CONSTIPATION--problem with so many of our drugs
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Rosieo and friends, .each subspecialty of the American Medical Association has it's own governing body that reviews the problems that effect/affect their subspecialty. These guidelines below were last written in 2014 by the ACG . By the time a guideline for anything is written the info is already old. Not real old, but old. In the last 16 years there has been an explosion of information occurring in science in the study of the Microbiome. The info published by scientist re : the biome of the gut is going to be a major focus of research for the forseeable future. ( next 100 years)
In the guidelines note the mention of probiotics. Not all that long ago probiotics were spoken in whispers b/c it was considered quack science. Now it's quacking all over science. The microbiota of the gut is being connected to all sorts of systemic problems. A disruption in the flora of the gut directly is connected with IBS, CIC(chronic constipation). Whatever disrupts the flora of the gut causes illness. That statement is taking a flying leap. Science is producing more studies each month supporting that statement. Medicine is slow to respond when science produces evidence that is radical to the existing thought(paradigm). But the evidence is becoming overwhelming.
This summer I studied the microbiome while waiting for folks to post re: weight changes on a thread I did. I will link to that thread. Please, start from the beginning of the thread. When reading the linked articles, read for content. Try to pass by the statistics. Statistics are important to any study, but our intent is to get a sense of what the material is telling us. Drowning in numbers can cause us to loose sight of our goal.
The care and feeding of the gut biome is what we need to do to promote the health of the gut and the other body systems.(see next post)
There are so many chemicals that we ingest that alter the gut biome. Antibiotics are one of the biggest offenders. Doctors indiscriminate use of antibiotics since the modern introduction of antibiotics in 1939 with Penicillin and the subsequent development of other antibiotics has hurt us. The indiscriminate use of hormones and antibiotics in animals that then are ingested by us, has hurt us.
The increase in C-sections has hurt us. Yup, being born by C-section can hurt us later in life. By altering the total body biome which affects the immune system.
The connection to obesity and an altered gut biome is becoming stronger with research projects being produced in the last 16 years. Particularly, since 2010. I said a few posts ago that I rage at the Healthy Lifestyles ad programs of different organizations. Well, what won't be admitted by science and medicine for probably 50-100 years as historians look back at this time is that many of the diseases today were caused by our own interference with the natural function of the human body. Yes, recognition is occurring now, but the overall picture won't be truly understood for many years.
Below is a link to the accepted American College of Gastroenterologist management of IBS and CIC(chronic constipation). Reading this material from the linked page below and then wandering through the links re: the 2014 ACG guidelines will give you an idea of what medicine is accepting as the current approach to IBS and CIC. What you will conclude I think is, for those that have followed this thread from the beginning, we pretty well followed the guidelines. We are within accepted practice guidelines.
In reading the material on the Weight thread, what I hope to convince the reader is that we can carry our actions to the next level. That is again the care and the feeding of the gut microbiome.
http://gi.org/media/current-press-releases-and-media-statements/acg-review-in-ibs-and-cic-2014/
American College of Gastroenterology Releases Evidence-Based Systematic Review on Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation(2014)
Highlights of ACG's New Recommendations on IBS Therapies
- Special elimination diets may be effective, but existing evidence is weak.
- Fiber may be helpful in relieving IBS symptoms; there is better evidence in support of an effect of psyllium than of bran for IBS.
- Prebiotics and synbiotics have insufficient evidence of effect in IBS.
- Probiotics improve global symptoms, bloating and flatulence in IBS.
- Rifaxamin, a poorly absorbed antibiotic, has moderate evidence in support of effectiveness in IBS with diarrhea.
- Linaclotide and lubiprostone have strong recommendations for IBS with constipation.
- There is better evidence than in the past to support the use of antidepressants and psychological therapies in IBS.
Highlights of ACG's New Recommendations on CIC Therapies
- Fiber supplements are given a strong recommendation for use in CIC.
- Laxatives—including polyethylene glycol (PEG), lactulose, sodium picosulfate and bisacodyl—have strong recommendations for the treatment of CIC.
- Prucalopride, lubiprostone and linaclotide have been given strong recommendations for treatment of CIC.
