 54, and o2 95%. I then tell him what is going one and I am classified as non-emergency and told to wait in the waiting area. As I am waiting I wonder about why my 02 level dropped to 95% while standing.
After 5 1/2 hours they finally take me back to an exam room to be seen by a doctor. When the doctor comes in about 20 minutes later the first thing he says is "I understand you are having trouble with diarrhea. " Here I though that all nurses knew the difference between constipation and diarrhea.
After I straighten out the doctor on what is going on, that I have Neuro problems and IBS. He tells me he is no GI expert but will try some experiments to try and get things working right again. So I am to use Metamucil ( 1 tsp each day) and if things are still not working right in 1 - 2 weeks I should come back. He also gave me an Rx to help control the spasms in my IT for the IBS and put in a referral to a GI doctor to have them get me working correctly or at least better down there. I have been talking with my regular doctors for over a year about the problems I have been having with no referral from any of them. So that least that is one good thing that may come from this. When I picked up the Rx for the IBS med the first thing I noticed is that one of the side effect can be constipation. So I will hold off taking it for at least a few days to see if the Metamucil works.
Speaking of IBS, as it was 6PM by the time I left the VA I stopped for dinner in Nashville. Every time I eat up there not only do I have to use the men's room at the restaurant before I head home, I also have to stop twice on the way home due to the IBS. I did my normal routine stops on the way home but was not able to go. Not sure if this means the constipation is getting worse or the IBS was not active for some reason this time.
I'm not sure what Quix wanted us to discuss on this topic but I think it probably has to do with:
What the signs of constipation are when you can't feel being constipated.
How to treat it before you end up having to see a doctor
I have been numb so long, I do not know the signs. I just keep a schedule for bm's. If I miss a day, the next day I begin with 6 ounces of prune juice. If that doesn't work, I add another six at lunch. I keep adding until I am able to go. I have never had more than three glasses at 6 ounces. I drink plenty of other fluid with the prune juice.
Ironic you posted this at just the right time....Good advice Quix!
I was never so happy to have finally had a BM yesterday that I was doing the Happy Dance! sounds crazy I know but we never really appreciate the little things in health that we DO have....Such as regular Bowels!
I went like many many days w/out one. I finally took the Old moms remedy of Phillips Milk Of Magnesia.......i went w/ in 4 -5 hours but it was not solid and I knew I still needed to go. So then I went and got stool softner, lots of water, and then BAM!
It worked....Thank You God! I said to myself. But I was starting to think that perhaps I had a blockage or cancer or something....you know how your mind starts wondering...Lol
I wish you luck. And make sure you drink lots of water w/ that fiber...if not, it could possibly do the oposite and take longer to go :( No fun there.
OK Dennis, I'm gonna tell you my experience in hopes in can help. I have IBS too. I think lots of MSers do and that it has to do with the ANS influence.
Once upon a time when I was on home IV antibiotic therapy and pain meds (they stop up the gut in a minute) following hand surgery, I got so constipated that NOTHING was forthcoming for two weeks. At that point the term goes from constipation to obstipation (obstinant bowel, I guess).
When I was miserable, in pain, nauseated and unable to take in anything but an occasional cracker and sips of water, I too ended up in the emergency room. Like you, I found that the personal there do not consider this anything to be overly concerned about. I may have even provided their topic of entertainment for the evening.
But when they didn't solve the problem on the first visit they had to deal with my return trip (the thing their own instructions say to do if your symptoms continue). They ended up admitting me that time. The experience almost made #1 on my list of worst and saddest medical encounters. The MS diagnostic journey tops it only because it took longer to find the doctor with a solution.
Without making this tale longer than necessary, I'll tell you the solution. Once an abdominal x-ray has determined that true constipation/obstipation is the problem, a doctor needs to order a container of the bowel prep liquid used by patients in preparation to have a colonoscopy. Take the jug home, fill with water and drink a cup of it every 15 minutes until you start to go. You can stop drinking at that point and discard the remainder of the jug's contents but DO NOT stray far from the toilet for a while.
