safest laxative?

Discuss different Pain Management Options; Medication options including side effects and Worldwide variances in names etc.
bikelover
Posts: 93
Joined: Sun Sep 22, 2013 1:47 am

Re: safest laxative?

Post by bikelover »

You need to leave fear alone and try it once Kathy, who knows it might suit you.
I suggest you start by a small dose, probably half a teaspoon.
About opiates and drugs in general, slowly by slowly I've stop taking them. They numb you, don't really get rid of the pain, and I believe in the long run, which is what is required with a condition such as ours, they bring more bad than good (damage to the liver, intestine issues etc). To me these drugs have been like trying to cover the sun by pointing with your finger...Don't get me wrong, I've taken NSAIDS, pain drugs etc, for other conditions (shoulder surgery) in the past with real relief. But for this though one, its been nay..
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Hi Bikelover and everyone,
Thanks for your advice.
I agree with you about the drugs ...for the most part opiates have done little for my pain, and now it's thought by some docs--(one of them is the pelvic pain gyn who started me on opiates!) that it can actually worsen pain. I agree in my case.
I did get some limited relief from hydromorphone rectal supps, but over the past few years I've had to up the dosage,and now even a 12mg dose doesn't do much, -- helps a tiny bit and for only a short time.

My type of pain seems to be severe muscle spasm which could explain why all along, pain meds have not helped. My PT has some ideas and we will be working on things again when she returns from a conference.

About the 'Nature Calm', I will definitely be giving it more of a chance.
I did try it last week, but had diahhrea ----prbl'y due to the Dulcolax I'd also taken the night before...Sounds dumb I know, but Dulcolax can often take over 16 hrs or more to work for me; meanwhile I have a painful pressure feeling which leaves me desperate to get the stool out.. so I added in the Nature Calm mid day, to get rid of that backed up feeling..
Another couple of times I took it, but not at bedtime, again mid -day, so its hard to tell what it did.

Often Dulcolax (literally empties my stomach out to the max, so i shouldn't be feeling anything the next day, but emtpy! If I take just 2 pills, or a milder laxative, I don't have much results, and have to 'push" ...which is not good.

Be careful with Dulcolax everyone,, I found I had to keep upping the amount over time.
Now I'm at 3 to 3 and 1/2 pills at bedtime and when it finally works it can bring on violent" and unpredictable "runs" often after I think I'm "done " and ok for the day, ..I'm about to go out somewhere, it kicks in again and makes me quite ill.
It often doesn't work until dinner time, then the "running" begins. Often Im not feeling calmed down until almost bedtime..then the dilemma of "what do I take tonight" ... begins all over again.
ie. No laxative or a less strong product... I get the back-up feeling..
or- Dulcolax again ... I hate to do this as stomach is still cramping and not recovered yet..from the previous "bout".
I sometimes will be very sick again the next day. No way to live
My hubby is so used to seeing me 'sick' he shows no reaction, which is quite upsetting. (he has never suffered from stomach issues, so he can't relate.

Docs have not been too helpful...saying "take Miralax" which can take 2 to 3 days to work!.. another gastro doc suggested a laxative suppository daily.. along with Sennacot the night before. Having to push a supp high into my painful spot daily does not sound like a great idea! -- the gastro doc only knows his "area" of medical info and couldn't relate to pelvic/rectal pain.
I tried his advice a year ago and did work effectively at the time! But I also realized I didn't want to become dependent on a daily laxative suppository, esp when my opiate drug level was pretty low and not even effective! ( I eventually stopped this routine, and went back to to the Dulcolax. Prior to opiates I rarely used a laxative, unless constipated from another med.

My thought now is to skip the Dulcolax and take the Nature Calm tonight? maybe a bit more than the 1/2 teaspoon? along with my colace softener... I want my stomach to heal, from the constant' 'dumping ' the Dulcolax causes. but not get backed up! (Sorry for TMI!)
Does the the 'Nature calm' actually calm/sooth the stomach a bit while doing its job? hope so ..
Thx everyone for listening and for any thoughts on Nature Calm.. It know all our systems react differently etc. BTW my son who is healthy but has 'normal constipation issues', prbly from his college kid "diet'" of burgers and fries,tried Dulcolax also and said it really messed with his system as well..He stopped it.
BTW
has anyone ever tried the "MAGIC Bullet Suppostory? A gastro doc told me about that, but I wonder if that may produce violent results
as I heard it's pretty potent.
Thx all!
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Hi NYT,
Thx for the info... Am checking it out. I thought I had posted a reply to you last week.. but cant find it...
Just wanted to let you that I appreciate your kind response and advice.
hope you are well
Kathy
Carlie
Posts: 23
Joined: Sun Nov 10, 2013 11:22 pm
Location: TULSA, OKLAHOMA

Re: safest laxative?

