bm's

Ok, another question. I haven't had a bm since 9/21.09; I'm worried; should I be? I have spoken to my doctor's office, they said to take milk of mag., and I have. I'm not in any discomfort, but still concerned. I had a rny 9/1/09. I am passing gas. Is this gross or what???

Not gross but concerning for this nurse. You really should be having a BM every three days at the very least especially if you are eating anything solid. Passing gas is a very good sign, that means things are working. My surgeon recommened MIRALAX when I started to have problems. I'm not a fan of milk-of-mag for any one. Here's what I did to resolve my issue --- I took MIRALAX every night for a week and now that it is resolved I take it every three days just to keep things moving.

Good luck!

Call back surgeons office if you are worried or perhaps repeat MOM!


Here is my typical info on constipatin post RNY COMMON!!!!!!!

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!!! Benefiber IMHO is worthless and made issues WORSE for me even thugh it doesn't swell it made my concrete butt issue bigger! Literally!
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 I had this issue so bad that I developed a PAINFUL anal fissure (crack in anal area) that did not want to heal, (moist environment yeast loves to breed in)..so Miralax OTC or by RX called GLYCOLAX was a lifesaver!

thank you so much, i have miralax, and i was using it, I will return to it. I did finally go.