constipaton again

[kathyd]

Hi everyoone
I having big constipation issues tho for awhile I had it wlll managed..What a lovely subject! Im sorry to have to bring it up.. All of sudden this week the bad back up is bac,
I have a fairly small amount of dilaudid in my pain pump along with Marcaine, but the goal is to go up to address my pain.
Intrathecal meds can constipate but not badly.
I have used diluadid rectal supps for over 2 years and have been at 12mg level for a long time.. My painDoc says these are the source of my stool back-up. I agree
Problem is they do help a small amount with pain as they feel cooling and soothing right at the spot of my pain (rectal area)...and I need them for now.
Doc wants me to stop them and just rely on the pump meds which haven't helped as yet. I just switched to him (he is a good doc but he is just getting to know me...doesn't know my whole history yet
He is staying with the meds my previous doc put in the pump for now.
But he has given me a device I can push which emits a tiny bit more med each hour... as needed.
Im scared to do this as it might worsen constipation.
I finally got the stool out yesterday after taking a lot of laxatives, drinking water and eating fibery foods.
I had w so many trips to the bathroom that my poor bottom was raw!(sorry for TMI)...Then today I'm constipated again!...How can that be if I emptied my guts out yesterday?
I took only stool softeners at bedtime, cause I was "empty" I thougght, but must be vigilant, I guess due to the opiate meds.
I have a small body and am not a huge eater.tho I try.
With a pain pump the meds are constantly going into your system but intrathecally it takes a long time for it to constipate...so its not likely that it would cause what Im describing according to my new pain doc.
I also take about 0.5 to 0.75 Clonepin for sleep (been doing so for a few years) and
I take Azo Standard which helps with bladder flow,, emptying.
The only change is that Ive been taking more Azo Standard daily --- which does not appear to be constipating. My pelvic gyn/doc approved me taking it daily
Any thoughts on how to calm this issue so I can take my pain meds would be so appreciated.
Thx you soo much friends.
Kathy

[nyt]

I have to take Miralox, prune juice and Colace everyday and that helps a little bit. Need to make sure you drink a lot of water. You also might need to work on some bowel training. My youngest son had some issue when he was little and the pediatric gastroenterologist had a saying "Table to toilet for 15 minutes." So, after every meal he had to go sit on the toilet and it did help him a lot. I've recently started trying that to see if that would help train my bowels. It is a similar idea to what they do with bladder training. My constipation is not from meds, it is due to a pelvic floor that feels like I have a vice grip in it and my pelvic floor PT would tell you I do. It is a constant struggle for me so understand where you are coming from. You might want to double check with a pelvic floor PT to make sure some of your problem isn't due to pelvic floor muscle spasms or at least see if it is contributing to the problem.

[Violet M]

Kathy, I'm sure different things work for different people so I guess I'll just tell you what works for me and you can try it. Stool softeners, prune juice, and miralax don't help me at all, BTW -- maybe because I'm a difficult case. I have to take at least 800 mg. of magnesium citrate a day and eat a high fiber diet, otherwise I run into a lot of problems and I'm not even on any narcotics like you are. If I don't take mag citrate every day, I'm toast. Taking a good book into the bathroom is another trick to try.

Oh, the joys of talking about constipation on the internet. Good luck!

Violet

[Cora]

Hi Kathy,
You might want to ask your doctor for some samples of Linzess which is a new drug that helps with constipation. It's labeled as exclusively for women with IBD, but it's prescribed for constipation. It's quite expensive, but at least maybe see if you can get some samples to see if it works.

Cora

[nyt]

Violet, I will try your suggestion of Magnesium Citrate. Always picking up suggestions on this board.

[Violet M]

NYT, I take the tablet form, not the liquid form. I get the "NOW" brand pretty cheaply through Vitamin Cottage. It was my acupuncturist who suggested magnesium citrate and my GP said it was fine to take them on a regular basis. Hope it works for you.

Violet

[kathyd]

Hi Violet, Cora, NYT and everyone!
Thx for all your suggestions.

Its hard to say whether the drugs alone or the disease itself are upsetting my bowels issues. (maybe a bit of both!)

