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Advice for those who suffer with constipation
Hi Guys,
I am sure that many people with MS and other neurological diseases suffer from constipation, this can happen either due to the medicines that we are taking for our MS or due to the nerve pathway damage, in my case it has been caused by both, for a while I was on a drug called Vesicare which I am sure many of you take for bladder urgency.
This drug is known to cause constipation as it drys out our mucus, so usually we end up with a dry mouth and dry other bits.
I stopped Vesicare due to the constipation, although I find it such an affective drug, but my constipation is caused by the fact that my nerves that supply my back passage and the urge to go are effected, (suspected lesion at T10)
I had been increasing my fibre, but apparently this is not the thing to do, my gastroenterologist told me that you can eat too much fibre in this type of case, he said that the increased fibre intake was in "my case" probably making the problem worse rather than helping me, so he said to have moderate fibre intake, I was having all bran, fruit, fruit and more fruit and then having psyllium husks etc. He said this was prob making it worse for me.
His suggestions were to take some epsom salts 2 to 3 times per week, 1/2 a teaspoon, to 1 teaspoon in water can increase to 2 teaspoons if necessary, also apparently the prep stuff can be used the picolex once a month toclear out everything, if you suffer really bad like me, also Movicol sachets can be helpful.
I just thought I would share this as so many of us suffer from constipation, please check with your Dr first before trying any of this as if you are on DMD I am not sure if it would make a difference, I don't take anything other than the Gabapentin.
I hope this was helpful
Cheers,
Udkas
I am sure that many people with MS and other neurological diseases suffer from constipation, this can happen either due to the medicines that we are taking for our MS or due to the nerve pathway damage, in my case it has been caused by both, for a while I was on a drug called Vesicare which I am sure many of you take for bladder urgency.
This drug is known to cause constipation as it drys out our mucus, so usually we end up with a dry mouth and dry other bits.
I stopped Vesicare due to the constipation, although I find it such an affective drug, but my constipation is caused by the fact that my nerves that supply my back passage and the urge to go are effected, (suspected lesion at T10)
I had been increasing my fibre, but apparently this is not the thing to do, my gastroenterologist told me that you can eat too much fibre in this type of case, he said that the increased fibre intake was in "my case" probably making the problem worse rather than helping me, so he said to have moderate fibre intake, I was having all bran, fruit, fruit and more fruit and then having psyllium husks etc. He said this was prob making it worse for me.
His suggestions were to take some epsom salts 2 to 3 times per week, 1/2 a teaspoon, to 1 teaspoon in water can increase to 2 teaspoons if necessary, also apparently the prep stuff can be used the picolex once a month toclear out everything, if you suffer really bad like me, also Movicol sachets can be helpful.
I just thought I would share this as so many of us suffer from constipation, please check with your Dr first before trying any of this as if you are on DMD I am not sure if it would make a difference, I don't take anything other than the Gabapentin.
I hope this was helpful
Cheers,
Udkas
Thank you, Mary. I understand now. :)
When I talked to my doc about the senne ones not working, I can't remember if I told him i was still on the dolculax too. When he started to write down the cocktail for me, he said that he doesn't like to do this, but that we may not have a choice...or something like that. He also said that the first day I start it, I should plan to stay at home all day, close to the bathroom. lol Then, he said it should even out.
I have not started the cocktail yet. I wanted to make sure I understood everything before I did and, quite frankly, I am not looking forward to spending the day in the potty.
Funny thing happened night before last. I just got finished posting on here that I don't get cramps from the dolculax. I was in bed watching tv when the cramping started. And after about an hour I had to rush to the potty. No constipation involved. This happened again last night. I am kinda not looking forward to heading to bed tonight. :/
So, what do I do now? lol
Addi
When I talked to my doc about the senne ones not working, I can't remember if I told him i was still on the dolculax too. When he started to write down the cocktail for me, he said that he doesn't like to do this, but that we may not have a choice...or something like that. He also said that the first day I start it, I should plan to stay at home all day, close to the bathroom. lol Then, he said it should even out.
I have not started the cocktail yet. I wanted to make sure I understood everything before I did and, quite frankly, I am not looking forward to spending the day in the potty.
