CONSTIPATION--problem with so many of our drugs
Comments
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SAS - My last chemo was 12/11 & I haven't taken any meds except my normal vitamin supplements since then. Now all of a sudden I'm having BIG C problems. Seems if i don't take a Collace every couple of days for a couple of days, the stools are so big & hard I feel like I'm being split in two. (sorry for the graphic - TMI, but...) Drinking prune juice at least 2 days a week too. I'm not eating that much yet since my taste is still off - but I'm sure confused what might be causing this constipation. BTW - all through both sets of chemos, I had Big D instead of Big C. Go figure. The Collace is from my first surgery in 2011 since I know anesthesia causes me problems, but I hate to keep taking it. Any thoughts?
THIS IS A WONDERFUL THREAD. Glad you keep bumping.
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OH MY Minus Two I'm so sorry , I haven't been watching. God lord I hope you didn't rupture something.
First thoughts, check in with your doc...reason you have had a new onset change. I'll think or try to think of what to ask and plan. But I do think wityh any new onset change the safe practice is a doc check in. In this case if you have a GI doc that would be good. But your PCP is good to.I would go first to my PCP, but I also call her Saint PCP. I don't necessarily think MO's are good for this b/c they may not cover all the basics. I'll type this so you can cut and paste or print and fill in the answers to take with you for doc visit
History of present problem: New onset constipation
When did it start?
Description of stools ?
How often? How many days between stools?
Abdominal Pain with stools?
How much liquid do you drink a day?(take a couple of days and actually measure)
Location of pain?
Does pain in abdomen remain after stools?
What cause you to finely evacuate? (you've continued taking colace, but if you don't take it you have large hard stools--did I get that right?)
other things used to promote evacuation?(prunes)
Physical description of stools?
Change in medications?when?what?
Pain meds? Change? How many per day?
Talk to PCP about following plan:
1. Miralax daily.
2.Stewed prunes/apricots warm with some lemon in am..
3.Probiotics-tsp to a tablespoon a day for a week.
4. Colace PRN
5. Emergency plan: meaning what do you do if your regular plan isn't working and you need to poop.
6. Develop a bowel retraining plan: basically using the 1-4 working it through overtime until your bowel functions again on it's own.
This plan is a mix of recommendation from the gastroenterology guidelines--miralax daily. Stewed prunes or apricots-- common SUCCESSFUL method here. Warm water and lemon another common plan----so if you put them together it may make it all come out in the end very smoothly and easily
Probiotics, something may have disrupted the good bacteria that you aren't aware of. Colace the common doc go to med, but you want to wean away from all drugs eventually.Have an emergency plan i.e. no BM in ____days what can you use? My go to drug is a bottle of magnesium citrate, but the aftermath is the squirts for a few days. Sometimes unpredictable. For me severe constipation can occur after I've used oxy for a couple of days when I have a bone/joint/ muscle flare.
The key here is you 've involved your doc. Reread the first page on my posts about diverticulosis/itis. The doc is going to ask questions to assure you haven't got something going on. You said the thread is wonderful---tells me you've read it. Many wonderful ideas here. If there's something from here you like, add it to the plan above.
What I like about walking into the doc's office with a plan, is it causes them to focus on what you are saying, They can see it in writing, this further focuses their attention. They then can say yay or nay to each item.
You're then able to leave the office with a clear plan with all the bases covered. I'll cut and paste this to you in a PM. If you need me in the future and I haven't responded, please, PM.
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Thanks SAS. I re-read the first page. Oh, I miss Apple. I KNOW I'm not getting enough fluids. I forced them to give me a full litter today at the infusion center before they started Herceptin. I'm seeing a new PCP/Internal Med doc on Monday so I'll keep up Colace until then. I have your list of questions printed.
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Minus Two, glad the post and PM helped. You have identified a major element in function of the colon. Liquid. So, much of what occurs with constipation can start with a change in moisture of the stool. Hmmmmmm I write about such fascinating things LOL. So if you will bear with me, I'll write a few more thoughts.