Post by Carlie »

Kathy,
Hi, I hope you are feeling better. I have never heard of anyone taking that much medicine to treat a very common problem of PNE - to the meds I think. I had internal hemorrhoids - no external - and a blockage had formed. I cut the hard med (controlled substance some time ago for it did no good) - now, I have a tendency to go the opposite way - uncontrollable rectum incontinence. Right. A bowel doctor gave me Bentyl to help with the pelvic spasms. I have to drink two very large glasses of water before a large coffee each morning with a bentyl tablet (every 6 hours). I eat a bowl of cereal - large each morning. If I do not, things go either way. I like shredded wheat squares with my coffee and by the time I am ready for the shower, I am fine. I had to see four different doctors (all colon experts) to find this combination. So far, I have had no problems either way if I follow it all. I have the vaginal suppositories with valium in them for nighttime sleep without pain. They gave me some lidocaine cream for the rectum due to sensitiveness and it works for me. I need to do/use these two things not every night now - less with time. I have to have three meal a day - smaller than a lot of people. I cannot "stuff" myself or I have problems. I had to get rid of the hard med first, then if you may think you have hemorrhoids - who knows what we feel with so much damage there? - a surgeon can take a peek and tell you in a flash if you do or not. I have no allergies to any food. After the surgery, I have had a tenderness right inside the rectum that is burning - a small hemorrhoid left inside and can become tender and the lidocaine takes care of it. I use babies wipes and have a hand nozzle in the shower and can keep clean. I have had these monster hemorrhoids for years and did not know what was wrong. I would have done this a long time ago had I known how easy it was. I do not like drinking all the water before coffee, but it is the only way it works for me. If I miss a step in this routine, I have problems period. I eat anything I want to eat which is just about everything. The amounts are critical. It is a miserable feeling. A lot of people with PNE and are on meds have this problem. Instead of the meds (controlled) - try a glass of wine (small) before going to bed. Friends encouraged me to try it and I can sleep soundly now. I exercise a lot and always have - family, college, and working keeps a person busy. Do hope you are feeling better. Carlie
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Hi To All
This question is to anyone who can relate...,m still not able to get this problem worked out, tho you've heard me writing about it a bit!
So I wanted to ask this question.
I have a low level of opiate in my intrathecal pain pump plus another medicine, so I have to take laxatives.
i started taking laxatives in 2012 when my doc Rx'd Methadone for my anal pain...She said to stay ahead of the constipation that opiates can cause by pro-actively taking pain meds.
At that time Amitiza worked well for awhile.. but the Methodone did not help and I'm not on it anymore.
I also use anal suppositorieto help relax the anal spasms -- which my PT and I feel are the Real cause of all this anal pain.
I try to avoid the heavy hitter pain suppository (Dilaudid - 12 mgs) and take it only if I have to ..maybe once or twice a week.
All in all I'm not on a really heavy dose of meds, unless I take the above pain supp.
I don't have hard stools (I use Colace regularly and don't have to push much, I have a BM at least every other day, so Im not constipated in the true sense.
But I've found that I can only poop if I take about 3 to 3 1/2 Dulcolax.. Over a couple years time I had to up the dose.
For me this is a nasty laxative! ...little pills that are easy to swallow, but the results are completely un-predictable.
Results could be in the late morning or not until dinner time.
They are also violent...think colonscopy prep!
I don't stop 'pooping' until my colon is empty! -- and my backside is raw. (sorry for TMI)
The anus is my pain area and Im convinced this dang drug is adding to the pain and maybe slowing down my healing.
(I am working with a great PT and have made good progress lately,
but she referrs me to docs for laxative advice.)
My pain doc said take one less Dulcolax. My pump nurse and I thought that was wrong advice. If it takes 3 to make me go, why take 2, then nothing would happen, from my expereince..
So instead I take Double Strength Sennakot every other night -- a milder vegetable based laxative but it's still a stimulant. I take approx 3- pills -- equal to 6 regular Sennakots..A lot yes, but based on the advice of a gastroenterologist, and i don't go at all if i take less.
Sometimes this makes me go, sometimes not...and by evening I have that awful poop urge ,pressure or object in the rectum feeling. I usually go a small amount, so I know something is there.