Funny thing happened night before last. I just got finished posting on here that I don't get cramps from the dolculax. I was in bed watching tv when the cramping started. And after about an hour I had to rush to the potty. No constipation involved. This happened again last night. I am kinda not looking forward to heading to bed tonight. :/
So, what do I do now? lol
Addi
Sorry my post confused more than it helped Addi. I'm not too surprised as I put it together when I got home from work last night. I was very late and I was tired. I should have left it for later. Just knew I would never get back to it if I waited.
It looks like your 100mg gel caps sold under the Dulcolax brand name are a stool softener known as docusate sodium when it is sold generically. That is the drug I have been told NOT to take with mineral oil.
When you take mineral oil for constipation, it does the job because it coats your intestines or mixes with the waste products of digestion. It doesn't need to be absorbed to work and I don't know of any benefit to absorbing mineral oil into your body.
Something about docusate sodium can cause your intestines to absorb mineral oil. It can be harmful to absorb mineral oil. I personally wouldn't want to take it unless I had exhausted all other possibilities first.
I'd also be hesitant to try the cocktail. I've had some severe constipation issues and, like Candy, ended up in the ER twice and was finally admitted when I failed to move anything but gas for over two weeks. Oh yes, it was terrible but I think that cocktail would sent me over the opposite edge. I'd be afraid to leave the potty room let alone the house. But that's me and the routine that works for each person will vary greatly (and even need tweeking from time to time).
Only your doc knows enough about you to consider all the aspects and limitations of your body. I just want YOU to have enough information to ask questions and be an active partner in deciding (with the doc) what might work best.
Please let me know if this stills sounds muddled.
Mary
It looks like your 100mg gel caps sold under the Dulcolax brand name are a stool softener known as docusate sodium when it is sold generically. That is the drug I have been told NOT to take with mineral oil.
When you take mineral oil for constipation, it does the job because it coats your intestines or mixes with the waste products of digestion. It doesn't need to be absorbed to work and I don't know of any benefit to absorbing mineral oil into your body.
Something about docusate sodium can cause your intestines to absorb mineral oil. It can be harmful to absorb mineral oil. I personally wouldn't want to take it unless I had exhausted all other possibilities first.
I'd also be hesitant to try the cocktail. I've had some severe constipation issues and, like Candy, ended up in the ER twice and was finally admitted when I failed to move anything but gas for over two weeks. Oh yes, it was terrible but I think that cocktail would sent me over the opposite edge. I'd be afraid to leave the potty room let alone the house. But that's me and the routine that works for each person will vary greatly (and even need tweeking from time to time).
Only your doc knows enough about you to consider all the aspects and limitations of your body. I just want YOU to have enough information to ask questions and be an active partner in deciding (with the doc) what might work best.
Please let me know if this stills sounds muddled.
Mary
I don't think that drug is available in the US, Candy. We may have had something similar here several years ago. I remember a prescription drug called Zelnorm from several years ago. I think I may have even given it a stort trial run myself. It was only to be used by women with constipation predominant IBS as I remember. It was taken off the market after a fairly brief appearance of a year or three.
Thanks for the suggestion. I hope your combo continues to work well for you and maybe members outside the US will ask their docs about it.
Mary
Thanks for the suggestion. I hope your combo continues to work well for you and maybe members outside the US will ask their docs about it.
Mary
Guys, that is why I told you about trimebutine malaete tablets 200mg. that is what my GI Dr. told me to take. It is a prescription and helps the musles in the bowel not to cramp up and to relax and keep smooth and moving. I take it 3 times a day, as well as other things that I mentioned in my before post.
I hope that this might help too,,,
Candy
I hope that this might help too,,,
Candy
I have decided (yesterday) that I am going to get a neuropsych eval done. This stuff happening to my cog is frustrating me terribly. I took a picture test and failed it badly (37%).
With that said, Mary, can you please look at what I take and am suppose to start taking and let me know if this is a no-no? I usually read your posts and they explain everything to me where I understand. I enjoy that about your posts. But for some reason, that didn't happen here. :( I read it a couple of times and I still didn't get it. :(
The Dulcolax I am taking is the store brand one. Sorry I didn't clarify that. The ingredient it lists on front is docusate sodium USP 100 mg. I take 2 gel tabs each night.
I have been having urinary and bowel issues for at least a year, closer to two. I don't want to take things that may harm my bowel system or whatever. Is it time for me to see a poo poo specialist, do you think?
