CONSTIPATION--problem with so many of our drugs
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Ready, Bummer. Regretfully, it has been easier for docs to say just eat more fiber and drink more fluids than seek out the real cause of your problem.
Below is the Clinical Practice Guideline for colon care in neurologically injured patients. This one happens to be from the UK. But it's a universal guideline. If you care to find the guideline for the USA it could be found. This popped up first and it's an A-Z everything you need to know. Pathophysiology for different conditions and then management.
What you know is that you have a life long problem, that hasn't been given a proper diagnosis. In the end you don't care so much about a proper diagnosis, you are interested in everything coming out in the end without experiencing complications. i,e. colon rupture, diverticulosis.
Once you've read this 60 pages, you may be able to identify your problem, be able to go to your doc and say "I need this and this study to rule out these disease conditions". At that same visit, ask your doc to review what you want to do from the manual. Remember this is going to be a treatment and all treatments should be approved by your doc.
There is a multistep treatment plan to manage constipation defined within the manual, plus, a record keeping guideline. more sophisticated than what I've recommended.
This treatment plan components were developed for spinal cord injured patients. In their situation, literally, there is no colon movement. With that thought in mind you should be able to glean a plan for yourself, since you are above that level i.e very slow movement documented over decades, unresponsive to other modalities.
If you have a Regional Spinal Cord Rehabilitation or Acute care facility near you, you may be able to talk them into giving you a copy.
"Guidelines for Neurogenic Bowel Dysfunction in Individuals with Central Neurologic Conditions."
https://www.mascip.co.uk/wp-content/uploads/2015/02/CV653N-Neurogenic-Guidelines-Sept-2012.pdf
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Ready, This link lists spinal cord injury facilities by state.
http://www.sci-info-pages.com/rehabs.html
Plus, you could ask for a consult with an "Ostomy" nurse they are specially trained at Emory University in Georgia. You don't have an ostomy. But the ostomy nurse is the nurse trained in the therapeutic modalities in the manual in the last post.
The doc's order should read like this "Consult with Ostomy RN for Evaluation and Recommend Treatment Plan for intractable constipation". The word intractable in medicine means "we can't fix it" or "unresponsive to treatment". Make sure insurance covers the referral before seeing the Ostomy nurse. To get it paid for by insurance, you may have to have a better diagnostic word than intractable
It would be very cool to get the ostomy nurse, b/c you would have a resource for problems and troubleshooting after that. You will likely find her/him more knowledgeable than the docs that you have had in the past. Highly recommend them.
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Sas-schatzi - Thanks for the posts and links - I read them all, and it was quite informative. I don't know that I have any particular neurological problem - none of the ones specifically listed anyway. But obviously I have some motor issue, and massaging does help, so that seems to make sense.
One of the parts that stood out to me was the description of a "soft impaction" as being clay or putty-like in texture and just sitting in the rectum getting more and more impossible to get out. That's exactly what happened to me and happens way too often. So, that led me to google that in particular and guess what the main cause of that is?!! TOO MUCH soluble fiber! So all those doctors who kept telling me to keep increasing my fiber could have been making the problem much worse! It makes sense when I think about it. Duh!! It's like it absorbs too much fluid like a big wad of absorbing gel that actually stretches against and blocks the colon/rectum rather than making things a good consistency to keep moving.
So, I will give it a try decreasing fiber, especially the fiber supplements, for a couple of weeks, while increasing fluids and continuing the massaging and see if that helps0 -
Ready, Great that you have a plan to work on. With the motor thing. Think of it on a spectrum of
0(no motility<-----------------CS----------------------<Normal>--------------------------->180(diarrhea)
There are conditions that are related to low motility, but until you reach a clinically significant Constipation(CS)point the docs ignore it as a problem. Whereas, we may be quite uncomfortable with it.
I know you are reading the microbiome material on the weight thread. Seeking out a high quality probiotic from a reputable source is very important. I use Superdophilous that needs to be refrigerated. Consider Omega 3/6/9 Barleans. 2000mg a day. Neither should be exposed to heat.
