Health Organization for Pudendal Education

I agree with this article. Too much fiber can definitely cause symptoms to flare up.

I'm chronically constipated. It's a side effect of several of my meds. I eat a lot of salads, whole grains, bananas (used to eat up to 4 a day before I became diabetic, but they didn't help), & I eat bran & oat bran a lot. I can see how traditional thinking says 'eat lots of fibre', but my line of thinking says that if the fibre is dry-ish (like a bran muffin, for instance), it sits in your gut & absorbs the water/liquid you send to it.

Sometimes I don't go for up to 4 days. It used to be every day or day & a half.. I also get hemmorroids, which hurt or bleed when I have a movement. The doc had to cut them open almost 2 years ago because they wouldn't resolve & blood became trapped in them.

My doc has suggested Lactulose, & Dr G & his resident both suggested a laxative, but didn't recommend a specific one.. It seems pretty silly to take meds that are supposed to help me get better, then throw another med at them to help me deal with the constipation side effect, but I don't know what else to do.

Because I'm diabetic & those meds 'trump' all others, I have to be aware of drug interactions & allergies I have to medications.. I also don't know what kinds of fibre I should be eating, since I have to be aware of sugar content & I'm allowed only 3 servings of fruit per day.

Does anyone have any ideas for me to try, either in the laxative department, or foods I can have to help? I'd appreciate some ideas. I don't want my bowels to become 'dependent' on laxatives to move, but Dr G said the colon can become 'lazy' if we don't make it work.

Hi DS

Just wondered if Kiwi fruit may help you - if you google there is info about how kiwis help constipation. I now have a bowl with a very small amount of cereal topped with yoghurt, a sliced banana and kiwi fruit each morning.

I am on Notrtiptyline and gabapentin medication and manage to 'go' at least every other day, sometimes every third day, sometimes each day - breakfast is the meal that i keep consistent each day - rest of the day varies.

Also to say that an anal consultant i saw a few years ago said that lactulose causes bloating and that movicol was much better - maybe just his opinion but thought i would pass it on.

Rosemary x

Des,
I use Miralax and senna laxatives. This is a tough part of the side effects.
Janet

One thing that I found useful was to try not to panic and do very slow deep breathing while trying to do a BM. Curiously my constpation gets worse whenever I have a blocked nose ( which is very common for me due to the dryness of the nasal passages) and if I succeed in freeing my nose a bit I am able to feel a bit better. So I try to free up my nose and then take very slow deep breaths ( approx breathing 4-6 times a minute) for 2-5 minutes and I feel a bit of relaxation in the pelvic area and get a BM. This approach works 40-50% of the time, and if I have messed up with my diet the previous day or strained too much, then this strategy fails.

After years of trial Miralax works best (CVS generic is fine). My doctor prefers Colace, but I don't like having a set dose in a tablet. Sometimes it's too much laxative (even taken every other day) and that causes more pudendal pain. Miralax powder is adjustable and I use a fraction of the recommended dose. Add it to my morning warm drink, and increase/decrease based on the prior day's diet and BMs. Since PN decompression frequent BMs greatly increase the vulvar burning, so it's a balancing act to take the smallest amount of laxative to keep things soft but not heading toward diarrhea. A different doctor said NO psyllium and recommended Benefiber. I use powder to easily adjust, but don't use the full dosage or take it daily. Mostly on days when my diet isn't the best because I'm in too much pain to care about food. I also take a high quality probiotic several days per week (the doctor said to get one that must be refrigerated - better quality but more expensive) from Whole Foods or someplace like that. After the hell of C-diff last year from postop antibiotics, the cost is worth it. C-diff caused a major PNE flare.

My gastro put me on a no fiber diet and VSL#3, the best probiotic out there. You have to ask for it from the pharmacist,as it is kept refrigerated. Also, it is not cheap, about $1 per day, but worth it! After my bilateral PN surgery, I had a lot of numbness, making it difficult to work the plumbing. I upped the dose to 2xday and it worked great. It is labeled that it should be used under the care of a doctor, so be sure and check with them. They all love it if they know about it, but do not always think to tell you.

I've had irritable bowel syndrome since I was about 14 (I'm now 60). I used to get alternating diarrhea and constipation, but now my main problem is the latter. I also have hemorrhoids that flare up now and then. Medications can really exacerbate my constipation problems. I recently reduced the amount of methadone I take and noticed a big reduction in the constipation. I prefer methadone to other pain meds I've tried because it last a long time but it's very constipating. I am primarily vegetarian. I don't each meat or poultry but do eat fish occasionally. I eat a lot of fruit and veggies but not a lot of bran. I've tried fiber supplements like Metamucil but they made my problems worse. They caused gas and cramps. My go-to remedy for constipation is magnesium caplets. I've also found stool softeners helpful. Finding what works for constipation is really trial and error. It took me years to figure out how to deal with my issues. Even now, I can't always predict how my body will react to the magnesium. Do I need one or two? It's still guess work sometimes.

sadie wrote:I found high doses of probiotics 10-15 billion organisms a capsule and lots of strains of good bacteria mine has 8 strains....... which is good bacteria.... will help with your intestinal and immune health,
and i eat 8 prunes a day and everything is perfect in that part of my health. Pharmacist and health food stores can teach you what you need. I am using Jarro-dophilus brand ESP .....but I think they are coming out in reg stores ( and I don't mean the brand "TRUE BIOTICS" but i am house bound with PGAD so I can't get out there to do the research . I also have a blender drink every morning with a frozen banana to make it cold instead of ice and baby spinach leaves with the stems removed and 2 cups of welches 100% concord grape juice with out sugar and that can help with constipation too. Good luck and God bless Sadie PS you are not going to get the probiotics you need from yogurt plus they are filled with sugar .

what is PGAD

Permanent genital,arousel syndrome, I have it on and off absolutely horrid.