I also know this feeling is part of my disease, ( pelvic floor dysfunction -with anal spasm) but its hard to be on my feet with that 'urge' feeling plus the anal pain, thus my need take laxatives to feel empty.
My question: Am i over-doing it? Are these laxatives, both the violent Dulcolax and the more mild Sennakot, making things worse and causing urges I might not get if I just skipped a night?
I want to give my poor stomach a rest and let it heal from what the laxatives cause, but fear getting impacted, as I remember the warning of my obygyn to be pro-active etc.with laxatives. All I need is one normal BM daily.
I try to drink a lot of water and eat fiber.. You need a lot of water so the fiber doesn't make things like cement.
(I can't drink acidic stuff) so I stick with the water. I resort to prune juice at times but nurse warned me that's what was causing the bad cramping I got once.
Does anyone have this issue? Nurse says with my current program there's no risk of impaction.
Great, but I can't keep taking this Dulcolax! Its makes me sick and keeps me at home near the "throne' when I need to get out of the house,living life t,o help my healing.
I want to take Miralax but afraid it may take days to work (according to the TV commericals)..I heard tho that you can double up ,or even tripleonit it .. much safer but would it work in time? Anyone know how quickly i could get results
i also am thinkng of Amitiza again and or Linzess, but again wonder how long for "results"
Ive tried various laxatives,
Would anyone who can relate please reply? I so want a night/day off from these miserable laxatives and esp .to drop the dulcolax for something milder but effective, but don't want to risk impactment of stool.
BTW now that the weather is finally better I can get out and walk for exercise which should help a bit
Please help! Im desperate to find answer to this continuing issue Thanks so much everyone!
Kathy
PS. I am planing on seeing another gastro or colon doc when possible but must wait until hubby can off from work; he is run wild with various family errands due to my pain issue.
stephanies
Posts: 683
Joined: Mon Oct 25, 2010 3:07 am

Re: safest laxative?

Post by stephanies »

Hi Kathy,

I also get a terrible pressure type feeling like the one you describe sometimes, but it is not related to the need to use the bathroom. Only lying down helps to relieve it for me. When I stand up again, it comes right back. Luckily, this particular sensation has calmed down some for me in the last couple months, because it can be almost unbearable. I have been on low dose morphine sulfate for many years. I would love to get off as I am confident it is not helping the pain, but I am not yet in a place in my life where I can manage the withdrawal. This med combined with 10 mg. of a tricyclic is all the meds I take now and sometimes constipation is a problem for me and sometimes it is not. I think I have mentioned before that when I feel like thing are not moving the way they should, I use an enema. I probably am using an average of about 2 a week. At least one doctor has told me that this is fine. It makes going more predictable than the oral laxatives. Sometimes I will go a few weeks without using any and sometimes I will use a little more. We all need to find ways to deal with the side effects of the treatments for pain as well as the pain and this has helped me. Good luck to you.

Stephanies
PN started 2004 from fall. Surgery with Filler Nov. 2006, Dr. Campbell April 2007. Pain decreased by 85% in 2008 (rectal and sitting pain resolved completely), pain returned in 12/13. Pain reduced significantly beginning around 11/23.
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Thx Stephanie,
What you describe sounds like what I experience regularly. Its partly the pelvic floor issue that make me feel like I need to poop but there are times when I know I do as the meds in the pain pump are constipation--dliaudid and bupivicaine, as well as a suppository I use when pain gets higher ( after drving etc) - dllaudid 12 mg rectal supps.
Its a vicious cycle.
Im seeing my pain doc to discuss options this week.
About enemas ,they are a problem for me... my pain is right at the anal opening ..so I can't stick anything more up thre... tried it once and I got so upset with pain, I had to stop.
I also have scary memories of being given enemas by my mom, only as a very small child. Her generation and my grandma's generation before her seemed to use this method often, in my memories. I remember my grandma giving them to herself!
They had the mistaken impression that a person needed to poop each day or it was time for the enema. Nowadays we know that this is so untrue..
---unless of course you have this urge issue..but again ,,its sometimes coming from the spasms.