Thanks,
Addi
Hi, Thought I would put in my 2 cents worth. I too suffer from severe constipation. I even spent a week in hospital last September and they were surprised by everything they fed me, made me drink, injected, or whatever..... did NOT work. It was finally on day 7 that something finally happened. They decided that I have a spastic colon and I have to say................
Without fibre in my diet, I would be back in hospital . I do take 2 tablespoons of benefiber EVERY DAY, 3 metamucil pills, EVERY DAY, 2 stool softeners, EVERY DAY, and eat prunes (10) actually, and almonds every afternoon for a snack. On top of that, I take MODULON ( trimbutane modulon) 3 x a day to help with the spasms.
My GI guy told me that if we have diahheria ( sp) , or constiptation, that the fiber bulks up the excess water,, or in the other case helps hold on to water, and it will take about 3 weeks for it to work itself out. He said that it was odd to be old that when you have the RUNS, be told to take extra fibre, but he swears that it works.
So, far, evern with everything that I take, I still suffer sometimes from the constipation, and that is when I take the bisaydl sodium (sp) again, sorry............ and that usually gets me back on the road............ I now only wait for no more ethan 3 days before I act.
I did do the epsom salt thing, and I was told not to do it on a regular basis either, ( don't know why) ... and it tastes awful, but it does work.
Good luck to you, and hope that this helps.
Do you have more tests lined up for the future?
Candy
Without fibre in my diet, I would be back in hospital . I do take 2 tablespoons of benefiber EVERY DAY, 3 metamucil pills, EVERY DAY, 2 stool softeners, EVERY DAY, and eat prunes (10) actually, and almonds every afternoon for a snack. On top of that, I take MODULON ( trimbutane modulon) 3 x a day to help with the spasms.
My GI guy told me that if we have diahheria ( sp) , or constiptation, that the fiber bulks up the excess water,, or in the other case helps hold on to water, and it will take about 3 weeks for it to work itself out. He said that it was odd to be old that when you have the RUNS, be told to take extra fibre, but he swears that it works.
So, far, evern with everything that I take, I still suffer sometimes from the constipation, and that is when I take the bisaydl sodium (sp) again, sorry............ and that usually gets me back on the road............ I now only wait for no more ethan 3 days before I act.
I did do the epsom salt thing, and I was told not to do it on a regular basis either, ( don't know why) ... and it tastes awful, but it does work.
Good luck to you, and hope that this helps.
Do you have more tests lined up for the future?
Candy
Thanks for the advice on MOM. I just read the label!!
My MS Nurse only gave me that suggestion for occasional constipation, and not for everyday use.
Lactulose is available here as OTC medicine, BUT when I went to see my Dr yesterday he was wary about giving me another Rx for it, as it appears to have given me a raised sugar level, and to boot Thrush in the mouth - and it is really painful! I can barely open my mouth or swallow anything. Good for the diet though I guess:/
Thank you for the info.
Debs
My MS Nurse only gave me that suggestion for occasional constipation, and not for everyday use.
Lactulose is available here as OTC medicine, BUT when I went to see my Dr yesterday he was wary about giving me another Rx for it, as it appears to have given me a raised sugar level, and to boot Thrush in the mouth - and it is really painful! I can barely open my mouth or swallow anything. Good for the diet though I guess:/
Thank you for the info.
Debs
Hi Mary,
Wow, thank you for putting all the constipation meds into sub headings with info. The choice can be overwhelming and you are correct spinal cord constipation is different from the normal causes, thanks so much for the info and sharing it.
As I put in my post people should always check with their doctor or pharmacist etc. as you are right not all over the counter drugs are harmless and some of them interact with other things that we are taking.
I was merely bringing up a difficult problem for myself and how I was making it worse by increasing my fibre intake to ridiculous levels, in hope of actually being able to go!!! and obviously this is not always the right anser. I have never discussed my constipation with my neurologist, other than him asking me if I had difficulty going and answering yes, but I don't think he knew how big an issue it was.
My GP suggested the Movicol sachets and so did the gastro fella, I took the opportunity to discuss this issue with him after my colonoscopy I had done recently.
Just a word on Epsom Salts too, they contain sulphur and I am not sure if this would cause issues if you have a suphur allergy,
PLEASE do as Mary said check with your doctor first but it is great to explore the options as it is a problem that affects so many of us, shame we didn't have the specialists here that you were talking about Mary.