I'm delighted. I checked back on the first page. The very thoughts I was thinking of to write to you, were there YAY. I don't have to think too hard(pun) to describe how important liquid is to the smooth workings (pun) of the colon. I'm cutting and pasting those thought to here. If I have any new thoughts I'll bold them or add a note at the bottom.
Pg1---"Backing up for a moment-----the large colon has several functions. One is related to the absorption of some nutrients, but that is not cogent to this conversation-------so I will bypass it.
The colon stores stool and reabsorbs water. Stool exits the small intestine on the right side lower quadrant, at that point it is the consistency of sand. It then travels up the right side across the top part of the abdomen , then goes down the left side, The last portion of the large colon is called the sigmoid colon. It generally has a shape that could be described as a "s". In truth, it's shaped differently to a degree in each of us. As the stool moves along this path more water is absorbed from it. By the time it reaches the sigmoid colon it becomes formed.
If the core body lacks enough water, it draws more fluid out of the stool. In this case then the stool that reaches the last part of the colon will be very dry-------constipated------hard. The muscles of the colon wall have a very hard time pushing it forward. If this occurs the stool in the rectal vault-the portion just above the anus becomes very hard and difficult to pass. and painful. They look like little hard rocks. In pushing this hard stool out, the pressure causes the blood vessels to dilate. These dilated blood vessels are called hemorrhoids.
They are analogous to varicose veins of the legs or esophageal varices of the esophagus, or aneurysms.The point being when blood vessels in the body are put under too much pressure in the body , they will dilate. Eventually they will burst and bleeding will occur. The larger the blood vessel when it bursts the greater the bleeding.
The needs of the body for fluids are dependent on climate to a great degree. Each individual has a different need. Your doc and reading will describe range. 8-12 oz glasses a day. But again each body is different. Plus there may be other conditions that can influence how much you can drink i.e heart and kidney disease.
Using two supplements can work to your advantage and also promote health of the rest of the body. Omega 3 OIL either Flaxseed or fish. Buy a good brand from a healthfood store. Some brands should never be exposed to heat and need refrigeration. I would never buy off the super market shelf. The second is superdohilous -it has acidopilous and multiple other strains of normal colon bacteria. The quality again is based on where you buy it. Of course discuss this with your doc.
SO, the plan to train the colon:
1.In the morning allow enough time to take a proper poop. That may mean adding ten to 15 minutes to your morning routine.
2 Immediately upon awakening drink the warm water 8 -16 oz's. That will begin the process that gets the trained colon to be prepared to function within a short time. Continue with usual routine shower / shave etc. As soon as the colon signals it's ready to go. Don't delay, go. If you delay the body starts to reabsorb that water from the stool at the end colon. Too much of a delay can lead to constipation.
3. Keep the colon healthy by eating between 25-35 grams of fiber a day-average 30gms.The amount needed is being changed by science in these last few years, so, don't be surprised when you read different numbers. General Mills Fiber One has the highest cereal fiber content in the smallest amont of food . I swear they stole my phrase taste like cardboard. "No longer tastes like cardboard". Definitely has improved over last few years. If you started off each day with a 1/3 bowl you can meet a 1/3 of the days requirements. The average American only gets 12-13 gms of fiber a day.
4 Drink enough fluids otherwise you will become constipated. 8-12 glasses a day.
5 Consider adding omega 3 (flax or fish) and acidophilous to diet(more than what yogurt offers) which colonizes the last portion of the small intestine, and bifidius and many more colonizes the large intestine. Superdophilous is a probiotic that includes many of the good bacteria. Should be purchased through a reputable nutritional store. There is still much debate about Probiotics. If you wish to google it, please, use the following search term "Evidence based researech probiotics".
6 Be aware of the things that alter bowel function------PAIN meds, alcohol, antibiotics, other prescription meds. Dehydration. Illness. Overuse of antibiotics. Some medications can affect the motility of the gastrointestinal tract. This means it slows down or speeds up the way the muscular layer of the GI tract works. Other drugs kill off the good bacteria of the GI tract.
This covers the basics, great topic eh?
ADDITION TODAY 2/72014: A bit repetitive LOL, but I am consistent.