"This new meta-analysis of the literature on the management of IBS and chronic idiopathic constipation offers physicians scientifically-based guidance to make clinical decisions about these conditions based on a thorough assessment of the evidence," said Lawrence R. Schiller, MD, FACG, who is also a member of the ACG Functional Bowel Disorders Task Force. "However, it is important that patients talk with their doctors about their treatment options, as there is no one-size-fits-all approach to managing IBS or chronic constipation. It's also vital that patients not be embarrassed to talk openly about their symptoms with their doctor in order to collaboratively determine the best treatment plan for their individual situation."
About IBS
For the clinical gastroenterologist, IBS is one of the most commonly seen digestive problems. IBS is characterized by abdominal discomfort associated with altered bowel function; structural and biochemical abnormalities are absent. The pathophysiology of IBS is multi-factorial. Individual symptoms have limited accuracy for diagnosing IBS, and the disorder is considered as a symptom complex.
About CIC
Constipation is a symptom-based disorder defined as unsatisfactory defecation, and is characterized by infrequent stools, difficult stool passage or both. Difficult stool passage includes straining, a sense of difficulty passing stool, incomplete evacuation, hard/lumpy stools, prolonged time to pass stool, or need for manual maneuvers to pass stool. CIC is defined as the presence of these symptoms for at least 3 months.
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The link to the weight thread. Sometimes we by pass topic boxes. In this case it's a must read to understand that there are really two subjects being discussed.1. my hypothesis about weight and cancer 2. the microbiome.
With the study of the microbiome, I followed the breadcrumbs that were identified from one article that was then connected to the next article. Is it absolutely important to read all the links. No. But it does make sense in the overall look at what is happening in the study of the microbiome.
To make a short story of all the reading, I suppose a spoiler alert, care and feeding of the biome of the gut is paramount to health. My study lead me to believe that the paleo diet was what I should work towards. I failed in that b/c it doesn't appeal to me. You can lead a horse to the trough, but you can't make him drink. Secondly, use of quality probiotics is necessary to support the health of the bacteria flora of the gut. Assuring the health of the flora will improve our health.
BBL with a dissertation on Probiotics.
https://community.breastcancer.org/forum/73/topics/832722?page=1
What was fun in the late part of the year, when someone challenged what I was writing. It lead to Dr. Susan Love's web page. She has an extensive section on the Microbiome. Many reference's parallel articles that I or others have sited. I thought that great fun.
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Sorry MT and Sas on your pain. I'm in pain tonight but that's only from boot camp. My butt is sore. On another note, I have another mammogram/ultrasound to be done tomorrow. Hope this is nothing.
Ladies, I hope you heel well!
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Judi, praying
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Thanks Sas. Will let you know the results! Our former "crack smoking/drinking" mayor died of cancer today at age 46. May not have been the best person but no one should die of this horrible disease.
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Judi - yeah i saw about your mayor's death. Do hope everything goes well tomorrow. Will be anxious to hear.
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Thanks MT. Will let you know. I'm going to the local hospital for the mamo/ultrasound as there was so much todo around getting my oncologist to do the test and it would have taken time. They wanted the original CT scan to compare, and then book the appointment. I just want this all done. Sad about the mayor. No one deserves this!
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Judi, will be thinking of you today. Hugs!
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Thanks April!
Will let you know the results!
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Judi - I just hope they tell you something instead of making you wait for a doc to call later.
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Looking good ladies! The person doing the mammas said it didn't look any different from the last mammo (different hospital, different tech, different radiologist). She said that if the radiologist was concerned, he would have wanted a ultrasound so one wasn't done. I've had two tequila shots to celebrate and feeling it. I'm going to lie down!
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Judi - Woo Hoo!! for news that sounds good. I especially like the tequila shots. One think I HATE about these pain meds it that I can't drink. A glass of wine in the evening is so nice.
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Judi, Judi, Judi..........whahoo!
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Thanks Sas. One more to go - see the thoracic surgeon to see what he thinks/wants to do and then follow-up with the family physician. I know the tech wasn't supposed to say anything but I was so glad she did. Makes life a little easier. I'm having no problem going to the washroom these days since off of the Letrozole. But I always wonder if it is "c". God, once you have it you can never get away with it.
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Happy for you Judi,
. I should be working on the probiotics thing, but ran out of steam. They're is so much good info coming out that is evidence based. I'll get to it when the mind gets back from it's walkabout.0 -
YAY JUDI!!!!