Cheers,
Udkas
Wow, thank you for putting all the constipation meds into sub headings with info. The choice can be overwhelming and you are correct spinal cord constipation is different from the normal causes, thanks so much for the info and sharing it.
As I put in my post people should always check with their doctor or pharmacist etc. as you are right not all over the counter drugs are harmless and some of them interact with other things that we are taking.
I was merely bringing up a difficult problem for myself and how I was making it worse by increasing my fibre intake to ridiculous levels, in hope of actually being able to go!!! and obviously this is not always the right anser. I have never discussed my constipation with my neurologist, other than him asking me if I had difficulty going and answering yes, but I don't think he knew how big an issue it was.
My GP suggested the Movicol sachets and so did the gastro fella, I took the opportunity to discuss this issue with him after my colonoscopy I had done recently.
Just a word on Epsom Salts too, they contain sulphur and I am not sure if this would cause issues if you have a suphur allergy,
PLEASE do as Mary said check with your doctor first but it is great to explore the options as it is a problem that affects so many of us, shame we didn't have the specialists here that you were talking about Mary.
Cheers,
Udkas
Here are a few clarifications and caution notes for anyone fighting constipation. Sorry it's so long. It's important information when you need it.
Dulcolax is a brand name. The company has expanded their product line in recent years. THE Dulcolax ingredient used to be bisacodyl. Dulcolax products now contain a variety of laxative and softening agents, at a premium price (often double+ generic alternatives in stores here). Make sure you read labels so you (and the doctor) know what you are taking. If you just say "Dulcolax" it wouldn't be unreasonable for the doc to assume you mean bisacodyl.
Bisacodyl (5mg tablet or 10mg suppository) is a stimulant laxative. Cramping, especially with the tablet, is not unusual. Can also cause incontinence of stool if the contraction of the colon muscles is so stimulated that they contract involuntarily. Can interfere with normal bowel function if taken regularly (if the MS hasn't done it already).
Docusate sodium (100mg gel caps) is a stool softener (aka Colace). It has no laxative effect but may be all that is needed to keep some people regular. Should not be used in combination with mineral oil.
Mineral oil is a lubricant that acts locally (is not absorbed into the body). It can also help keep stool soft by preventing water from leaving the "stuff" moving through your GI track. Taking mineral oil in combination with docusate sodium can cause the mineral oil to be absorbed (not a good thing). Long term use usually is avoided these days as minerals can be bound (like the water) resulting in deficiencies over time.
Polyethylene Glycol-3350 (aka MiraLax), Milk of Magnesia, and Lactulose are all osmotic laxatives that act by pulling water into the intestines. MOM should not be used by anyone with kidney problems and is probably best when used for occasional problems only. Lactulose (I believe) requires a Rx. MiraLax is available OTC (and under several less expensive generic names) and seems to be safe for daily use. (Miralax is a simplified version of the 4L colon prep mixture you may be familiar with.)
Metamucil (psyllium) and Citrucal (methylcellulose) are bulk forming agents also referred to as bowel regulators. They can be used to treat diarrhea as well as constipation. They MUST be taken with increased amounts of water or will end up blocking what you desire to move.
Ground flax seed (NOT oil) provides daily fiber to assist the bowel and is also a rich source of omega-3 fat to help decrease cholesterol and aid heart health.
When constipation is chronic, a physician needs to be involved in decisions about a bowel elimination program. Tops for expertise in this area would be a physiatrist (yeah, not another ...ologist!) who sub-specializes in spinal cord injuries or neuro-muscular diseases.
If bowel evacuation is difficult or impossible as a result of nervous system damage in the spinal cord, a bowel training program may be needed. An experienced physiatrist could guide you through that process. You can also get a description of what is involved at the United Spinal Association website. Let me know if you want to read it but can’t locate it online.
As always, be careful when self-medicating. Not all OTC drugs are harmless and today’s little problems can get HUGE in a minute.
Mary
Dulcolax is a brand name. The company has expanded their product line in recent years. THE Dulcolax ingredient used to be bisacodyl. Dulcolax products now contain a variety of laxative and softening agents, at a premium price (often double+ generic alternatives in stores here). Make sure you read labels so you (and the doctor) know what you are taking. If you just say "Dulcolax" it wouldn't be unreasonable for the doc to assume you mean bisacodyl.