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Minus Two: I have posted this last paragraph on multiple other threads. , please, put the link in your storage area. For you, I would suggest studying all your meds before your visit with your new doc Monday. Concentrating on the gastrointestinal affect for each drug. In your case Herceptin. Also, take a look at Colace.
One thing that I've learned about drugs over time is------just when you think you know it all about a drug, re-look at it when something changes. Something that may not have meant much in a previous reading may jump out at you b/c of the new change
In case you don't have this link. It's a drug site that is great even though it was done by the government. Why is it GREAT! 1. after putting the drug name in the search box and the list is pulled up,the first drug manufacturer is the one that originated the drug. 2. importance---all the pre-approval clinical trial documentation is there 3. all post marketing data is there 4. hyperlinks throughout to connect within the report for easy referencing between topics.
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Minus Two-----------I miss Apple too, when I read older post areas and see her smiling face, she brings back so many happy memories of the great lady she was.
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SAS - the radiation oncologist today approved adding back in Omega 3. Hooray. I've been w/o it since last March since the MO said to cut for chemo. In addition to colon & bowels, it sure makes my knees bend easier. No antioxidants during rads so no Vit. E, but I'll settle for the fish oil for now.
I'm not in "dire straights". One Colace a day is keeping me soft enough for government work. Actually it reverted back the other way tonight. I'll post here too that before cancer, the juniper berries in the Gin & Tonics I drank always did a wonderful job of keeping me regular. Regular for me for 50/60/70 years was always one bowel movement every two or three days. I've never been a 'once a day' girl, but not for lack of my Mother's nagging.
You're right about the water. I really need to start concentrating on that since I'm starting radiation severely under weight & already dehydrated.
I'll look into the acidophilous. Thanks for all the posts. They're so helpful
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MinusTwo, I had horrible C when I was on chemo. I actually ended up in the ER with a bowel impaction. They prescribed something called GoLightly which really cleaned out my bowels. Before that I was taking two collace, senna and prunes everyday. After the impaction I started eating fiber one cereal with a glass of plum smart every morning. I also try to have a pear everyday and drink lots of water. Made all the difference for me. I know everyone is different, but I was able to get off of the colace and senna. After awhile those things just didn't work for me. Good luck, I hope it gets better for you.
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SDB's I think you'll get a laugh out of this. Back in the 90's I had a bowel problem presenting symptoms constipation and pain left side. I worked in a center that had some great GI doc's. Was scheduled for colonoscopy. The clean out was "so much fun" Pain left, but we proceeded with scope.
But the experience made me think. I asked my Gi doc if a study had ever been done to evaluate how many patients with the same presenting symptoms, had all symptoms disappear after go-lightly. He just smiled---no answer. I pondered. My conclusion was "if a high percentage of patients had all symptoms disappear after go-lightly , and there was a high percentage of these same patients that had negative scopes, would a reasonable safe first approach be to simply use go-lightly as a first intervention without a scope, and monitor progress" Study would include--hemacults on stool and evaluating and adjusting for risk factors and age. Post go-lightly adjust diet/fluids, and re-establish normal bacterial flora with probiotics.
I then realized if that approach was taken the reduction of scopes could likely be substantially reduced.
Also, if you look at the different historical cultural practices of many societies, there was a use of "something" in the spring and fall to clean the colon----Interesting? USA as a cultural group did this up till about the 60-'s. Then it essentially stopped. It was carried on by smaller ethnic groups , but overall it was something no longer done.
From then on I talked my GI doc into giving me go-lightly once a year for myself, DH, DS. I voluntarily took it. DH and DS thought I was killing them.
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Go-lightly counterparts are NU-lytely, and Tri-lytley. My phrase for them is go-lotley. They are covered by insurance for specific reasons only. My thing of the yearly clear out had to stop b/c insurance wouldn't cover it b/c it didn't meet their criteria for use. But with a script they can be purchased. $45-60$. An alternative that is inexpensive is magnesium citrate. 2-4$ a bottle have found though that I do have squirts for a few days after mag citrate.. BUT when I choose to use it, it's b/c the constipation is threatening the pre-existing diverticulosis to act up.