Once you have this relief you can work to establish a routine that keeps your bowel eliminations regular. I think that varies from person to person. For me, the best thing is an ounce of ground flax seed in 3-4 ounces of yogurt every day and a stool softener taken twice a day.
It took me close to four years of trial and error to find my personal successful combination! It's always preferable to avoid laxatives as a first line solution. Regular use of them can cause problems but softeners and regulators (like the Metamucil) are fine if they work well for you.
These days if I stick to my usual diet and med routine I'm pretty regular. But I watch myself carefully and if it's been 3 or 4 days since I've gone, out comes MOM (Tonya's recent friend). I find that with IBS, just when you are doing really well over a long period of time, if you aren't careful you will realize too late that it has been too long.
Sure hope this helps someone because it's a tale I hate to tell.
I really never thought I had a problem with constipation. I had my gallbladder out in 2004 and ever since then I have loose or runny stools. Everytime I eat I go, so needless to say, when I go to a public affair I tend not to eat and if I do I make sure it is something very small as for fear of having to run to the bathroom.
I went to my PCP a while back because my stomach was so bloated I looked like I was pregnant, I am a big girl but this was crazy. He did some poking and proding and tapping. Told me that he thinks I am backed up. I asked how that was possible since all I do is go and he said he isn't sure.
I go get the xrays and sure enough I am backed up. Then I listened in on the Teleconfrence about bladder/blowel issues and I finally understood how this was happening.
The doc mentioned that all the watery loose stools is what is getting around the edges of the constipation and that is what leads to bowel incontinence. My fear of loosing control of my bowels has been in my head for many years. Which I have a couple of times, but nothing I want to talk about. lol
Taking metemucil or citrucil (spelling) on a daily basis has started helping me, now I have a normal bowel movement every morning, but I still have the urgency to go everytime I eat so I am guessing it will take a bit longer or there is something else going on.
Anyway I hope that you find a soulution for your constipation, this is a good topic that most of us wouldn't want to bring up but it is out there and needs to be addressed so thank you Dennis.
Thank you all for your comments. What Mary was describing is what Quix was telling me through PM. She referred to it as "incomplete blockage" with a stool that is hard as a rock or industrial strength constipation.
While the ER doctor didn't do an X-ray to his credit he did go look up information about IBS and what I was going through in order to come up with his treatment plan. So I do think he was concerned about me and what is going on. Luckily I can still eat and drink without pain ( just have to run to the bathroom about after eating even though there are still no solids coming out). Although I still haven't gone after my nice dinner last night in Nashville.
When the ER doctor was explaining things to me he pretty much was telling me what Mary had just posted about having to come up with a balance of treatment to control the IBS while not getting things too solid to cause constipation. He told me that it will be up to the GI doctor to come up with this balance for me. But I should also say that I think I should have been given something stronger as Mary said. But hopefully I went to the ER before the pain started so maybe the Metamucil will work for me this time.
I too think you need something stronger initially Dennis. For an OTC treatment, you can try Miralax. It's the same medicine in the bowel prep stuff but without the electrolytes the Rx has. Mix it in some Gatorade if you like that stuff.
You can get Miralax in a much less expensive generic form. Ask the pharmacist at any drug store or Lulu always knows the name (glycol something). The metamucil is a bulking agent and a REGULATOR used for both diarrhea and constipation, not actually a laxative. I don't see it being enough. It may build up lots of gas though!
Another option is the Milk of Magnesia (any brand) as long as you don't have any kidney disease. It takes several hours to work but doesn't usually cause much cramping. You can take a single dose and repeat it in 12 hours if you get no results, take a double dose once, or mix it in some warmed prune juice (yum/yuck).
You need to get to a good clean starting place to find regularity, IMO anyway.