But you may want to wait with those until you run your experiment with the lowering the fiber.
I mess up my microbiome every time I drink wine, but I don't want to give up my wine
Please, let us know how your experiment works, thanks sassy
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Is anyone aware of this? There are more recen studies on bile and breast cancer...
Why do constipated women appear to be at higher risk for breast cancer? The results of a 1989 study out of the American Journal of Public Health suggested a slight increased risk of breast cancer for both decreased frequency of bowel movements and firm stool consistency. Women who had three or more bowel movements a day appeared to cut their risk of breast cancer in half. This could be because constipation means a greater contact time between our waste and our intestinal wall, which may increase the formation and absorption of fecal mutagens--substances that cause DNA mutations and cancer--into our circulation, eventually ending up in breast tissue.
The concept that more frequent bowl movements decrease breast cancer risk dates back more than a century, where severe constipation, so-called "chronic intestinal stasis," was sometimes dealt with surgically. Figuring that the colon was an inessential part of the human anatomy, why not cure constipation by just cutting it out? After the surgery, they noticed that potentially precancerous changes in the breasts of constipated women seemed to disappear.
It would take another 70 years before researchers followed up on the clues by those distinguished surgeons who claimed breast pathology cleared when constipation was corrected. A 1981 study published in The Lancet investigated the relation between potentially precancerous changes in the breast and the frequency of bowl movements in nearly 1,500 women (See Breast Cancer and Constipation). The researchers found that the risk of precancerous changes was four times greater in women reporting two or fewer bowel movements a week compared to more than once daily.
We know that even the non-lactating breast actively takes up chemical substances from the blood. We also know that there are mutagens in feces. It is not unreasonable to suggest that potentially toxic substances derived from the colon have damaging or even carcinogenic effects upon the lining of the breast. Toxic substances like bile acids. Bile acids were first shown to promote tumors in mice in 1940, but subsequent experiments on rats led to the mistaken belief that bile acids just promoted existing cancers and couldn't initiate tumors themselves. However, there is a fundamental difference between the rodent models and human cancer. Rats only live a few years while humans can live dozens, so the opportunity for cancer causing mutations may be at least 30 times greater in humans. We now have at least 15 studies that show that bile acids can damage DNA, strongly suggesting they can initiate new cancers as well.
Bile acids are formed as a way of getting rid of excess cholesterol. Our liver dumps bile acids into the intestine for disposal, assuming our intestines will be packed with fiber to trap it and flush it out of the body. But if we haven't been eating enough fiber-rich whole plant foods, bile acids can be reabsorbed back into the body and build up in the breast.
Carcinogenic bile acids are found concentrated in the fluid of breast cysts at up to a hundred times the level found in the bloodstream. By radioactively tagging bile acids, researchers were able to show that intestinal bile acids rapidly gain access to the breast, where they can exert an estrogen-like cancer-promoting effect on breast tumor cells. This would explain why we see 50% higher bile acid levels in the bloodstream of newly diagnosed breast cancer victims. These findings support the concept of a relationship between intestinally-derived bile acids and risk of breast cancer. So how can we facilitate the removal of bile acids from our body?
Slowed colonic transit can increase bile acid levels. Therefore, to decrease absorption of bile acids, we can speed up the so-called "oro-anal transit time," the speed at which food goes from mouth to toilet, by eating lots of fiber. A diet packed with plants greatly increases bile acid excretion.
Fiber can bind up and remove other toxic elements like lead and mercury as well as cholesterol and bile acids. But plants can bind bile acids even independent of fiber. Vegan diets bind significantly more bile acid than lacto-ovo or non-vegetarian diets even at the same fiber intake, which could explain why individuals eating vegetarian might excrete less mutagenic feces in the first place.
I touched on this in my live presentation From Table to Able: Combating Disabling Diseases with Food, but what I didn't get to discuss is the relative bile acid binding abilities of different foods. I cover that in my video Which Vegetable Binds Bile Best?