Like you , NYT I feel like those muscles -both rectal and vaginal are in a vise!--- In fact thats the \same word Ive used to describe my pain since 2006 when it started.
I hold my tension in the pelvic floor and abdomen esp. after my symptoms started and got scared silly by the research I did online!

BTW I have Magnesium Chelate as recommended by a "healer" I saw during the winter.. (no major results from him.. long story)
Has anyone tried the Chelate version of magnesium.. Not sure what the difference is and I wonder if its easier on the bladder?

Does anyone know if Magnesium detracts from the effectiveness of pain meds? My current regimen isn't working so my new pain doc is considering changes at the moment.
But just wondering --- as I know I need to take the Magnesium daily.
Like You Violet Im Toast also! but its more from the pain meds.

I take softeners, Miralax with every meal and Ducloax nightly...amount depending on need.. The Dulcolax is the heavy hitter but I hate the idea of being dependent on that to poop, and eventually having to up the amount.
Meanwhile my pain doc says its imperative to avoid constipation.
Dr Coady ---my former pelvic pain obgyn (now retired from active practice)--- also said that with our issues we need to do whatever necessary avoid constipation.

I notice its harder to pee after a bout of constipation and then finally emptying the bowels
that the muscles getting stretched pulled .. a bad cycle that cant be good, and Im trying to avoid

I try to drink water. as you get so de-hydrated with the diarrhea that comes form the laxatives..
but I can't drink it until the stomach calms down, or it sends me running to the bathroom with cramping..

I re-started pelvic floor PT...last week with a local person...she also does cranial sacral work which she feels is very helpful for chronic pain
I willl address the bowel issue with her as well.

I also wanted to recommend a book that I find interesting..It called "Healing from Chronic Pain" by Mary Ruth Valecki.
For some of us (not All of us) there are emotional issues that tie in with pain).
Her book chronicles her healing from chronic IC -PN issues.. and she stressed the importance of finding a good team of docs and practitioners. She also uncovered some emotional pain.Hers was very dramatic.
I don't have a dramatic emotional history, having had a normal happy life until all this, but I still know there are traumas.(mostly the ones that occured during treatment) ie: things said to me by un-caring irresponsible docs or read online.. that were traumatizing and hard to forget.
Anyway the book is on Amazon and is very interesting!

Thx again everyone! I so appreciate the support!
Just wondered about the magnesium Chelate.. and the effect of magnesium on pain meds.
Thats the tough part. Here in NY ...Its a matter of luck and tenacity to keep trying to find the right mix of practitioners.
The author of the book lives in LA., where she saw a doc and a PT I heard were great "gurus' on pelvic pain. I think CA as a state seems to have wonderful practitioners for our issues. Wish it was closer.

Thx again!
Kathy

[kathyd]

Hi Everyone
Does anyone here live in NJ or even In the NYC Metro area, and know of a decent gastro-enterologist?
I continue to feel constipated regularly from my pain suppss and my pump meds...

The gastro doc I saw put me on a program during the winter which required a lot of senna plus a laxative supp daily.
This worked for awhile but my pain doc didn't like the idea of s stimulant laxative suppository put in area of my Nerve pain daily (anus). I agreed.

So I stopped it
But lately the feeling of painful rectal pressure ...as if I l always need to go , comes daily...before my bowels are ready to empty. It hurts and I feel like I must go now..
I still have usual rectal pan and IC bladder issues as the pump med combo is not right...Im with a new doc for a couple months but he's taking things very slowly, and not making major changes yet. Most Docs are new to managing pumps for PN.
I do "go" at least every other day,and have soft stools. I am not bloated etc. Just that awful feeling.

No on gets it My infusion nurse just suggests another gastro docs..Hubby looks at me like Im from Mars...or "What next"? (sick of the $$ spent on useless
specialists. This is so hard. God I want my normal life back!
Please help!

Any docs names or other suggestions would be appreciated!
Thx!
Kathy

[rechbill]

Hi , my suggestioned is to try buffered Vitamin C powder. Start at the recommended dose and keep increasing daily until it works. It can cause diarrhea at high dosage.

[rechbill]

I get that pain from my rectal muscles cramping, because they are full of trigger points. I pelvic floor PT that does dry needling can help, if that is you situation. Another G doctor will not help because they don't the mucles. Start by looking at www.myopainseminars.com.