CONSTIPATION--problem with so many of our drugs
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Bump for me
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OMG, this has been a huge problem for me during chemo. A couple weeks ago, I seriously considered going to the hospital because I was in so much pain trying to have a BM. I have a hemorroid too, which made it worse, and of course it bleeds every time I'm constipated. I felt like I was giving birth through my butt! I tried mineral oil, prunes, lots of fruit juice, coffee, etc. Finally got some relief, but it's a recurring problem. I seem to alternate between constipation and diarrhea. Ugh...
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My oncologist told me to start Miralax every day as soon as I started chemo. I didn't want to take it so I didn't and got into some serious problems with constipation, I was miserable but finally I listened to her and it did the job...I was afraid it would be "too strong" but it was gentle and easy and I had no problems once I got started. I am still taking it as I continue to recover from the side effects of the chemo, she told me it would be 6 months to a year before I would be "back to normal" so I am trying to be patient...I'm so sorry you are going thru this (((spartygirl))), I hope you find an answer that helps you...(((Hugs))) Maureen
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So glad to have found this thread!
Post-surgery I had extreme issues. I didn't go for... 9 days? And even after that it was little teeny rocks. It took at least 2-3 weeks for me to start having bowel movements that even vaguely resembled "normal." More than once I was stuck on the toilet for 1-2 HOURS, worse than childbirth, really was traumatic!
For me it was the anti-nausea meds, I think, plus a bit of narcotics didn't help, but once I stopped taking any meds I started getting back on track. In the meantime, all the colace and veggies and prunes and senna and probiotics and stuff did nothing to get me going.
So I'm starting chemo in just over a week and terrified I will have similar results! But also worried that if I take something preventatively, I'll be the one to end up with diarrhea instead, and complicate things by taking stool softners. I just want the first round to go as smoothly a possible. So do I take something the day before/day of? Wait and see how I respond first? (I am getting TCx4.) Some of my nausea meds are the same ones I took after surgery so I'm really worried. What would be most gentle & effective without causing the opposite problem?
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indenial, I had major constipation issues with my chemo, same painfully traumatic toilet experiences as you! I would highly recommend starting a stool softener the day before chemo (they are gentle, something like colace) and continuing throughout the chemo. Drink lots of water, don't be afraid of Metamucil, and keep a gentle (senokot) laxative on hand. I needed to use all of the above on a daily (sometimes twice daily) basis and finally the only thing that ended up helping in the end was the addition of lactulose syrup. I had never had this problem in my life before so I couldn't believe how many bowel meds I ended up on, but my MO said you have to do what you have to do. I'm now 3+ months post chemo and all is good again with no meds whatsoever
(didn't take too long either, only a couple of weeks) good luck!0 -
Ducky, colon ulceration generally starts with "something" , a cellular change, bacterial, viral( I'd have to google but sounds plausible as viruses attack many things). The bacterial(possible viral) change can cause a diarrhea with a pass through of intestinal contents from the small intestine through to the large intestine also known as the colon. The contents of the small intestine are a different pH than the large intestine. The large intestine/colon the lining can be inflammed, craters or ulcers can occur. The inflamation can be so severe that passing of stool can be interferred with. The lining can be ulcerated or lost. When this happens bleeding can occur. If the ulcer is near a blood vessel, depending on size of the vessel, bleeding can range from small to severe. This is known as a GI bleed-gastrointestinal(stomachintiestine) bleed. If the intestinal wall is breached b/c of ulceration or break , it is known as a perforation. A perforation is an acute medical emergency s/s's increasing abdominal pain,'fever, board like abdomen. Google for further info b/c that's not the problem now.
There are conditions of the colon that the problem originates in the colon versus as a result of stool from the small intestine. The management can be the same or different-- depends. BUT big BUT for you (YEAH) the pain has reduced since you started the med. So, as your doc has said continuing the med appears good until you are seen by GI doc. The reduction in pain confirms that the intestinal environment is likely less inflamed. Otherwise, there would be no change in your symptoms. The right sided pain can mean it's still the colon nearest anus as anatomically there are variations, but could be over to right colon. Google keywords "picture of colon" or "anatomy of colon". What to report: symptoms change or worsen. Check each stool for blood can vary from bright red to black. Different reasons for the color reasons, the key is to report the change b/c it identifies a condition change and management changes.