Bisacodyl (5mg tablet or 10mg suppository) is a stimulant laxative. Cramping, especially with the tablet, is not unusual. Can also cause incontinence of stool if the contraction of the colon muscles is so stimulated that they contract involuntarily. Can interfere with normal bowel function if taken regularly (if the MS hasn't done it already).
Docusate sodium (100mg gel caps) is a stool softener (aka Colace). It has no laxative effect but may be all that is needed to keep some people regular. Should not be used in combination with mineral oil.
Mineral oil is a lubricant that acts locally (is not absorbed into the body). It can also help keep stool soft by preventing water from leaving the "stuff" moving through your GI track. Taking mineral oil in combination with docusate sodium can cause the mineral oil to be absorbed (not a good thing). Long term use usually is avoided these days as minerals can be bound (like the water) resulting in deficiencies over time.
Polyethylene Glycol-3350 (aka MiraLax), Milk of Magnesia, and Lactulose are all osmotic laxatives that act by pulling water into the intestines. MOM should not be used by anyone with kidney problems and is probably best when used for occasional problems only. Lactulose (I believe) requires a Rx. MiraLax is available OTC (and under several less expensive generic names) and seems to be safe for daily use. (Miralax is a simplified version of the 4L colon prep mixture you may be familiar with.)
Metamucil (psyllium) and Citrucal (methylcellulose) are bulk forming agents also referred to as bowel regulators. They can be used to treat diarrhea as well as constipation. They MUST be taken with increased amounts of water or will end up blocking what you desire to move.
Ground flax seed (NOT oil) provides daily fiber to assist the bowel and is also a rich source of omega-3 fat to help decrease cholesterol and aid heart health.
When constipation is chronic, a physician needs to be involved in decisions about a bowel elimination program. Tops for expertise in this area would be a physiatrist (yeah, not another ...ologist!) who sub-specializes in spinal cord injuries or neuro-muscular diseases.
If bowel evacuation is difficult or impossible as a result of nervous system damage in the spinal cord, a bowel training program may be needed. An experienced physiatrist could guide you through that process. You can also get a description of what is involved at the United Spinal Association website. Let me know if you want to read it but can’t locate it online.
As always, be careful when self-medicating. Not all OTC drugs are harmless and today’s little problems can get HUGE in a minute.
Mary
So, I am not the only one with this Sx either! I take 2 Colace every morning and sometimes it doesn't work, the senacot was rather "rough" on my tummy.
Epsom Salts - does it have a taste? I know I use it in my bath for soaking or soaking tired feet, never thought of drinking it.......
I now get severe back pain before having to go......then sometimes it eases off afterwards, someone said constipation presses on many nerves in the spine?
Just thoughts
Epsom Salts - does it have a taste? I know I use it in my bath for soaking or soaking tired feet, never thought of drinking it.......
I now get severe back pain before having to go......then sometimes it eases off afterwards, someone said constipation presses on many nerves in the spine?
Just thoughts
WOW, I was going to post a thread about this.
My MS Nurse told me to take 3 tablespoons of Milk of Magnesia in the evening and believe me it does work - and without the stomach cramps too.
My Neuro, has me on Lactulose. This works pretty quick. So I alternate between both.
My Grandmother used to take Epsom Salts every night, she lived until she was 92, and was always taking them before bed time.
I do have a lesion on my T10, so hence the problem - I guess.
Debs
My MS Nurse told me to take 3 tablespoons of Milk of Magnesia in the evening and believe me it does work - and without the stomach cramps too.
My Neuro, has me on Lactulose. This works pretty quick. So I alternate between both.
My Grandmother used to take Epsom Salts every night, she lived until she was 92, and was always taking them before bed time.
I do have a lesion on my T10, so hence the problem - I guess.
Debs
I have this problem too. My bowels are just sluggish. Nothing wants to move. I use Colace after each meal. If I didn't by the time the waste makes it down (which would take a week) it is too hard to pass. Ugly subject, isn't it?
I get pains every once in a great while. Like I only remember 2-3 times. My problem is not really the consistency of my stuff. It more has to do with my muscles used to go, you know what I mean? It is like I have to wait until my body pushes it out for me and when that time comes, I have to get to the bathroom NOW. Since something is going wrong in the muscles in that area, I cant seem to hold it or release it. I also get muscle spasms in my pelvic floor area.