So for me, even the thought of an enema, is unpleasant, even if I didn't have the anal issue...(But then it would be moot as I wouldn't be using the constipating meds!
BTW Taking a laxative suppository usually works for me when absolutely necessary --- within about 20 -30 mins of using it... It helps to
drink water while waiting... it usually get results and not as invasive IMHO-- like the enema.
But whatever helps you effectively etc is the important thing for you.
Thx again.
esthome
Posts: 16
Joined: Fri Dec 12, 2014 4:27 pm

Re: safest laxative?

Post by esthome »

Hi

I am only putting this out there as a suggestion because I have similar symptoms regarding urges to go, feeling of heaviness/pressure in my rectum (which feels as if I have a weight inside there) and I've been diagnosed with having an internal rectal prolapse (no tissue leaves the anus). I saw a consultant as I was having difficulty emptying fully and I had a defecatory proctogram (xray whilst expelling paste in your rectum)which looks for this problem. Apparently many women have this but are unaware. Some are symptom free whilst others believe they are constipated. The internal rectal prolapse telescopes down on itself causing a blockage. It is caused by weakened pelvic floor muscles. It can also cause pain. If you want more info there is a good website:-Oxford pelvic floor centre.

Like I said it may not be this but if it is, there are solutions.

Regards
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Thx you for posting this possiblity,
It comes at the right time as I am struggling tonight with severe feeling of back up, even after taking laxatives (last night) a laxative supposi tory today ,
and since it's urgent, I even swallowed about 2 oz worth of the Magnesium citrate stuff they use for colonscopy prep.
only results were a small soft BM earlier this evening and a few bits n' pieces after the laxative supp..
Like you my Pt feels I have pelvic floor issues and not IC or PN.

Is internal rectal prolapse another word for rectocoele?
I have a very good phys therapist who feels I have anal spasm due to years of pelvic floor dysfunction and the anxiety all the symptoms and research brought on.
Ive written her about your thoughts . Are you from the UK?. The pain is beyond description ...anal throbbing not helped by drugs in my internal pain pump and regular feeling of backup from prb'ly both the opiate meds and the condition I have --whatever it is!
The constipation feeling is really as bad as the pain lately!. My life revolves around bathroom as issues started with bladder urge/frequency 9 nine years ago. still have varying bladder issues you may've seen my posts.
Will see what PT says.
Thx so much for checking in . I'm seeing my pain mgmt doc tomorrow and will tell him about this too..
I appreciate it!
Kathy
kathyd
Posts: 699
Joined: Mon Dec 20, 2010 8:48 pm

Re: safest laxative?

Post by kathyd »

Hello again
Forget to tell you a few things I did see a rectal surgeon several months ago. I mentioned possible Pudendal Neuralgia (what I thought I had at the time) and she rudely dismissed me, saying she had no time for "those types of cases'. She did do a quick exam tho and said all looked normal.
I may have to see another color -rectal doctor
After I speak to my PT tomorrow I will know more. She is highly experienced and knows my pelvic floor very well after working on me for for awhile.
The doc who told me I had a rectecoele, years back, was kind and caring but admitted to knowing very little about other medical fields aside from her own...ob/gyn.
I saw colorectal surgeon at that time (2009) who said the rectecoele was tiny, but could change in the future. He didn't seem worried tho.
Later I saw a well known PT in NYC who practically laughed, when she examined me and said that it was barely there, not a true recteceole and that my obygyn was wrong. But things can change.
Those exams you describe sound painful as all my pain in the anal opening.. so hopefully this is not the case, as I don't want those areas touched unless absolutely necessary.
--- tho the symptoms do match up from what you described/
I probably have a weak pelvic floor ,, but my biggest factor is that it is very tight! (from stress/worry over years and bracing from pain, vicios cycle.
BTW I had a "transit test" a few years ago and all was normal .
Thx again for offering this info! very kind of you. Hope you are doing well.
Can't wait to speak to my local PT here in my home area.
Kathy
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