CONSTIPATION--problem with so many of our drugs
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Morning Ladies, glad we work collectively as we are all trying to find our way
Loverly several posts back I wrote two questionnaires. If you can run them off and complete. The constipation form you can likely file for now. Complete the diarrhea one. You will eventually take the diarrhea one with you to the docs. Please, get going on the appointment for the GI doc. It'll take several weeks to get in to one once you have chosen one. Loverly, can you post the link to the Marble machine?
MT loosing my mind, when Loverly posts the Marble Machine, you will see why
Thanks on the Quinarcine Judy when did you start posting? It coincided with the discussion about you being prescribed the Quinarcine.
Have a nice day
Enjoying all the subtleties of life in the end 0 -
Thanks MT. The Infectous Disease Doctor had it compounded so you have to find a pharmacy that does compounding. MT was right - Quinacrine hcl 100 mg - Quantity is Quinacrine Hydrochloride 2.1630. Sure appreciate you posting this for me.
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Sas, I started posting on this thread on May 6, 2015. MT, put me on to it. Yes, it did as I just had a colonscopy and was told I had Diverticulosis and with the cancer drugs, etc. I couldn't go. I had seen the Infectious Disease Dr. and was going over my drug to get rid of Giardia.
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MinusTwo, on the poop calendar, consider a smiley face with a smile or a frown, and size the happy smiley to indicate size. the frown one of course meaning "no go".
I am still doing well on the apricot, prune, golden raisins and cranberry stew I cook up, eat approx. 3 tablespoons a day atop of my greek yogurt, don't even need the fiber supplement. I do drink a cup of warm water before brewing my coffee, and "go" before I have coffee, breakfast and meds. So thankful for this thread that lists solutions to constipation problems.
Dsgirl
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Thanks, MT. Quinacrine is an interesting drug, but I guess no longer available in Canada either.
Ms. Sas, I have not seen a GI doc. What other tests could I ask PCP to run? I have different insurance now so different docs. I have learned to live with this IBS. Sucks at times. The probiotics might be helping me though ( if only I remember to take it regularly). When IBS is active, I have to use the restroom about 30-60 minutes after eating and as soon as I wake up in the morning. I truly believe my stomach issues is stress related. Like I said earlier, when I am on vacation stools are good majority of the times. Maybe I should take more vacations
Here is the link to the marbles machine. Enjoy.
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Oops....technical difficulties. Double posting.
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WEll been on Aromasin for two weeks and guess what!!!! YES, its a no go, at best slow tiny go situation......was not like this before on Aromasin but now, so totally fed up, and full up! Need to plan a strategy, wáter, prunes not working.........................
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lover, I looked up making my own sauerkraut . Sadly I keep forgetting I haven it to eat. Suppose to be best flora for the intestines. I believe it was just cabbage and kosher salt in water. But do look it up. It creates lactick acid...spelled that wrong.....which keeps the cabbage good for a long time. Suppose to be best pro biotic out there. I did real well while I remembered to eat it. Good luc
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LOVERLY WORK WITH ME
Look I wish you could get appointments with both docs at the same time, but it's not going to happen.
Loverly, you have an alteration of the bowel. It occurred at a specific time. Cut and dried. It occurred in Nepal. You need a bowel evaluation just b/c it's gone on to long. You need stool studies. Local ova an parasite testing may not cover your problem.
Outrageous and fun thought take a stool sample to the vet. No joke try it.
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Lover, the drug is available but the pharmacy must obtain it. Obviously, the pharmacy was able to compound it. I think it is not available at all drug stores. You won't know what is available to work on you until you see a GP/Infectious Disease Doctor as Sas as told you to do, and the plan is then put into place on what drug is needed to eliminate whatever bug/parasite is residing in your system. If it was up to me, I would have been there yesterday. We all tend to think we know what is wrong with us as we "google" stuff now to find out what's wrong immediately. Remember "google" can be a good or bad thing but only a GP/Infectious Disease Doctor who order the test will confirm what you have!