So, hopefully this new thing my doc wants me to try will work. And if it doesn't, I can tell him about what you are doing and see what hecthinks of that. :)
I hope yours does the trick for you!
Addi
I re read my post, and I meant that the Ducolax we savage and gave me pains, not the Movicol, I am not sure if it read right :-) but of cause you may not have the same problem.
Hi there,
I hope all goes well for you with your special diet, my gastro doesn't like the dulcolax, apparently that can do something to the bowel (blacken it?) but he said that you are better to use the movicol sachets, but I guess as long as you don't use it long term, I tried it and found it too savage as in the pains. My stuff is not hard, so I don't need a softener I just don't seem to get the urge to go!!! Pardon the pun but it's such a pain in the arse. I can go over a week without going, but i think the fibre just packs me up even more and makes it worse for my type of constipation, so the metamucil etc. that i was taking was actually making my problem worse, that is why i thought i would share my new found info with others like me that have spinal lesions may possibly be encountering the same problem, I have also had the bowel incontinence thing too, this is only new to me, I think and I agree with you Paula, I would rather be constipated and not be able to go than have fecal incontinence as it is rather awkward!! But in my case I think I had so much fibre that it added then to that type of situation when I did go :-)
Geee am I glad that nobody really knows who I am on this forum, as how damn embarrassing this subject is, but however one that affects most of us and needs to be talked about.
Thanks for sharing.
Hope it works for you Addi and you get some relief.
I hope all goes well for you with your special diet, my gastro doesn't like the dulcolax, apparently that can do something to the bowel (blacken it?) but he said that you are better to use the movicol sachets, but I guess as long as you don't use it long term, I tried it and found it too savage as in the pains. My stuff is not hard, so I don't need a softener I just don't seem to get the urge to go!!! Pardon the pun but it's such a pain in the arse. I can go over a week without going, but i think the fibre just packs me up even more and makes it worse for my type of constipation, so the metamucil etc. that i was taking was actually making my problem worse, that is why i thought i would share my new found info with others like me that have spinal lesions may possibly be encountering the same problem, I have also had the bowel incontinence thing too, this is only new to me, I think and I agree with you Paula, I would rather be constipated and not be able to go than have fecal incontinence as it is rather awkward!! But in my case I think I had so much fibre that it added then to that type of situation when I did go :-)
Geee am I glad that nobody really knows who I am on this forum, as how damn embarrassing this subject is, but however one that affects most of us and needs to be talked about.
Thanks for sharing.
Hope it works for you Addi and you get some relief.
Paula-
I used to have the problem you are having and I definitely feel for you on that one.
I used to eat 1-2 bananas daily and it really helped. If I forgot to stock up on bananas and missed a day, I regretted it.
Just a thought,
Addi
I will definately keep this in mind. My problem is more of the bowell incontinence, sometimes I wish it were constipation at least then I wouldn't have to be worried if I will make it to the bathroom or not.
There are times where constipation is an issue for me but more times than not it is the incontinence. Hopefully I will remember this information when needed.
Thanks for the info,
Paula
There are times where constipation is an issue for me but more times than not it is the incontinence. Hopefully I will remember this information when needed.
Thanks for the info,
Paula
Funny...this topic was once again something I just brought up to my pcp this morning.
I have been taking Dulcolax for several months now, 2 100mg gel caps in the evening. This was doing the trick for a while. Then it wasn't enough. So my pcp put me on senne lax. Try without the Dulcolax first, then adding back if needed. It was needed. So, now I am taking the 2 caps of Dulcolax in the evenings, 1 tablet of senne lax in am and noon. And I still was having trouble.
So today I was told to take: 1tbsp milk of magnesium, 1tbsp mineral oil and 1tbsp of fiber (mera-lax, cetrucil or metamucil). Mis these three things in small glass of water or juice. Take two times a day. Once my body responds to this, I am to quit the Dulcolax and see how it does. If all is well, quit the senne lax. He wants me just on the 3 tbsp cocktail, which I can tweak the amount if needed...like 2 tbsp of each item.
So, hopefully this works for me. Just wanted to share another option. :)
Addi
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