Skin care of rectal area. As the colon can be inflammed , the tissue around the rectum can feel as if it's burned when freguent diarrhea occurs. Some suggestions. 1. Use a squezze bottle filled with water to spray on area before wiping. 2. Wipe gently or PAT clean, using Tucks can be good --place in fridge to keep cold. Very soothing on a burning butt. 3. Apply a soothing rectal ointment once skin clean. Ask doc for recommendation, many products on market or availble by prescription. MY personal favorite is Bag Balm. 4. Careful handwashing with an antibacterial soap is good. In severe situations using gloves even for your own bottom is good, then still wash hands thoroughly. 5. In woman care must be taken to not contaminate the vagina and urinary opening. I think this is the only thing that guys have, that's an advantage.
Ducky going to transfer this to my teaching library and my constipation thread. I write about such fun stuff LOL. I'll bring back the links for the constipation thread, and the diarrhea thread that Jill(?) started. You may find some pearls or nuggets(pun) on either. Sassy/sheila
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Good Morning-friends, have been working on an issue with a member. Wanted to share with you all the note below b/c of it's importance. Hope you find it useful Sassy
(members name deleted) Glad the link helped. If you get the AARP magazine this months issue (probably dated may 2013) , there is a story about the safest hospitals and what safety procedures that are in place that cause them to be safe. The article cites that 180,000 people die a year due to medical/surgical errors AND 400,000 drug errors are made a year. The articles states that these numbers are likely higher b/c these are the ones that are reported. I agree. I know you've seen where I've said on the threads "Sorry etc for too much info, just want too make you(BCO memebers) safer". Guess I should stop apologizing for writing stuff in this regard. These numbers are higher then the last set of numbers that I had known. The problem is either getting worse OR there is better reporting. I'll go with better reporting.
It cited that one of the safety items was having an ICU Intensivist. It cited that only 35% of hospitals had Intensivist. I was dismayed at this percentage since residencies for Critical Care Medicine have been available since the 1980's. Truly thought by now that the "industry" would have been driven by demand for better care that this statistic would be 70 to 80%. ICU medicine is absolutely in need of a specially trained doc. Just as in all subspecialties of the American Medical Association(AMA), the knowledge and skills of this subspecialty are critical to survival when a patient is at this level of need.
I'm going to post this on the threads, I'll take off identifiers. My hope is those seeing this will locate a copy of the AARP article. Read it throroughly. Then question there local hospitals on each item. Based on what they elicit re:safety of each facility, they can choose the safest hospital near them for care. It can mean the difference between life and death, and or avoidable complications. Spreading the word to others regarding this may save lives.
Your description of where your friends daughter is now is typical. So, the care may have been fine or she recovered in spite of them. I'll go with the care b/c of your description of how she appears now. What was truly lacking here was the communication in lay terms to the family of was what was going on with the patient. All the lay person then can do observing is assume, as in this patients case, there appeared to be fractured care delivery and choas. What can the untrained person concluded observing this. As in all care, communication is the center of it all. Very often even the care givers question what the recovery will be. AND then the patient pulls through. Continuing with evaluating the records will lend a lot to the understanding of this event.
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Here's how I was feeling yesterday. slightly better today!
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Repost from another thread in response to Phgraham,
Went to get constipation link, and see that you've been there, 8 pages talking poop, if you can't find sumpin to get you going let me know and i'll do a search. BTW your taking calcium because of? Calcium as you likely know is a constipator, add that to opiods-narcotics, it's like mixing cement. If your taking the calcium b/c of ostopenia/osteoporosis, a talk with your doc is in order to see what they recommend. The problem is not just the pain and discomfort of constipation. Prolonged and or severe constipation puts to much stress on the colon wall. Can lead to troubles like diverticulitosis(condition of pouches on colon wall) diverticulitis(inflammation of the pouches). Pg 1 on C thread I did a thing on divertic. Not recommending you change tx w/o talking to doc, but chat with them about not taking the two on the same day, or reducing calcium dose when taking narc. Watch your diet for things that can bind like cheese i.e high calcium foods. Is there any food in your past that only caused loose stools that you removed from your diet? Cabbage soup for me is a true thing to cause diarrhea Ugh. So, the thought being if you had a food trigger that caused diarrhea in the past that isn't contraindicated( definition--Do not use) with present drugs, re-add that to your diet and see what the outcome(pun intended) is. Actually measure for several days how much fluid your drinking. Calcium+ narcs+ to little fluids= reinforced concrete. Discussion of high fiber diets has fallen into disfavor by the American Society of Gastroenterologists. BUT BUT it does not mean that all GI docs agree with it. This position is very contraversial at this point.Good luck with outcome sassy---Transferring this to constipation thread
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sas - I read through all 8 freekin' pages! I read them through the last time I had chemo also. I was thinking it might be the senna-s that was causing the cramping (and not working all that well) so I quit taking it. I have always had cramping with any kind of laxative. Once before I had tried room temp prune juice followed by hot tea with the senna-s and that sorta worked.