Thanks for the info. I have already taken the Metamucil this morning ( gaged it down mixed with tea ). Not sure if I should wait until tomorrow to try something else or not.
I've never had any Gatorade so don't know if I would like it or not. Does it come in flavors to pick from?
I suppose if I get desperate I could make some of my grandmothers stewed prunes using ground cinnamon. It is a super laxative. Only problem there is I have never been able to find pitted prunes around here other than those chopped up into small pieces. For some reason the stewed prunes is a mild laxative to help regulate a person if you use cinnamon sticks, but with ground cinnamon it is a very strong laxative.
I definitely know this problem. It's frustrating. My Dr suggested using miralax and then when I had a good bm he said to use it at least once to twice weekly to keep me on track. He says u need to test what's right for your system. It does work. I also eat bran cereal daily and think that makes a difference.
I make the.mistake if thinking I don't need to.follow this regiment and am back to square one. I hope it helps u.
Well, I've had both problems, and I think it has specifically to do with lack of motility. The longer stuff stays in your large intestine, the more water gets sucked out of it - and that leads to the proverbial concrete block. It's horrible.
This seems to happen to me without warning. I'll be fine, and then WHAM! I'll have this out of the blue. Even worse, I'll get the urge, sit down, and nothing's happening. I guess it's muscle weakness or something.
Everybody else has had great ideas for supplements to take. The only thing I would recommend is to make sure you drink plenty of water.
Oh, boy, potty talk! Just kidding, because this is not really funny. Do I ever miss the days when I would finish my cup of coffee, visit the reading room (pardon my wording) and take a good dump.
Dennis, I’m glad that you brought this topic into the open. It’s become enough of a problem for me that I was researching it about a month ago.
For me, my gi sx started about 1 ½ years after other sx started, but were very intermittent. For a while there, I thought it was IBS, but after talking to my sister who does have IBS, I realized that was not the case. Foods don’t trigger it, and for the most part, I still am a morning person.
In the last year, things have gotten progressively worse. I make multiple trips to the bathroom in the morning, each lasting at least 10 minutes, to evacuate my bowels. It is painful and I have a lot of cramping. I have to be careful not to strain, because I don't want hemorrhoids on top of everything else. Sometimes it can take me more than 90 minutes to get to the point where I feel safe to leave the house, making me late for work. Stool consistency ranges from slightly hard to diarrhea. I have also had days without any movement at all, as many as three days in a row. I’ve found myself bloating more often now and I am thin as a rail, so it is very noticeable to me.
What I found when I was looking into this is that in people with CNS problems or spinal nerve problems, the muscles in the gi tract don’t work properly to push the waste out of the body. Other factors cited were that people in these groups also may not be getting enough exercise or have a poor diet. With constipation, the consensus is that if more than three days pass without passing (LOL), it needs to be addressed, but they don’t say how. Reading the posts here, many of you have gone longer than that and have been summarily dismissed by the ER. If fecal matter sits in the gi tract for too long, it tends to dry out even more and just makes the problem worse.
In the old days, we would have just taken cod liver oil.
My sister recommended a gummy type chewable fiber supplement that works well for her, but I can’t remember the name. I’ll have to check with her on it. Fiber is important, as is drinking lots of water. That still doesn’t address the muscle function, which might be the main contributing factor.
Hopefully, someone will post here with some good advice on what to do if you go for more than 3 days without a BM.
I may be wrong on this one, but I seem to recall that in years gone by in England, it was considered polite to ask "Have you moved your bowels today?" as a sign of concern over someone's good health.
I'm so sorry to hear that you have this problem and haven' gone in so long. I don't have any idea what this feels like becuase I have the opposite problem. I have IBS too but the opposite.
When I was young 20's-30's I used to have a BM everyday at the same time. My mother told me I was "blessed". But not anymore.