What intestinal transit time should we be shooting for? See Food Mass Transit. That may be why Stool Size Matters. Also, How Many Bowel Movements Should You Have Every Day? We can improve speed and size by Bulking Up on Antioxidants and eating lots of whole plant foods (Prunes vs. Metamucil vs. Vegan Diet).
Fiber may also help women remove excess estrogen from their body. See my video Fiber vs. Breast Cancer. For more on the wonders of fiber, see Dr. Burkitt's F-Word Diet.
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Send to
Int J Food Sci Nutr. 2009;60 Suppl 6:116-25.Bile acids as possible human carcinogens: new tricks from an old dog.
Author information
Abstract
Bile first attracted man's interest long ago. The actual tumour-promoting effects of a bile acid were reported in 1939 for deoxycholic acid. Ever since, much evidence has accumulated that supports an important role for bile acids as cancer promoters in humans through DNA damage and selection for apoptosis-resistant cells, both of which can lead to increased mutation rates. The evidence reviewed here indicates that, in humans, bile acids are likely to be implicated in the aetiology of a number of different important cancers in terms of morbidity and mortality, such as cancer of the colon, oesophagus, stomach, pancreas, gall bladder and cancer of the breast.
- PMID:
- 19499433
- DOI:
- 10.1080/09637480902970967
- [Indexed for MEDLINE]
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nice Mari good stuff
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Foods that increase bile flow
Your liver manufactures bile primarily from the breakdown products of excess cholesterol, known as bile acids. Bile also contains lecithin, a substance that emulsifies, or disperses, fat particles, and waste products that the liver filters from the blood. The gallbladder stores bile and secretes it into the small intestine when you eat fat-containing foods, where it breaks large fat globules into smaller particles in preparation for the action of fat-digesting enzymes. Healthy, unobstructed flow of bile helps you digest foods and removes excess cholesterol and toxins from the body. Certain foods promote production and flow of bile.
Bitter Foods
Bitter foods offer particular benefits for enhancing bile secretion, according to a study published in a 2011 issue of "International Journal of Food Sciences and Nutrition." Taste receptors for bitter substances trigger your pancreas to secrete digestive enzymes and your gall bladder to release bile. Bitter artichoke, Cynara cardunculus, also known as cardoon, traditionally recommended by herbalists to stimulate appetite, relieve nausea and improve liver function, increases bile secretion by up to 150 percent. Bitter artichoke has also been shown to reduce abdominal pain, bloating and constipation. Native to the Mediterranean, bitter artichoke is related to the globe artichoke and has a mild, artichoke-like flavor. However, instead of the flower bud, the stalk of the plant is eaten.
Whole Grains
Whole grains improved bile flow in an animal study published in the May 2012 "Journal of Hygiene Research." In the 8-week study, a group that ate a diet supplemented with a mixture of whole grains showed significantly increased bile secretion compared to a group that consumed a diet supplemented with white rice flour. A study published in the December 2005 "British Journal of Nutrition" demonstrated bile-stimulating effects of oat bran. Animals that ate diets containing 500 grams of high-fiber oat flour per kilogram for 6 weeks showed higher bile acid secretion than a control group that ate an oat-free diet.
Fruits
Fiber in some fruits might increase bile production, according to an animal study published in the June 2009 "Journal of Agricultural and Food Chemistry." In the study, researchers modified insoluble fiber found naturally in starfruit and orange. The resulting smaller-sized fiber particles increased excretion of bile acids by 133 percent in a group of animals that ate diets supplemented with the fiber compared to a control group that did not receive fiber-supplemented diets. Additionally, the modified fruit fiber was 4 percent more effective at stimulating bile flow than unmodified fruit fiber.
Dandelion Root
Dandelion root, a highly regarded food and herb for supporting liver health, contains a compound called taraxacin, that promotes bile flow and helps to decrease liver congestion, according to nutritionist Jonny Bowden, author of "The 150 Healthiest Foods on Earth: The Surprising, Unbiased Truth about What You Should Eat and Why." You can prepare dandelion roots in similar ways to parsnips or make a beverage from dandelion root by drying then grinding it and brewing as you would tea or coffee.