Yesterday I went with my fiber supplement, warm prune juice and hot tea. The good news is that I was able to poop! The bad news is that I still had the same sicky cramping in my belly. I'm thinking that a 10 foot python lives in there now and is still trying to get comfy.
Today I'm going with the fiber and half of the prune juice and hot tea and see where we get. I will also monitor my water intake. I've always been able to drink LOTS of water - between 2-3 liters a day, but with my taste buds dying, I might have been slacking. I'll check it. And yes, I cut out the calcium until MO yells about it. She and I had a mild argument last fall, after treatment, about whether EVERY WOMAN in the world needs it. I think I'm special - no osteopenia, no osteoporosis and no signs of such. She got all technical on me and I lost the thread of the conversation, except that I was supposed to take the calcium
I really might be able to stand this forking chemo if I can just get my gut to go along with it.
Thanks for you help here. You are the BEST!!!
Phyllis
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Hi, I'm learning a lot thru this topic. Thank you all!
About adequate water intake: a registered dietician told me to examine the color of my urine. If I am getting enough water, my urine should be the color of light lemonade. Anything deeper yellow means your water intake is not enough.
Tried it for several days, some of which I was able to drink a lot of water and other days I didn't. Quite a difference in the color of my urine.
Question: Pre, during, and post mastectomy I treated myself to Fiji water. The best bottled water I've ever tasted, absolutely no after taste like I get with other waters.
Now it's time to get real with the budget. Fiji is the most expensive water around. Has anyone found a bottled water with no after taste that's reasonably priced?
Peggy0 -
One more thing. A doctor I know recommended cooking up a batch of dried prunes, dried apricots, and any other tasty dried fruit in your grocery. Add slices of lemon which you will discard at the end of stewing these fruits in water (she left it to me to figure out the amount of water, since it was her grandmother's recipe and she hadn't made it in some time.)
It worked but i have two concerns about using it frequently: 1. It takes a lot of time to make up a batch of this and 2. We're supposed to be cutting back on sugar and these dried fruits contain a lot of sugar.
Today I need to go. I look pregnant. Going to try some of your suggestions.
Peggy0 -
Peggy, I can sometimes drink tea, but I've always liked water better plus it's easier on your kidneys. Now though with chemotastebuds, I'm having a harder time. Doesn't seem to matter whether filtered or bottled for me. Good luck!
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Thanks ph, I'll never forget the chemo taste buds. Every thing tasted like cardboard to me except for McDonald's strawberry jam. Only McDonalds serves it (it is made specifically for this chain restaurant) and my DH would go to different McDonalds trying to buy a case of it and some days he would come home with three packets for $0.15 cents and other days he'd hit the jackpot and bring a bag home free.
Does anything taste good to you now?
Peggy0 -
Peggy, great addition about checking urine color. I bet if you contacted McDonalds , they would send you a bunch. Love your doc's GM's recipe. The overall opinions in the first eight pages, identified apricots and prunes and lemon as the best to get things moving. It just seems logical with that in mind that putting them together would really work well. Probably at least 12 to 18 oz's of water would give enough for two days. Adding Ginger would help with nausea. (Avoid ginger if on coumadin/warfarin).
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Phyll, if that cramping doesn't straighten out check-in with your doc. or let us know when you pass that python. Glad you cleaned out some. Reading so many pages on pooping is not something any of ever thought we do! That's why I say any pun that comes to mind alleviates some of the serious thinking about such an uncomfortable topic. We should get Chevy here for a few posts . Her wit would certainly help!
