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

[Sailorsong]

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.

Dennis

[twopack]

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.

Mary

[Sailorsong]

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.

Dennis

[figuerpa]

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.

Paula

[twopack]

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.
Mary

[tonyad]

   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.

Take Care,
~Tonya