I'm, with Mary on this one, I know you have taken the Metamucil and are waiting, I'm wondering if doing the prep for a colonoscopy would do the trick. You do a product called Fleet first in the evening. THen the next day you drink this yucky stuff fairly quickly. I think it's like a gallon of liquid. Then everything eventually comes out but it's painful and it seems to go on forever.
I'm sorry that you are all plugged up, that has to feel bad.
Well I picked up some MiraLax ( generic form ) when I went out to eat. I keep debating if I should do it tonight or not. After I got home I did have some movement though not much, but it was normal consistency. So things seem to be opening up at least a little bit.
My understanding is that the active ingredient in MiraLax is the same as the stuff for a coloscopy prep less the electrolytes. When I had that done in 08 it really wasn't that bad. After drinking all of that stuff in about 1 hour I was in the bathroom for about 1/2 hour dumping everything and that was it. Only one trip to the bathroom.
I kind of wish I was in pain from this as I should be. Has me kind of concerned that maybe I am losing all feeling down there. :) I still have a lot of gas, but have not been feeling any gas pain either. Maybe it is all of my Neuro pain med stopping the pain from registering ( I hope) :) and not nerves damage going on.
One of the main reasons I am considering doing the MiraLax tonight is my friend called today and said they may be letting him out of the hospital tomorrow. I don't know how I would be able to pick him up if I am in the bathroom all day tomorrow.
I have been having more problems with constipation over the past year. When I get to the point where I'm having bloating, and nauseated, I know I have to do something. For me, I found a concoction that seems to work very well. I take a small portion of raisin bran, add some bran buds, a tablespoon of ground flax meal and a good teaspoonful of DiabetiSweet brown sugar (has laxative effect) as an evening snack. I almost always have a bm the next morning.
For me, I seem to have a problem controlling gas. It is so embarrassing. I do my darndest to control it in front of other people, but once in a while, it just comes out. Most of the time, noone says anything cause I'm straining so much to not let it out it's usually not real loud (very uncomfortable in the nether regions though, I must say) I hate it! Does anyone else have this problem with flatulence? If anyone is bold enough to make a remark I just shrug and say, "the joys of MS".
Okay, I am glad this is out there and we can discusss it again. We need to visit this stuff every few months to catch everyone.
Dennis - I am dismayed that your first instructions were to use a bulking agent. Until they know what kind of back up you have you do not want to add a lot of bulk to the mass.
The safest thing until you see the GI is to use the Miralax (Polyethylene Glycol 3350). Use the 17 gram measured amount (about a heaping tablespoon) in any liquid once a day for up to 4 days. This will both hydrate the stool, thereby softening it, and help it move through the colon - typically without cramping. Depending on your status it may give you a great result (soft formed stool and lots of it) or it might cause diarrhea with the passage of a lot of stool.
At that point I hope the GI will put you on a clean out, if needed, or place you on one of the many regimes that help people with lazy bowels. Some of us need just softening. Some need softening and bulk, and some need bulk and some stimulation. Depends on how neurologically impaired the bowel is.
Please hold on the Metamucil. While it's a great product, you may not want to bulk up.
At any time if you get severe cramping and/or vomiting especially with distention of the abdomen, it can be an emergency. Mostly we with MS do not get actual bowel obstructions. But, a true obstruction is a medical emergency.
Right after I injured my leg and was forced onto recliner-rest and was taking narcotics for the pain. I didn't have a movement for 12 days. I began the Miralax as instructed on the bottle and the third day we had "lift-off"!
Gas - since my farts sound like raccoons growling, when I pass gas, someone wisely nods their head and says, "Raccons."
I want to bring up another problem. And that is the sudden losing of all sensation or strength in the rectum during a movement. No pushum at all. This has been one of the worst problems I have had to deal with. It makes me misersable until the urge strikes again and I can finish. I am sorry to be so graphic, but there is no way of disguising this like a fairy tale.
Haha. You didn't gross me out. I must be hard to gross out. I have been eating breakfast while reading this thread!