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Saw this on active thread, don't know if this has been suggested: I go to Costco and get their LARGE bag of pitted prunes. Use about 8, add water, lemon juice, or lime juice, microwave for a minute or so - and eating them MOISTENED is important, work faster. Also HYDRATION is crucial, drink more water than you ever thought you'd be able to drink. good luck.
eta: NO CHEESE when you are constipated - it will only add to the problem.
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Sunflower Thanks, all have been discussed, but each are so important, rementioning them always has value.
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Note on hydration, Previous post mention the average amount an adult should drink--arrorximatly 2 liters a day. We just had a discussion re: measuring what you actually drink versus what you think your drinking. And then looking at urine color. Pale to clear urine idicates --well hydrated. Dark yellow indicates poor hydration. This is medically referred to as concentrated urine.
Would like to add if you determine your hydration status indicates you need more fluids. Add these fluids slowly over several days till you reach your goal of the amount you want to maintain daily. The important reason for this is you want your body to adjust. The kidney is responsible for maintaining fluid balance. The kidney just like any organ needs time to "recognize" changing levels. It will then change how it controls these levels. If too much is added at one time, it may not adjust fast enough. This would then stress the heart. Just as too much fiber added to the diet in a short period of time can lead to blockage or obstruction, too much fluid can lead to problems. The key is moderation when initiating something new
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I haven't read all pages so maybe its mentioned but, magnesium 500 mg a day. I tried a lot of things that just didn't work but this was the magic bullet for me. But it had to be 500 not 250. I have to take calcium because of being on XGEVA. I think its good to take the mag with the calcium for absorbtion anyway. Try it out. Just plain cheap mag oxide pills.
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Apr 30, 2013 09:52 PM, edited Apr 30, 2013 11:17 PM by sas-schatzi
Scottie and Cami and all, I reviewed multiple articles with changing keywords. Keywords as we all know change what we pull as responses. The words I put about the immunocomprimised person are the same. I did find a nicely written article about "Rectal Administration of Medication"
www.healthline.com/galecontent...
The significance of this article is that is directed at nurses as to how to do it correctly. For us as patients, it gives us a guide to know what is correct. For those of us that need to have a home guide, it is valuable for self use, or training someone to do this for us. The ideal would be to have a nurse train both you and helper to do this. Again what I like about this internet article is it covers all the basics , just like I learned it.
______________________________________________________________________
www.mayoclinic.com/health/drug...
The significance of this article by Mayo clinic is they teach about the drugs by name and then talk about use. Trying to keep the name of the drug attached to it's use is hard let alone how it works. These instruction pages do a good job. FYI, I didn't use keyword Mayo Clinic, but Mayo should be a first go to site for info on all things medical. They have teaching info on everything. Analogy, BCO main board is a first go to site for all things BC, thats what Mayo is to all other stuff(glad I can use slang versus prettified language).
Tired now, no more searching. Please review links, if they don't satisfy your need to know question, post question
sassyLast thought about use of enemas and suppositories, The doc technical papers all stated not to use in "a reduced immune state". All referrenced neutriplils and WBC's being below normal as a reason to not use. None refferenced that are immune systems are altered when using things like AI's and Tamox. So, discuss with doc , I suppose the MO is the most qualified. Lastly when using , lubricate well and be very gentle with insertion.
Your review of these links and the questions you pose ARE IMPORTANT, it will identify flaws in the search. Once no other questions are received , I will then add this to the Constipation thread.
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sass - I had 76 oz of water (about my usual intake) yesterday plus juice and tea so I may be in the ballpark on fluid intake. And my pee is very light yellow. You're right, I had some relief but today I'm back to square one. My python is still there, but seems to be sleeping this morning.
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this one looks better!
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OMG Phyll, that stawberry snake is soooo cute and yummy looking. A nice visual diversion here. Measuring your fluid intake has been valuable. Figuire 8 oz to a glass, you are at 8 plus glasses a day, urine indicates well hydrated. So, constipation is not from lack of fluids. Good thing to know. Allows you to concentrate on finding a remedy that works for you:)
Note on abdominal cramping: can be normal individual response when colon working. Can be abnormal when blockage or obstruction present. Generally, if cramping becomes intense or exceedingly painful, prolonged in time, doubles you over, takes your breath away that is a warning to seek medical evaluation.