With the go-lytlley nu & tri,, I have NOT experienced the after squirts Keep in mind if you use these products you won't have a BM for several days -----b/c there's no stool in the system
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sas, Actually I think you may be on to something there. Ten years ago I had a colostomy and a reversal. Since then I've always had a hardening around where they sewed up the colostomy. I was told by my doctors that it was just scar tissue left over from the surgery. After taking the GoLightly it went away. I notice it slowly coming back, although not as bad. It really was unbelievable how well it worked. Interesting assessment.
Edit: just saw your Go-alotly. Hahaha - I said the same thing - also Go-Quickly. Great minds!
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SDB If you do the go/nu or tri let me know what you think of the outcome LOL. Love how this subject is so easy to make a double entendre about. Seriously, though the go/nu/tri is so superior to mag it's amazing. I would be doing it today. The whole system functions better for months and months. I figured what it helped in doing was wipe any negative over growth of bad bacteria. No proof, but if something feels so good and functions so much better-----somethings different.
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hahaha - good one! I think a once a year cleaning is an excellent idea. Kinda like cleaning out our closets.
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I have never had chemo, have a system that only functions when my schedule is regular and all the stars align. Given that I work full time, in a job where I just can't leave to use the bathroom, I find my constipation problems worsening. Ironic as for almost 30 years I never had a problem due to multiple cases of amoebic dysentery and giardiasis when I was in the Peace Corps. Colace is not working, prunes no longer work,I take probiotics, eat lots of fiber and only drink water. Off to pick up some Miralax, dried pears and senna tea!
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EXBR---HOLY CHIT! those are some bad bugs---worse that having to watch "Married with Children" every morning with the new BF. Bad joke. Not what you signed up for when you listened to JFK's speech.
Exbr, we know each other from other threads. I know you are very knowledgeable and proactive RE: your health. Knowing you I would guess that b/c of the change you've been evaluated by your doc, in particular, Gastroentrologist. For others reading new onset changes should always be evaluated by your doc.
Exbr:The only thing in your plan that's not working is really not part of your plan. Evacuating your colon when it signals, not when the job does. In colon retraining which complete methods can be found on the net. Two key components are necessary : 1. recognition of the signals that the colon is ready to evacuate and 2. responding to the signal by having a bowel movement. If the signals to evacuate are ignored over time things don't signal well. Too simplistic and okay, or not making sense?
Work isn't cooperating,...................Chit, I hate when that happens. It's Like Oliver Twist.
Look at spinal cord injured bowel training programs. This is a shot in the dark. The routines are generally done every three days. Particularly, if daily caretakers aren't involved. A CNA goes in inserts the suppositories, leaves for a couple other calls, then returns and completes the routine of stool removal.
My thought being that you could pick apart this type of program and see what you can apply to yourself.
This again supports why the GI doc eval. You are describing a gastric motility problem versus other i.e obstruction. Is the motility problem a primary cause i.e nerve, or 2ndary timing.
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re: colonsopies - and a more conservative approach.... colonoscopes are hard to clean: http://www.cnbc.com/id/100798338 and in fact can spread disease from one patient to another.... also I know someone who had a perforated colon and peritonitis and nearly died from one.... a fecal occult blood test can detect 70-80% of cancers, and has no risk.....
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boy can i relate
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Colace 100mg 2 tabs twice a day and senokot 2 tabs twice a day. Neither one will your body become dependent on. Colace brings water from the bowel into the stool to keep it soft. You must drink a full glass of water when you take the pills. The senna is a natural vegetable laxative that will not cause cramping.
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SDB--------CONGRATULATIONS AND MANY MORE PASSINGS IN YOUR FUTURE
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I was under the impression that one could become dependent on senna. Sas?
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Flavia--------How I respond---dunno. The article states the problem correctly. As one of my duties in a surgery center that also did scopes and many other procedures, was to monitor the patient under IV Conscious Sedation. A qualified nurse needs to be on that side of the table. The person assisting the doc with the scope on the other side of the table can be a RN, LPN, or GI technician. I was always very happy that I didn't need to learn that side of the table. Actually, it was the only job in the building that I didn't do.
