Constipation question... ( I know not a great subject)

(deactivated member)
on 10/14/08 8:54 pm - Long Island, NY
Hello~

I am 21 months out.  I have had a constipation issue ever since I had surgery.  It has gotten worse.  I have been rushed to the hospital with terrible back pain (pain like I have never had and can not describe) Just horrible pain. I lay in bed crying with it sometimes.  I went to a gastro doctor and he put me on amitistza- which is a pill to help constipation. It helps but then it seems to stop working and then starts again.  Now the pain has come back not often but enough for me.  It just hits me and then I am done for the day. I take a laxative, the amitistza, a stool softner and flazseed oil pill ( I heard it helps).  Has anyone had or have this problem with the terrible pain and the constipation? If so how do you fix it? Please help.

Thanks,
Tara   
jamiecatlady5
on 10/14/08 9:11 pm - UPSTATE, NY
Join my club....My fix is to eat more carbs *The high protein and high calcium suppliments and iron I take make it worse!*, flax SEED (not oil will help) ground 1T 2-3x day (start slow), and MIRALAX! It is avail by script (Glycolax) or OTC.... also colace two a dayBut here is all the info I have on Constipation, consult with your medical provider!
CONSTIPATION

Constipation can be from so many things including BUT not limited to:

~1) FLUIDS: simply from not getting in enough fluids...
So first before you do anything ask yourself? Am I drinking at least 64 oz a day (8 cups)...If not try increasing and see if this helps. Look at this neat hydration calculator! It may open your eyes! It says I need 117.5 oz day (I do get that too still not enough for me!) http://nutrition.about.com/library/blwatercalculator.htm

~2) EXERCISE: Get moving! I do 30-60 min cardio a day + wts. Yes it helps! Start somewhere! Something is better than nothing!

~3) FIBER: We get constipated because our diet is now volume in general & lower in fiber especially due to lack of tolerance also (less fruits and veggies).
So many try increasing fiber by using benefiber (non swelling/no taste) or some like liquifiber at Vitalady: www.vitalady.com I have used Metamucil caps in past but I DO NOT RECOMMEND it is a SWELLING FIBER & may NOT be good for pouchie! ***We do not want to stretch it!!!
I swear by Flax Seed ground (oil is not helpful). I get mine here: http://www24.netrition.com/now_flaxseeds_page.html
I started with 1T ground a day (in yogurt, shakes or on my salad it has slightly nutty flavor) now I am up to 1T three times a day. The benefits of flax are so much more than just for fiber!!! Read for more info! http://www.flaxcouncil.ca/flaxnut10.htm (A lower risk for heart disease, Prevention of some forms of cancer, Treatment of immune disorders, Diabetes helps in stabilizing Blood Sugars, Relief from constipation) http://www.flaxcouncil.ca/faq.htm You can also buy it in GNC, health food stores, Wal-Mart has it in vitamin aisle and baking aisle. KEEP refrigerated for longest shelf life and so it doesn't go rancid! It has to be ground (bought that way or ground in Magic Bullet or a small coffee grinder for the benefit ok!)


~4) OTHER NUTRITIONAL/SUPPLIMENT CAUSES: Higher protein (in diet and shakes), Calcium Citrate (form we need to absorb after bypass), Iron supplementation can all add to the constipation scenario postop (things we need!).

Different forms of Iron are more constipating than others (Ferrous sulfate for instance AVOID!!! Many feel carbonyl iron like vitalady's tender iron www.vitalady.com, ferrous gluconate *I get OTC at Wal-Mart just ask pharmacist, ferrous fumarate, polysaccharide iron are less constipating).

Another solution Magnesium: HERE IS JULIA Z's recommendation: Magnesium as magnesium citrate or amino acid chelate 400-1000 mg a day. OK to take with calcium but not with iron. Can be taken all at once or throughout the day. Start out with 200 mg and increase dosage every few days until the desired level is reached; decrease dosage slightly if loose stools result. Preferred dosage is 1 part elemental magnesium to 2 parts elemental calcium or 1000 mg magnesium to 2000 mg calcium, but this ratio is not accurate for each person. Increasing the dosage until you get loose stool and than backing off a little seems to work best for most people. Also there is a tastier Mag citrate by Peter Gillham Natural Calm http://www.petergillham.com/product-line/peter-gillhams-natural-calm.php http://www.petergillham.com/literature/pdf/Calm-balance.pdf
Vitalady Tender Magnesium Citrate (200mg) 400 caps/btl $18.99
http://www.vitalady.com/cgi-bin/commerce.cgi?preadd=action&key=1905

IF still NO GO: my surgeon recommended Colace. It is an over-the-counter stool softener. Try it once a day and increase to 2-3x if needed. (It is cheap too, buy the generic brand, docusate sodium)...

