Constipation, and other stuff

[Sailorsong]

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


Dennis

[Quixotic1]

I think there is no contraindication to taking the Miralax for a longer time.


orrr


There are always Dr. Bing Bong's Little Rectum Rockets.....


Quix

[Sailorsong]

You are the greatest.

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.

Dennis

[steph74]

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...

Stephanie

[Quixotic1]

I hope I didn't gross people out here.  Maybe we'll hear from others tomorrow.

q

[Quixotic1]

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.

Quix

[willowwoman7]

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".