Not just anyone can assist the doc or clean the scopes. The training is extensive. The responsibility is taken very seriously.
There is risk. Everything has risk. It would take a textbook of time writing here for me to explain. I'm staring at the computer hoping for words to come forth out of my fingertips that can help all understand that while the article states the risk, depending on hemacults to be anywhere near the usefullness of a colonoscopy is risking your life. By the time you have a positive fecal sample for blood, the cancer may be to advanced to do anything or must be treated with surgery/chemo/radiation.
Yes, fecal stool samples can detect 70-80% of the cancers, but again it's because the cancer is much further in it's growth. What the hemacult is testing is for blood. By the time a lesion causes blood, there has been something that caused enough tissue disruption to allow blood cells to mix with stool and be evacuated.
A scope can catch a growth in the earliest stage, where cutting it off is simple like a skin lesion, and that tissue/lesion is NOT considered cancerous.
But if left to grow quietly , uninterrupted because it can't be seen, then one day this noncancerous lesion/growth crosses the line in it's cellular growing and becomes cancer.
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EX working the problem check back for my answer. I have an answer, but searching for evidence based resaerch
While I'm gathering some info to complete my thoughts, please read my post on page 10 re:laxatives
Starting to construct an answer please be patient:
YOOHOO HERE I AM---THERE ARE 328 EVIDENCE BASED CONSTIPATION ARTICLES IN PUB MED. i'VE GOT THROUGH 60 SOME. i'M TIRED OF READING ABOUT POOPING AND LAXATIVES. MY LEGS ARE SWOLLEN AND MY SWEETIE IS HOME. i WILL REVISIT THE SUBJECT SOON.
I HAVE FOUND ARTICLES THAT SAY YES AND NO TO THE QUESTION. SO, MANY MORE ARTICLES NEED TO BE LOOKED AT. FOR THOSE NOT USED TO SEARCHING , NOT UNCOMMON TO LOOK AT 100-200 ABSTRACTS. THEN NARROWING IT DOWN TO 20-25 BEST. THEN LOOKING AT THOSE TO SEE WHAT THE PROS AND CONS ARE ON THE QUESTION. ANYONE BASING IT B/C THEIR DOC SAID SO CAN DO THAT, BUT....................
I HAVE BEEN READING FOR HOURS AND i HAVE THREE OUT OF 60 SOME ABSTRACTS THAT I COPIED HERE. I DID HOWEVER BREAK TO LET THE DOGS RUN BY THE FARM SO THEY COULD POOP.
J Clin Gastroenterol. 2003 May-Jun;36(5):386-9.
Is chronic use of stimulant laxatives harmful to the colon?
Author information
Abstract
Although stimulant laxatives cause structural damage to surface epithelial cells that is of uncertain functional significance, there is no convincing evidence that their chronic use causes structural or functional impairment of enteric nerves or intestinal smooth muscle. Nor are there reliable data to link chronic use of stimulant laxatives to colorectal cancer and other tumors. The risks of laxative abuse have been overemphasized, and this has minimized their rational use by physicians. Stimulant laxatives may be used chronically when patients fail to respond adequately to bulk or osmotic laxatives alone. These can be combined with bulk or osmotic laxatives in sufficient amounts to soften the stool, or they can be used alone, according to clinical circumstances. The dose of such agents should be titrated to effect. Bisacodyl may be used if anthraquinone laxatives are unsatisfactory.
- PMID:
- 12702977
- [PubMed - indexed for MEDLINE]
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J Clin Gastroenterol. 1998 Jun;26(4):283-6.
Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited.
Joo JS, Ehrenpreis ED, Gonzalez L, Kaye M, Breno S, Wexner SD, Zaitman D, Secrest K.