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Thank you, Ms. Sas. Started on the diary of stool and food intake. Will make the appointment to see PCP. I guess I am a bit hesitant to go through with the testings again. The thought of it honestly stress me out. I know, dysfunctional thinking. IBShas become part of my life and sadly I have learned to live with it.
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Dear Loverly, you had a start point. That is way different than an unkown. you all had a bug. Not happy, that all weren't tested. Not happy no resolution. The importance of Judi's story is she found a doc that lisented. Again, notnsyingyou have the same bug, Loverly,, your life was altered by a bug. We are going to get that bug;---------yes, sink it,,,,,,,,,,,,,,,,
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Susan, thank you! I can handlesauerkraut.
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Good morning ladies! Sas, you are so right. It is so important to be tested to make sure that whatever is in your gut, that should be there, is properly treated. Lover, it is a big pain what you are going through but trust me, after 20 years you don't want it. Also, you have to be so careful when handling food, etc., so not to contaminate and make anyone else sick. Funny, my last doc asked me if I should be doing my job as a health inspector (inspecting restaurants) being +ve for Giardia. I told her, take me off with a note and I would be happy. She just laughed and didn't give two hoots. As Sas said, I was lucky to find a doc who genuinely was interested in me and loves his job. Get going girl!
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Loverly, I was pretty tough on you in that last post. SORRY. I took the bitchy stuff out. PULEESE pretty puleese............Get doc to do a GI referral. I so would love for you to see an Infectious Disease doc., but the Gi doc should rule out other stuff before you see the ID doc.
Judi can you ask you ID doc if he knows anyone in Sacramento?
Hey Lily, your body definitely doesn't like AI's
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my GI doc has never been extremely helpful. Doesn't go outside the box ever. Just stays with proven, normal, widely perscribbed stuff. Had a ton of tests over the years. Even into my small intestine. Push and pull enteroscopy. I have had I t all done. No polyps, no internal problems, perfect, beautiful intestines. So I guess pain doesn't show up o tests...go figure. The more I exercise, the better I am. Prob things just move better. But exercise is done when feeling better, so not good consistency on that.
Good luck everyone
Thanks for all your research sas
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Susan okay.
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chemo yesterday. Takes a while to get back to normal. Nausea, constipation, then a well relieved blow out. Same old. Not comfy right now. Usually ok by Sunday . Never been able to get on the other side of it. But at least it's only 4 days til normal. And maybe that is the best it can be.
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Sas, done! I will email the infectious disease doctor and ask!
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PATIENT INFORMATION SHEET
CONSTIPATION
Constipation and Cancer Patients:
There are many reasons why a cancer patient may have constipation, such as:
- Some medications, such as pain medications, certain anti-emetics and some types of chemotherapy, can cause constipation. The constipation from narcotic pain relievers occurs in most patients, and should be prevented in advance.
- Reduced activity and poor eating habits, often caused by the cancer and its treatment, can also cause constipation. Reduced intake of fluids and high fibre foods, along with general weakness and fatigue, reduce the body's ability to keep regular bowel movements.
- Blockage of the bowels by tumours or invasion of the bowels by cancer cells. Some of the signs of constipation
- No regular bowel movement for 3 or more days.
- Small, hard stools (bowel movements).
- Leakage of stools, resembling diarrhea.
- Stomach ache or cramps, bloated abdomen (belly), feeling of fullness or discomfort.
- Passing excess gas or belching.
- Nausea or vomiting. What should you do if you notice any of these symptoms: If you have not had a bowel movement for 3 or more days (or 2 days, if you are using regular laxatives), you should call your doctor or nurse. You may need some medication to help you start having regular bowel movements again. You should call your doctor if you have any of the following symptoms:
- Blood in the anal canal or stools
- Abdominal cramps or pain for 2 or more days For more information on this medication, please call your doctor, pharmacist or nurse, or call the Cancer Information Service at 1-888-939-3333.
Constipation
CONSTIPATION DUE TO MEDICATION? e.g. narcotics or chemotherapy
- DIETARY MEASURES – Increase consumption of fluids & fibre-containing foods such as bran, fruits & vegetables, prune juice and figs. Drink 8 or more glasses of non-caffeinated liquids each day.