If this is ineffective, my surgeon said I could use a gentle suppository (such as glycerin, ducolax or the generic form)....only to get things going, they can get habit forming so be careful. It is always best to ask your surgeon or MD about his but this is what I have been told. I use Colace 2x a day, it does help (with my flaxseed)

I also have used Milk OF Magnesia a few times a week if needed.

My Clinical Nutrition/Bariatric MD prescribed Miralax (generic is glycolax) works great also (I used a daily for months on end when needed now mostly 1-5x month in severe cases w/ some bloating but no taste!, it is a powder mixes in water great!) They say can be used long-term! It is now available OTC as well.

Many swear by Smooth move tea, it is just senna in a tea (you can buy senna tabs OTC also called SENOKOT Tablets: Each tablet contains 8.6 mg sennosides.). Or ingredient in: PERI-COLACE® TABLETS (Purdue Products)
docusate sodium and standardized senna concentrate (so is a stool softener and laxative in one!) http://www.tealand.com/SmoothMove.asp BY: Traditional Medicines in Health food, Wal-Mart of many health food aisles of grocery stores!
Contents: Active Ingredient: 20mg. Sennosides A & B per cup from senna leaf. Other herbal ingredients: Licorice root, fennel seed, orange peel, cinnamon bark, coriander seed, ginger rhizome, natural orange flavor. Directions for use: Pour 8 oz. of boiling water over one tea bag and steep, covered, for 10-15 minutes. Adults and children over 12 years: Drink 1 cup before bedtime. If necessary, repeat the next day not to exceed 4 cups in 24 hours.

A few prunes (3) also have helped me in a pinch...few times a week (watch cal/carbs)...Some gain w/ carbs/sugar or get triggered hunger! It has been ok w/ me as it is seen as medicine and used accordingly!


Just my thoughts/ideas! I do Exercise/Water/Colace 2 day/Flaxseed 3T total a day and it generally is ok, only needing Miralax ~1x week or 3 prunes 1-2x week! J

Take Care,
Jamie
[email protected]


Take Care,
Jamie Ellis RN MS NPP

100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current)  5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005  Dr. King
www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
(deactivated member)
on 10/15/08 9:27 am - Long Island, NY
Thank you so much!! I am going out now to get some of the stuff you mentioned. I have tried MiraLax but did not think that I could take it everyday!


Thanks again.  
jamiecatlady5
on 10/15/08 8:19 pm - UPSTATE, NY
My clinical nutrition doctor(Dr. Denning) told me I could take it everyday and the risks of not were much much greater. I developed a anal fissure (crack basically) that hurt so bad w/o keeping things movng and softer kept opening up...Miralax is a godsend to me!!! Be well. But for you ask a health care provider what is best ok!
Take Care,
Jamie Ellis RN MS NPP

100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current)  5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005  Dr. King
www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Suzanne Fromtling
on 10/18/08 1:55 pm - Schenectady, NY
So glad to read what you had to say about the Miralax! Have some on hand from pre-surgery and no doubt will be giving it a try if what the surgeon suggests does not work. Haven't had a bowel movement since a tiny amount the day after surgery (September 30), which was more than likely residual from all the pre-op "clean out." Was on fluids for a while before surgery and after, but began eating pureed foods starting on October 9, nine days ago. So, I called the surgeon's office, and a few days ago they suggested using the Ducolax suppository, but when the wound care nurse called them, they changed it to using a fleet enema (enemy) ... not my favorite, but I sure can't imagine what not going all this time might be doing to me!

The surgeon says they prefer to work from the "bottom up," but (no pun intended!) considering the problem doesn't originate there, it seems rather useless to me.

In any case, was wondering if anyone else had used the Miralax, so thank you for that and all the input. You're just fantastic!

Warm Huggies ~ Suzanne

A good character is the best tombstone.  Those who loved you and were helped by you will remember you when forget-me-nots have withered.  Carve your name on hearts, not on marble. ~ Charles H. Spurgeon

Remember that everyone you meet is afraid of something, loves something and has lost something. ~ H. Jackson Brown, Jr.

Suzanne ~ Suzywoo2
www.woowebdesigns.com

blueyeleo18
on 10/20/08 8:56 pm - Schenectady, NY
Thank you so much Jamie,

I logged on this morning just to ask this question. I have been having constipation since surgery,I am one month out tomorrow the 22nd. I have always had constipation and did use Mirilax before. I have been doing the Fleets too (yuck)  I am going to start taking miralax now every morning in my Crystal Lite. :)
Lorie






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