Author information
Abstract
Cathartic colon is a historic term for the anatomic alteration of the colon secondary to chronic stimulant laxative use. Because some have questioned whether this is a real entity, we investigated changes occurring on barium enema in patients ingesting stimulant laxatives. Our study consisted of two parts. In part 1, a retrospective review of consecutive barium enemas performed on two groups of patients with chronic constipation (group 1, stimulant laxative use [n=29]; group 2, no stimulant laxative use [n=26]) was presented to a radiologist who was blinded to the patient group. A data sheet containing classic descriptions of cathartic colon was completed for each study. Chronic stimulant laxative use was defined as stimulant laxative ingestion more than three times per week for 1 year or longer. To confirm the findings of the retrospective study, 18 consecutive patients who were chronic stimulant laxative users underwent barium enema examination, and data sheets for cathartic colon were completed by another radiologist (part 2). Colonic redundancy (group 1, 34.5%; group 2, 19.2%) and dilatation (group 1, 44.8%; group 2, 23.1%) were frequent radiographic findings in both patient groups and were not significantly different in the two groups. Loss of haustral folds, however, was a common finding in group 1 (27.6%) but was not seen in group 2 (p < 0.005). Loss of haustral markings occurred in 15 (40.5%) of the total stimulant laxative users in the two parts of the study and was seen in the left colon of 6 (40%) patients, in the right colon of 2 (13.3%) patients, in the transverse colon of 5 (33.3%) patients, and in the entire colon of 2 (13.3%) patients. Loss of haustra was seen in patients chronically ingesting bisacodyl, phenolpthalein, senna, and casanthranol. We conclude that long-term stimulant laxative use results in anatomic changes in the colon characterized by loss of haustral folds, a finding that suggests neuronal injury or damage to colonic longitudinal musculature caused by these agents.
- PMID:
- 9649012
- [PubMed - indexed for MEDLINE]
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Am J Hosp Pharm. 1977 Mar;34(3):291-300.
Use and abuse of laxatives.
Abstract
Colon physiology, the causes of constipation, an approach to management of constipation, and the features of various laxatives are reviewed. The categories of individual agents discussed include the bulk-forming laxatives, stimulant cathartics, saline laxatives, hyperosmotic laxatives, surfactant laxatives, emollient laxatives, enemas and suppositories. Dietary change and attention to proper bowel habits are frequently the only therapy necessary for the treatment of constipation. When laxative intervention is necessary, one of the milder agents should be employed over a short period of time. The chronic abuse of stimulant cathartics, often deeply rooted in family or ethnic traditions, is a significant problem and difficult to treat.
- PMID:
- 324272
- [PubMed - indexed for MEDLINE]
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Just as any of you who research, you know you have to read allot to get the exact answer you are looking for. THEN there's the diverging........ Well on one quest, I located something else that I just had to follow the breadcrumbs----this is on probiotics. The info of how to evaluate a probiotic and why they are useful is/are good. But the breadcrumb of verifying the evaluator Consumers Guide http://consumersguides.com/ isn't/wasn't easy.
Consumersguide was rated by Alexa. Alexa is a legit business-they just measure business stuff, there's a technical word for it_________metrics. I've used them before in following other breadcrumbs.
http://www.alexa.com/siteinfo/consumersguides.com
and Scamadvisor which is a legit business. They rate CC suspicious because the actual owner of ConsumersGuide is hidden.
http://www.scamadviser.com/check-website/consumers...
They still could be a legit organization, but it does cause one to wonder whether or not they receive behind the scenes money to rate a product. So I'm going to post the info from the page I found but delete the products. That way 1. it follows BCO rules to not try to sell something 2. I can't verify the breadcrumb trail, but I've researched enough about probiotics to know what is being said is true and they are saying it better than I can. This will take a few minutes b/c I have about ten or so browser windows open. Then I will go back to the original question.
Well that was fun-- NOT. I couldn't get the page to copy and paste. So, I will leave this now and continue on the original quest. If you connect to the consumersguide page evaluating probiotics. ignore the info regarding the products mentioned.
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bump
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The question: Can a person become dependent on senna?
In the above three abstracts you will find conflicting statement regarding whether a patient can become dependent on senna. The first two abstracts state that structural changes can occur in the colon. The second abstract defines that it is the haustral fold that are altered. The below link defines what haustral folds are and what the function they perform.