- NORMAL BOWEL HABITS, e.g. do not delay bowel movements.
Try stimulant laxative, SENOKOT® (senna): 1 to 4 tablets twice daily (in the morning and in the evening), starts working in 6 to 12 hours (maximum dose 8 tablets/day)
AND / OR
Stool softeners:
COLACE® (docusate sodium) 100mg capsules: 1 to 2 twice daily, each morning and evening, starts working in 12 to 72 hours.
SURFAK® (Docusate Calcium) 240mg capsules: 1 to 2 capsules daily (may be taken once or twice daily), starts working in 12 to 72 hours.
If still constipated: increase Senokot® to maximum daily dose of 8 tablets a day AND take MILK OF MAGNESIA (MOM)*: 30 to 60 mL at bedtime.
OR
Change Senokot® to stimulant laxative DULCOLAX® (bisacodyl) 5mg tablet: 1 to 3 tablets aday.
*Consult with your pharmacist or physician if you have heart or kidney problems before taking this medication.If still constipated: add ACILAC® (lactulose): 15 mL (1 tablespoon) two to four times daily.
If still constipated, contact your physician, primary nurse or pharmacist.
Only after consultation should the following laxatives be used to relieve your constipation and they should be used on an 'as needed' basis only:
Glycerin Suppository : starts working in 15 minutes to 1 hour.
Bisacodyl Suppository : starts working in 15 minutes to 1 hour.Fleet® Enema : starts working almost instantaneously.
f
For medication (e.g. narcotics or chemotherapy) induced constipation, avoid bulk
orming laxatives that contain psyllium such as Metamucil® or Mucilax® . For low
fibre diet-induced constipation, take a psyllium laxative 12 to 30 grams daily in 3
divided doses, with plenty of fluids.
Prepared by the Toronto Sunnybrook Regional Cancer Centre Pharmacy. Revised by the Cancer Care Ontario-Professional Pharmacy Advisory Committee- Medication Information Sheets Working Group. Any comments about the contents of this sheet, please email: drugformulary@cancercare.on.ca Date: May, 2005
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Sas, I found the above when I was looking for the Infectious Disease Doctor's email. I was given this was I met with the oncologist at the start of my treatment.
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Sas, this is the Infectious Disease (IF) doctor's office response.
He is back in the office next week so I will ask him
Sent from my iPhone
On Apr 14, 2016, at 8:55 PM, Judi Hishon <judihishon@sympatico.ca> wrote:Hi Sharon
I am a member of a cancer group and one member who is responsible for the "Constipation" thread was so impressed with Dr. Stuart. This member is a nurse and couldn't believe that he was able to get rid of my Giardia. I've touted Dr. Stuart to many.
Anyways, she asked me if I could ask if Dr. Stuart knew of any Infectious Disease doctor(s) in Sacramento, California and could I pass on this info to her if I was successful in obtaining any names.
Could you let me know.
Thanks.
Judi0 -
Thanks Judi. Good docs gravitate to other good doc's. That's not to demean the run of the mill docs. In med school and residency, it is drilled into them the importance of following the accepted practice until science identifies a different way. Then they have a meeting i.e like ASCO. Each subspecialty has a governing body. This is to assure that practice is firmly grounded in Evidence Based Research. BUT what is not drilled into them is the Sherlock Holmes attitude. If a patient falls outside of the normal of the abnormal, the patient can get lost in the system. It's in this abnormal of the abnormal that docs can make a huge change. It takes a different effort.
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LOverly Hootie Hoo. Are you pissed at me. Yes, you have the right to be pissed. I haven't done a good job at communicating. So, I will try to do better. Interesting that Lily popped in. I did the same with her when we were trying to fix her. Then I settled into it and did better. Please, allow me to do better. Ultimately, Lily made the very personal decision to stop a drug. Now finding the same problem with another drug.
I'm going to review each one of your posts and see what I can put together.
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Apr. 9th--you and judi had shared stories. You posted
" foul smelling bright yellow watery stool" Occurrence every few weeks. Watery stools rare formed. GI noisy before each episode. The episode wipes you out. Then all you want to do is sleep.