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Have you al tried Miralx? Our dialysis patients on peritoneal dialysis had to keep Bowels clear or their Pd catheters wouldn't drain. Our docs would recommend the Miralax ( or generic) the same as the bowel prep for colonoscopy.......a dose in a cold glass of water hourly....usually after 4 doses even the most constipated would have a bm.
Now that I'm on fentanyl patch...it is constantly at war with the Herceptin diarrhea. It is so hard to find a happy medium. Constipation vs diarrhea
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It is so hard to find a happy medium. Constipation vs diarrhea
Beatmon, you think they would counteract each other and we would be normal
That would be too easy. I am constipated for days on end, and then diarrhoea for a couple - that is my normal these days.I was given a recipe by the palliative care nurses that works a treat for constipation. I have posted it on another thread, but it was pointed out that some of the products, which are OTC here, are not available in America unfortunately.
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Freya - would you mind re-posting here or sending a link to the thread? Thanks in advance.
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Yes Freya, I would like to see it too! Thank you.
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Hi Minus, actually it was on this thread (page 45), the mind just isn't what it used to be LOL. It turns out it was you that pointed out it wasn't possible to get all the products. For what it's worth I copied it below. The discussion we had about the products is on page 45.
1 tablespoon of Agarol
1 tablespoon of Lactulose
1 tablespoon of Normicol
Mix together in 1/2 (a half) a cup of warm milk and drink.
It has helped me immensely.
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Freya - well that means my mind is gone too. Sigh. Sorry I didn't remember. Thanks for re-posting.
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Okay, my fiends this will likely just gross you out. But you mentioned diarrhea. Diarrhea can get to the point that your poor anus is just burning like hell fire. Been there. You will never see this anywhere else . until it's plagiarized.
Poop as much as you can in the commode.. But if you are pooping so much that your anus is burning, Step into the shower, use the hand held shower unit. Spray it at your anus and poop in the shower as the poop is coming out. It will be relieving of that acidic pain. Then Clorox the shower.
Then protect the skin. Computer is Marjorly malfunctioning. . Sorry.
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Sas, I think most of us are well past anything "grossing" us out unfortunately. I have a friend with IBS who has told me the shower thing before.
I'm still trying to get over bacterial pneumonia, even though I am sleeping 16hrs a day (sleep for a couple of hours, wake up for an hour type of thing) I am so tired. Found a new word that is so apt, I thought it kind of fitted on this thread.
Exhaustipated - when you are just too tired to give a shit!
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I needed that chuckle today. Thanks.
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Good one, Freyya,
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mari, would you do me a favor and find two simple definitions of soluble and insoluble fiber and examples of each? I promised Readme I would do it. Computer is making me nuts because the b&n don't work. Using the screen keyboard is irritating beyond belief.
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Soluble and Insoluble Fiber: What's the Difference?
By Amanda Gardner Share on FacebookShare on TwitterShare on PinterestSaveEmailPrintFiber does way more than just keep you regular. The rough stuff can also help lower cholesterol, keep your blood sugar stable, make it easier to lose weight,, and even help keep you alive longer.
To get all those benefits, there are two types of fiber that your body needs: soluble and insoluble. Both come from plants and are forms of carbohydrates. But unlike other carbs, fiber can't be broken down and absorbed by your digestive system. Instead, as it moves through your body it slows digestion and makes your stools softer and easier to pass.
Most foods contain both insoluble and soluble fiber but are usually richer in one type than the other. The easiest way to tell them apart: Soluble fiber absorbs water, turning into a gel-like mush (think of what happens when you add water to oatmeal) while insoluble fiber doesn't (think of what happens when you add water to celery).
Soluble Fiber
Foods rich in this type of fiber include oatmeal, nuts, beans, apples, and blueberries.