This statement from the wise/geek description "Because the formation of sacculations increases the surface area of the large intestine, this helps the colon achieve its three primary functions of retaining, transporting, and finally eliminating digested material as fecal matter. Muscles of the colon move the watery waste material forward and slowly absorb excess water. Soluble and insoluble indigestible carbohydrates travel down the large intestine.
As material travels from one haustrum to the next, a majority of the water is removed. Digestive remains are mixed with bacteria and mucus to make feces. Next, this material moves to the ascending colon where more water is removed, and the stools become more solid as they travel along into the descending colon. At this point, intestinal bacteria use some of the fiber to nourish themselves.
Haustral churning is the sequential movement of colon contents from one haustra to the next. These contractions are slow movements, during which one haustrum expands as material fills it, causing the muscles to contract, and the contents are pushed to the next haustrum. In this manner, waste material from digestion is moved through the colon. A diet high in fiber and fruits can help most people avoid problems with their colon and assist haustral movement."
http://www.wisegeek.org/what-are-haustra.htm
MY answer to the question of whether senna can cause dependency:
In science unless an absolute connection is made then it's not made. So, technically the answer to whether or not someone can become dependent on senna and other stimulant laxatives CANNOT be stated as yes or no b/c no absolute connection in nerve alteration could be scientifically established . The fact that stimulant laxatives change the structure of the colon by altering Haustral folds is important to consider in long term use. What is agreed upon is that senna and all stimulant laxatives should not be used as a routine long term management of constipation.
I haven't looked at the emollient laxatives---colace was part of the intitial full statement re dependencies a few posts ago.
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These links are to a web based research center. A subject is discussed by the author similar to what I have done with the question re: senna dependency. The first link is on constipation. Generally, it states what I have stated. The second link is to the main page that states what they do, how they do it.
What I like about the site is it reviews the subjects based on evidence based research with links to the research from which the based there article on. AH-HaH---LOL, I just realized I like them because that's the way I do it.
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Not sure these links will be helpful, but perhaps there is something in there new?!:
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Thanks Mods appreciate it
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answer reposted from another thread. This is an editorial opinion by me.
Chevy there are 12 pages of pooping suggestions on the constipation thread. Members had all kinds of suggestions. The most commonly reported effective things, I put into a combined recipe is-- Stewed prunes and or apricots(from fresh if available), taken with a warm glass of water with lemon in it, with senna--either as a pill or a tea. The most common orthodox(Doc recommended) plan was Miralax.
After about page 8, I reread all the responses and tabulated what were the "treatments". The stewed prunes and apricots were number one. I thought this very nice b/c it's centuries old versus Mirilax which is polyethylene-glycol ,a manmade chemical. Manmade chemicals have been found to be a problem many years later. There's some very outrageous damning stuff about Polyethylene-glycol (PEG) on the web. Here's one http://www.gutsense.org/gutsense/the-role-of-mira... But we won't know for a long time if it's really as friendly as the American Society of Gastroenterologist claim or as bad as the manmade invention from 1930 era Margarine was with it's trans-fatty acids. This wasn't identified as a health risk until the last decade or so. The American Heart Association pushed margarine as a better alternative to butter for decades. The system that the margarine hurt the worst was the vascular system. Ironic. GOOD LORD Chevy, it was a simple question about pooping.
I'd go with the centuries old approach. Hmm, hope that statement becomes literal.
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i don't really know what my system is doing. It's different every day. Right now, I am taking colase every night and eating chia seeds and drinking lots more water. That seems to be working. I still have not gotten in touch with gi doc. I call and it just rings and rings. I'm thinking of pushing the number that is for doctors, just to see if someone answers. Weird. I have a ct scan on Friday. Sas--did I ask you this already...would a ct scan pick up on stuff going on in the colon? Not to be to gross, but I only have blood when the bm is a certain size and I think it tears something? But I am concerned because I have read this entire thread and other info you have posted and the other things that I picked up on were that I have always been constipated, always. And now the only time it doesn't hurt to go is when it is pencil thin or not solid. And I feel like I don't have any muscles working down there...like no contractions? Sorry that is tmi. Thank you for sharing your knowledge sas...and for everyone's suggestions!
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