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Hallelujah!! We have achieved poopage! Two days in a row...and the python may be sleeping. Abdomen still doesn't feel normal but it's WAY better than the python fight.
Current treatment is 6 oz room temp prune juice followed by hot tea followed by breakfast followed by Xeloda.0 -
Congratulations! Lol!! I just remembered something and again, sorry if its already been mentioned. If you search youtube there are instructions for massaging the abdomen and I found that sometimes it really works. At the time I think I was half going off the deep end over it and that was just contributing to the problem, so I laid down and did the massage very slowly and thoroughly which really helped me to relax mentally as well. I starting imagining I would have to go to the ED to get disimpacted and how utterly mortified I would be, then I thought, even worse, I could have an obstruction and need surgery and a colostomy and just really turned it into a total nightmare in my mind! Lol
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Hi Ladies,
I just started my chemo treatments and by far the worst SE (except for bone pain) was the constipation. Like most of you, I've tried the senna-S, 3 litres of water daily, bran buds, yogurt, etc, but my bowel was still lacking the stim it needed to push things along. I used Microlax to get things moving after the 3rd day because I didn't want to become impacted.
Because I've always had IBS-C, I've used Microlax on occasion throughout the years. It has always worked without issue to stimulate a movement and acts as a laxative through its faecal softening and lubricant properties. It comes in a box of 12 and I have had to use it twice daily when I swore I was trying to pass a softball
It may be something to ask your doctor about. It's available OTC in Canada. 0 -
Congratulatios to all you poopers!!!!!!!!
found sthis old post I did on PORT placement thread eaons ago. Is applicable here as we all have so many surgeries.
Jul 2, 2011 05:53 PM, edited Jul 5, 2011 08:17 AM by sas-schatzi
Post -op hydration or the taking in of oral fluids is very important to avoid dehydration. That was discussed a couple of posts ago.
BUT solid food you have to be careful with. The meds used during surgery can slow down the working wave like motion of the intestinal tract. Introducing too much food, too fast post-op can cause the intestinal tract to go to sleep. The medical term is an ileus. It's as if the intestine is saying "I'm not ready yet". You can avoid this problem post-op by starting first with clear liquids.
Clear liquids include anything you can see through--clear broths , jello, tea/coffee,Popsicles. If you tolerate the clear liquids i.e no nausea or vomiting,abd pain, bloating, burping, then you can move onto full liquids.
Full liquids include milk or anything made with milk --like ice cream,custards. If full liquids are tolerated, again no N/V-bloating, burping, then move to a soft low residue foods.
Soft low residue diet is easily digested and doesn't irritate the intestinal tract. The hyperlink below is a very complete listing of what is include on this diet-www.nlm.nih.gov/medlineplus/en...
Again , if there are no abdominal complaints----N/V, bloating, pain, burping, The BIGGEST question of all, is are you passing gas from the rectum. This is important because it tells us the intestinal tract is awake and moving in the right direction-------Yeah And a first bowel movement is to be applauded.
The exact amount of time at each level cannot be predicted. The key is no symptoms/ passing gas/ and bowel movement.
Time to move to a regular diet------this means there are no dietary/food restrictions. Start with small portions, and may be 4-5 small meals for a day or so.
This is a limited outline of how to avoid an ileus. Googling ileus will give you more info. I've put this here, to make you aware of how to protect yourself from this complication of surgery. I suggest further reading and discussion of this with your doctor.
In general with IV conscious sedation, also known as twilght, you would not expect an ileus to happen, but being careful to avoid it can prevent allot of problems, So, have a little patience waiting for the positive passing of the gas and poop -er BM.
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HLB - I responded to your post yesterday, but can't find what I wrote. Or remember for that matter! anyway, I'm going to check out YouTube. Who knew stuff like that would be posted? Amazing!
Tunerville, thanks for the tip. Right now things are working but you never know when you'll need something new.
As for you miss sassy - I love you to pieces!
Phyllis
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Phyll, Love you back sweetie sassy,
Turner, your post was a DUH moment. Yes abd massage has been around for ever, BUT you are the first to post of it here. THANK YOU! GREAT ADDITION!
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