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Rosieo and friends. I discussed this link on the weight thread.
http://care.diabetesjournals.org/content/33/10/2277.full
Mechanisms linking gut microbiota to obesity, IR, and type 2 diabetes
My explanation: In this study it showed how gut disruption of bacteria can cause a change in Liposacchrides being able to cross into the portal circulation and then on into the rest of the body. The liposacchrides are related to endotoxins(bad bacteria). This study showed how these LPS's set up housekeeping in the liver and cause physical changes to structures within the liver that lead to Insulin Resistance and T2 diabetes
Those bad endotoxins found their way across a membrane. It described the changes in the intestinal wall caused by complex mechanisms that allowed this crossing to occur. This isn't normal. We weren't designed to have these bad bacteria cross this barrier.
The chain of events occurred b/c the balance of the gut was thrown off by a change in diet.
typing
Sorry, I went back to the study. Ain't up to deciphering it again. I used to have a memory that didn't forget. Well.......not anymore. I'll work on it when my mind is better. If you want to go to page 3 of the thread you can find what my thoughts were at the time.
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SAS - as usual, you are a wonder. Thanks for the advice I read about stopping pain meds for 48 hours to see if the gut would start working. With collace continually & senna w/colace too for several days, I was still unable to go after 10 days with all the Tramadol on board for my broken arm. Couldn't even do a Fleet since I only have one arm. Yesterday I stopped the Tram. Living on Aspirin for now & it's ouchy, but... Tonight finally some production. Funny because I had a friend go get me some glycerine suppositories this afternoon since I was really getting desperate. I guess just holding the bottle worked. So thanks even though I know you weren't addressing me. I'll be able to take the Tram Tuesday for the trip to the doc at least.
Can't believe it's only been 2 weeks so far with this dumb arm totally immobile. It already feels like a month. Broken in 4 places up by the shoulder. Of course no driving. Tuesday they'll do more X-rays to see if this treatment appears to be working or if we go w/plan "B" (surgery & pins). The hidden blessing? Certainly related to this thread... It's my non dominant arm so at least I can wipe once I have production.
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MT, I thought I was addressing you. The 48-72 hours is arbitrary. I find it's about half way through the day after skipping the morning dose that things are accomplished.. If you don't have one of those shower heads that can be taken off and sprayed on your bottom, I strongly recommend getting one. You will feel so much better. One time in a different fall, I broke a bone in the dominant hand. OMD, I have a bidet. Very unusual for the price range of my house. The lady that built the house was Japanese. Bless her. My criteria to return to work was I had to be able to wipe my bum. I was off 6 weeks with it. Boss was very unhappy. I asked if she wanted to volunteer, she backed off.
The things we talk about LOL.
Goole FootSmart. It's a catalog company. They have a foot washer that you put in the shower and you can rub your foot over it and through it. It 39$ I think. I was going to get one and got side tracked. Hard to wash your feet even with balance being thrown off. If you haven't gotten a shower chair. Sit on the toilet, works fine. Just lay a towel on the floor to keep from slipping.
I found the pain really changed at the 5.2 week point. Sleeping's a trip isn't it? It's always sumpin. I see the ortho doc April 1st. I feel your pain sweetie. It sucks.
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SAS - cute scrubber. Thanks for the ideas. I do have a bath chair from my double mastectomy days, and I have a hand held shower head. I'm so jealous that you have a bidet. I've always wanted one. I love your idea of challenging someone to help wipe if they want you somewhere bad enough. I'm so sorry, is your dominant arm/hand involved this time?
Just got up in the middle of the night with a brainstorm. Well, wasn't sleeping anyway, but I had to turn the computer back on. Somehow it never connected that popcorn is great fiber. For years I've eaten a bowl full at least three nights a week. So looking at fiber charts I apparently usually self select good fiber things, like raspberries & apples & oatmeal & All Bran & rye bread & black beans & green peas & broccoli & Brussels sprouts. I feel better about my self now even if I don't like whole-wheat spaghetti. Maybe I can get comfortable & sleep some. Almost 3:30am here.