Tested upon return for giardia, ova parasites---negative.
Discussion about gallbladder might be an origin for foul smelling greasy yellowish stool(combining Judi's and Loverly description of stool)
Judi plugs the toilet. >>>>start flushing when it happens>>don't use paper till all stool flushed from commode.
Apr 10th, Location Kathmandu, Nepal. Suspected food related b/c 3:4 ate the same food at an orphanage. One didn't and didn't get sick.
Of the 3 that got sick. Daughter first to be sick. That was ________days after eating at the orphanage. DH & LOverly sick one week later.
Common s/s's diarrhea 2-3 days, N&V, fever. Neither DD or DH had bright yellow watery stool
Tested upon return for giardia, ova parasites---negative.
Apr 13th: Ongoing s/s abdominal pain upper & lower Gi then explosive diarrhea. with sweating and feeling like passing out " Can't seem to pin point which foods trigger it besides high fat. Stress makes it worse." "When IBS is active, I have to use the restroom about 30-60 minutes after eating and as soon as I wake up in the morning"' on vacation stools are good majority of the times."
Tests: CT mild fatty liver, celiac neg,
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Okay Loverly, went over your posts again. Been holding back about one test. Need to do some research. L
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Hey Sas, no problem communicating with doc. When I get an answer, I'll post it here. Interesting point you made re "the practice is firmly grounded in evidence base research". That is the new norm now. I am not against this as sometimes they just go around in circles but we do need "the good bedside manner, knowledge, and understanding". All go together hand-in-hand. What did you think of my post earlier re what the hospital gave me for "constipation"?
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Sas, I was thinking Lover may have a couple of bugs in her intestine - both S. pylori and Giardia. Can one hide the other?
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Judi, the constipation handout is the usual for cancer centers. Nicely done. It's an a several step plan that identifies action related to severity. Very similar to what we have been doing here for years. Also, very similar to other members that posted plans given to them by their cancer centers. What's nice is it's routine to address constipation as a problem right up front. When I started this thread it was not the common approach. The several step plan is important.
I think the addition of cautionaries about not using suppositories or fleets in an immunocompromised state would be good. A newbie soon learns what that means. It's safer to clearly define it.
They didn't mention Magnesium Citrate. That has always been my go to suggestion for severe known drug induced constipation. Plus, for those that constipation is a real plugger with ongoing chemo, should consideration of a pre-emptive clean out be done before chemo. Way back I had pdgraham post her experience. I influenced her to do that b/c nothing worked. She did experience the pfitt's, but the trade off was comfort in the chemo period.
Susan, ever do a preemptive clean out?
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Loverly Healthgrades does a nice presentation on yellow stools. Healthgrades does nice teaching info. It covers our concerns of Giardia. But you tested negative?
http://www.healthgrades.com/symptoms/yellow-stool
You do have liver fat noted on CT. Liver fat in someone your weight is unusual. Liver fat is associated with certain conditions. Obesity and alcohol are the biggies. You don't have those risk factors. The cause of liver fat should be pursued to a conclusion i.e. diagnosis.
Liver fat can be present up till a certain % without it being noted in the impression. It's in the radiology guidelines. Once it reaches the % and is reported, they're is a fair amount of fat. (I quizzed a radiologist on it one time).
You do describe that when you have an event it occurs 30-60 minutes after you eat and that there is an association with fat. Your s/s's and complaints do fit a liver/gallbladder origin. You don't necessarily have to have stones, all that's needed is sludge. Sludge doesn't show up on imaging.
You note that you haven't identified any food triggers other than a loose(pun) connection to fat as noted above. You have the stool diary going, but to make it really work for you, a food diary needs to be done. So, very very tedious and necessary.
The morning stool being loose falls more in the normal range than abnormal. It has to do with a normal body thing of evacuation in the am. There is a peristaltic wave from the esophagus to the anus. If we pay attention to this we will generally evacuate the same time every day. With the normal BM there is a certain amount of what can be perceived as pain, but it is normal.
I didn't see that the yellow stools are a constant. Are they? I read that it occurs every few weeks.
Who made the IBS diagnosis? Based on what tests?
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