I have what are pretty mild GI sx compared to many of you. I seem to alternate between consitapation and everything moving "too fast" and clearly not having complete digestion.
The other problem I have regularly, with both my bowels and bladder, are what feels like spasms or cramps after I go (or worse, while I'm going!) Generally, the worse the constipation is, or the more full my bladder is, the more likely I'll have painful cramps. Sometimes I have to sit there for several minutes after I'm done going, just to let the spasms stop. Does anyone else get anything like this? I haven't mentioned it to my dr because it sounds weird...
What if I still haven't gone after 4 days of the MiraLax? What then?
I did take the MiraLax last night but still nothing but gas so far. I have no idea yet of when I might get in to see a GI. With the VA they put in a "Request" for a consultation and someone else will decide if the consult will be granted and when. I have had consults take up to 6 months to happen.
I also have something like the last thing you mentioned about the no pushum at times. But luckily not too severe. I will have a BM and feel like I have finished because I can't get any more out. But them as soon as I stand up I have the urge again and can sit back down ( quickly as it wants out as in yesterday ) and finish up the BM.
I finally had my first BM a little while ago. But I'm sure there must be a lot more in there that has to come out yet. I will continue with the MiraLax for another day or 2 just to make sure I get cleaned out.
Okay so I finally joined the throng late as usual!!
I believe that the UK equivalent to Miralax is Movicol, so here is some recent advise from my continence adviser regarding my bladder issues =
You need to get in control of your bowel before we can truly find what is causing your bladder problems. As the bowel and bladder are so close together if you have any material in the bowel that is acting as a block it just adds extra pressure to your bladder.
Take up 8 sachets a day of Movicol and as you have MS just take as many as you need to clear any blockage, just experiment to find the right level for you. It may be 8 to clear any back up and then one sachet or even half a sachet a day. Some people may take only half a sachet every 3 days - it has to be right for you.
Then came the really gross bit - have you seen the Movicol 'poo chart' - gulp - no I hadn't - so she gave me a copy and pointed at a nicely formed bm saying - that is the shape you need to aim for.
I checked the basic ingredient in Movicol and they are the same as Miralax and the lovely chart is available on line for those who are really keen.
I have been trying for 3 weeks now and still haven't got the dosage right swinging from one extreme to the other, this stuff takes practise.
Ok i'll be brave (lol), i've actually learnt a lot from reading this but i noticed no one has mentioned mucus (blush) whats that about???
I was dx IBS years ago and the first thing i was rx was a bulking agent, but my only issues were constipation and as time went on, then painful piles, so it just got worse for a while. I am still having the same problems and i've eaten just about everything recommended, all i can say about that is sometimes it just doesn't matter what your putting in, it doesn't want to come out lol.
On a different note I would like to throw out a heads up, my dad was one of the healthy people, mind body and sole, he never seemed to get sick (here comes the but) BUT became constipated for 10 days. First time anyone knew he was having a problem was finding him in tears due to not being able to go at all, (it is the only time i have ever seen my dad cry) nothing he tried was working and he was in agony. He had bowel cancer, he had all the best dr's and until he was under the knife, they all believed they'd caught it early, not so unfortunately. He was in late stage bowel cancer, from start to dx it took only 2 weeks, there wasn't any hint that he was a sick man living with a disease that would take his life, just boom here it is!
So my heads up is to never asume when it comes to the bowel that its nothing, always get it checked out, always better to err on the side of causion.
I don't have much to add to this since everything appears to be covered. Just that in my car I have sirrius radio and was listening to doctor talk the other day on the way to work - it was a GI doc from NYU who was talking about bowel and bladder issues.
He is known as Dr. Stool and has written two books for medical use - the first is
What your stool is telling you
and the other
What My Pee is Telling ME
His whole point was that we must use observation skills with these bodily functions to track changes in our health.