The health benefits include:
Heart protection: Inside your digestive system, soluble fiber attaches to cholesterol particles and takes them out of the body, helping to reduce overall cholesterol levels and the risk of heart disease. Oatmeal may offer the most heart protection.
Diabetes protection: Because soluble fiber isn't well absorbed, it doesn't contribute to the blood sugar spikes that can put you at risk for type 2 diabetes and heart disease. If you already have diabetes (either type 1 or type 2) soluble fiber can even help keep your condition under control.
slideshow
High-Fiber Super Foods
startWeight loss: Soluble fiber can also help you get to -- or stay at -- a healthy weight by keeping you feeling full without adding many calories to your diet.
Healthy bowel movements: Soluble fiber soaks up water as it passes through your system, which helps bulk up your stool and guard against constipation and diarrhea. In fact, most fiber supplements contain mostly soluble fiber.
Insoluble Fiber
This is found in the seeds and skins of fruit (so always eat your peels) as well as whole-wheat bread and brown rice.
The health benefits include:
Weight loss: Like soluble fiber, insoluble fiber can play a key role in controlling weight by staving off hunger pangs.
Digestive health: Eating lots of insoluble fiber also helps keeps you regular, and if you do get constipated, adding more of it to your diet can get things moving. Insoluble fiber can also improve bowel-related health problems, like constipation, hemorrhoids, and fecal incontinence (problems controlling your bowel movements.)
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Thank you Mari
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Anytime Sas. If your order a new keyboard, I'm going for an illuminated one next time
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****************plus, type etc.
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Here are several memes for exhaustiped. Thought you would like them. Sorry for the size but the downsizing isn't holding.
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Whooopoophasdevelopedsomefuwordsyay!
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ump
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Just came across this thread re constipation. I had my first Prolia shot a few weeks ago and am experiencing this as a side effect, it is an issue I NEVER have trouble with so I am relating it to the shot. dsgirl, can you please share the recipe/proportions for this stewed fruit concoction so I can try it?? Thanks!
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cbaird99. Sure.
I use 1/4 of box of golden raisins, 1 bag of prunes, 1 bag of Apricots and and bag of cranberries. The bagged dried fruits are the small size, around 8-12 oz I think.
I cover dried fruit with water. stew om low for 2-3 hrs, stir to mix fruit, cool, and store in refrigerator. I eat 2-3 tablespoons a day, and have been regular ever since. It can be boring to eat this every day, but I don't dare not to, lol.
Hope it helps you too, let me know.
dsgirl
PS: next time I purchase the bags I will make a note of the oz. per bag of each, I am due to get more this week.
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I am suffering through constipation again after my second infusion of TC. About a week after my first infusion, it was so bad that when the Senokot took effect, I felt like I gave birth to a baby through my rectum, and then suffered with diarrhea for the next few days. AARGH!! I thought I could avoid it by starting Colace as soon as I had the next infusion, followed by one of the senna teas (called (Dieter's Tea), which helped a little bit but not enough. I think I'll try dsgirl's dried fruit recipe. Any other ideas for me? I heard people sing the praises of Miralax, but how is that different from Senokot? Will it also leave me with diarrhea? I appreciate any
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Tiny Dancer, Miralax is polyethylene glycol. it is the same chemical that's in all the pre for colonoscopy. it's abbreviated PEG. It is widely used. Way back here ,I did a couple of posts on it.
What I don't like about it is that the warning says not to be used by people with a history of kidney disease. That tells me there is a potential for absorption. PEG shouldn't be circulating in the body. Have I used it since, I learned that? Yes. But just for the scope prep.
Peg Mirlax is highly recommended by the American Society of Gastroenterologists. The bigwig docs of the GI system that establish national guidelines for that specialty.
BUT when possible use a natural product like the recipes here. They have been around centuries.
Think of do a clean out the day before chemo or prolix, or surgery. That way you are entering the situation empty.
Consider reading from the beginning, so, as to not miss any pearls(ideas). The thread has gotten long now, so, it may take some time
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