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this may be a silly question but when is it constipation and when is it just there's not enough food in your system to move through? I haven't eaten anything solid in 3 days due to nausea so no bowel activity either. I did take a stool softener but nothing happened. Should I be concerned? TIA
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OMG Minus, the exchange between you and Sas had me LOL at my desk at work....especially when Sas asked her supervisor if she wanted to volunteer for the wiping job. Hahahahaha! Love it.
Hope you feel better. When in a lot of pain, the world just seems so dull and not at all vibrant. I do know quite a bit about chronic pain so don't envy someone who is not used to it at all. Hugs!
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April glad to have made you laugh. It is so good for the spirit, not matter what the subject or outcome(pun).
Tia, Hi. Generally it is said in most sources that three days without a movement is the bench mark for constipation. But you have asked the right question. If there's nothing in there, can you expect much to come out.
The body still produces fluid that as saliva, gastric juices and perhaps some juices from the upper duodenum. So even if you don't take much in, those juices travel through the small intestine into the colon. As it transits the large colon it becomes more solidified as it gets closer to the rectum. It's the consistency of watery sand as it enters the colon on the right and becomes solid and formed by the time it gets to the left rectum area.
Knowing how your body feels when constipated is important b/c it will help guide you to when to take 'something'. Bloating, abdominal pain, feeling icky, left sided/ rectal pressure. Hard stool when it exits is an important signal b/c it's too dry.
The body has a natural time that there is a cleansing wave from the esophagus(lower 2/3rds) through the whole system to the rectum. This generally occurs in the am. The trick is to be aware the wave is occurring and respond by assuming the position. For those that are lucky enough to be aware of the wave, they have a movement at the same time everyday. Sheldon's proverbial 7:00 am to 7:20 am. Any trick you can assist this wave to be successful is encouraged i.e a warm glass of lemon water or the Miralax the night before. Avoid laxatives/stool softner's as your aid if at all possible.
Another thing is the first stool out may be a bit hard. That is b/c the job of the colon at the end is to reabsorb water. Once that stool passes it generally stimulates the colon to work. The stool behind it is, generally, formed or even a bit loose. This part of the wave may come in a second stool within a period of time after the first stool .i.e.20 minutes. That is b/c it is coming from higher in the colon and the reabsorption of water hasn't occurred. The reason I say this is b/c some may describe this is more of a diarrheal type stool rather than a normal stool. This can get someone to thinking that IBS/IBD is present rather than this being normal. By definition of these problems, they are alternating constipation and diarrhea when what is really happening is normal. As with anything when we get to the extremes is when we should be concerned.
Know thyself, know thy colon
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Hello ladies! Well, just got power back late yesterday evening. Off since 5:30 p.m. Thursday, March 24th so I've had no contact. Thanks for the laughs Sas and MT. You are both too funny. MT, popcorn works like a "charm". I've been eating 3 cups a day and not only does it's job, it also supposed to be a 'stress reliever". Hmmm, worry about not going, eat popcorn to relieve the stress of worrying about not going!
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Sas, thanks so much! Great explanation and kind of what I assumed. I don't have any constipation symptoms and I'm pretty empty so I'll give it another day or 2. I'm drinking lots of water so hopefully that will aide the process.
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((((((((JUDI)))))))))))) no electricity for 5 days in the far north. You must have an alternate heat source and all kinds of survival plans set up. I know it's off topic. But I love survival planning. Always can learn more tricks. I used to do disaster work, now it's just an avocational interest. Glad you survived
Myra glad it helped
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Sas, just pure wit, warm clothing and cell phone. Had lots of water to drink and as they started opening up restaurants, places to eat. They did set up "warming centres" but only knew this after I got power. Now I know that I have to set up "google" on my cell phone. All I can say is that I'm glad it was not January/February when this happened!
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Ha, ha ladies. I had the worst supper the last two nights. I bought this sweet and sour pork from the grocer's (Sobey's). I made it last night with Rice a Roni and ate it last night and tonight. Tonight I had a lot of gas. Thank God I knew when to go and not think it was gas. Pure diarrhea. Even the wet gas I have to be careful with. Boy, I'd share this gem with you but I live too far away. I'll make sure never to buy this crap again!
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And on that happy note, I've gone from totally plugged to watery explosions just by stopping the Tramadol 5 days ago & switching to aspirin. Panty liners again!!! It's enough to make you want to spit.
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