I think this probably explains it best (borrowed from about)
Question: What Are the Causes of Mucus in the Stool?
Stool normally contains a small amount of mucus, but passing stools with visible amounts of mucus can be from a variety of causes. Mucus in the stool is a common symptom of irritable bowel syndrome (IBS) and ulcerative colitis (UC), and is seen to a lesser degree in Crohn's disease (CD). A bacterial infection, anal fissure, or a bowel obstruction may also cause the passage of mucus.
Mucus is a clear, white, or yellow substance with the consistency of jelly which is produced by the mucus membrane of the large intestine. Mucus is also produced by other organs in the body such as the lungs, where it helps to trap any foreign particles that are inhaled. In the intestine, mucus protects the inner lining and helps ease the passage of stool.
Ulcerative Colitis and Irritable Bowel Syndrome
In UC, the mucus membrane of the intestine becomes inflamed and develops ulcers. These ulcers bleed and produce pus and mucus, which may be visible as they are passed in the stool. In IBS, there may be increased mucus production by the lining of the intestine, which is then passed. Mucus is more often associated with diarrhea-predominant IBS. Mucus is less frequent with CD, but may be associated with the development of an anal fissure.
Bacterial infections, such as those from Campylobacter, Salmonella, Shigella, and Yersinia may also cause mucus in the stool. A bacterial infection may also cause diarrhea, fever, and abdominal cramps. Some bacterial infections may resolve on their own without treatment, but some cases may be serious and require treatment with antibiotics.
A bowel obstruction is associated with constipation, severe cramps, abdominal distention, and vomiting as well as the passage of mucus. A bowel obstruction can be from a variety of causes and is typically treated in the hospital, with surgery being necessary in some cases.
The passage of mucus in the stool in the setting of IBS or UC is not necessarily a cause for alarm, but should be mentioned to a physician. Mucus without an underlying cause such as a pre-existing condition should be reported to a physician immediately.
I am glad to hear you've been checked for cancer, i didn't want to alarm anyone or anything just felt in light of what happened to dad, its not something to ignore and ignore is something many of us do, me included so at least one of us is on top of things lol.
Someone earlier had mentioned cod liver oil for constipation as used in the good old days. This is still true. I learned this by accident seeking multiple sources of Vitamin D. In addition to stronger nails, hair etc. cod liver oil keeps things-a-moving when I take meds that cause constipation. They are no match for cod liver oil. It seems to act as a softener as well as being a producer, if you know what I mean.
If you seek a good BM and to keep on schedule, try the cod liver oil supplements - the maximum allowed on the particular brand you choose for a couple of days. I do not know if this conflicts with IBS or Metamusil usage.
Hope things keep a moving in all the right direction. :-)
Audrey, I think your description actually sounds quite a bit like one of the many forms IBS can present. There is no rules. It's kind of like MS looks different in each person.
I wanted to make another note that medications like Metamucil and Citrucil are bulking agents or bowel regulators. Many people think they are laxatives. They can provide the extra fiber-like bulk to produce bowel elimination but ONLY IF YOU DRINK PLENTY OF WATER WHEN YOU ARE USING THEM (LIKE 64 OZ A DAY).
If you don't drink enough water they will form the same ball of goo in your gut as they will in the glass when you don't get it down fast enough. That's clearly NOT GOOD.
Good information on what foods to eat when your bowels are too loose or too hard, as well as general and specific tips for a bowel routine can be found on the Paralyzed Veterans of American website. (pva *******) It's in a free PDF download format. They have other MS info as well.
Yes, we don't want to be poisoned by mercury. That's why it's available in a "molecularly distilled" form that removes the contaminants.
I have been fortunate to be able to attend MS Seminars of late. Many prestigious neurologists are now recommending Fish Oils (not cod liver oil) for the benefits of EPA & DHA. Cod liver oil contains the healthy oils too.
Whatever the case, it can be healthy pooping days are here again in short order. :-)
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