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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by cgd092 on February 23, 2007, at 11:55:05
What, constipation isn't a fun topic? :)
I'm taking:
50mg/day Lamictal
40mg/day Celexa
75mg/day SeroquelAll of those have constipation as a possible side effect. And I have had bad constipation for quite awhile now. With accompanying abdominal pain that sometimes wakes me up at night. I even went to the doctor and got an ultrasound because I was sure there was something going on with my left ovary. But I'm guessing it's probably a spastic colon or similar instead.
So now I'm taking a lot of Metamucil. What else can be done for constipation due to meds? What do you guys do, when it appears your meds are causing constipation? Do you think the amounts of meds I'm on are causing this? Does one ever consider changing meds due to constipation? Personally, even waking up at night with gut pains is preferable to depression/anxiety. Thoughts?
Thanks!
Posted by UgottaHaveHope on February 23, 2007, at 12:08:55
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
Posted by Phillipa on February 23, 2007, at 13:00:36
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
Well you're not on an MAOI. Try adding about 125 of magnesium from the health food store . I take it nightly. It works. Love Phillipa ps might want to start with less break the tablets.
Posted by Joe Bloe on February 23, 2007, at 13:01:26
In reply to Re: Okay, let's talk constipation!, posted by UgottaHaveHope on February 23, 2007, at 12:08:55
I wonder if the constipation caused by meds can increase the risk of colon cancer significantly, as it may prolong the exposure of colon cells to the toxins in the stool?To avoid this I would do most of the typical things:
-lot of fruits and veggies, high fiber, maybe a stool softener? Just a thought.
Posted by alienatari on February 23, 2007, at 16:24:54
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
Seroquel gave me bad constipation. Was treated with Laxatives.
I'm on clomipramine now and on a high dose (200mg) and it makes me very constipated. I take quite a lot of laxatives and they help out a lot. Also eat lots of fibre and drink pleanty of water.
Take care
Chris
> What, constipation isn't a fun topic? :)
>
> I'm taking:
>
> 50mg/day Lamictal
> 40mg/day Celexa
> 75mg/day Seroquel
>
> All of those have constipation as a possible side effect. And I have had bad constipation for quite awhile now. With accompanying abdominal pain that sometimes wakes me up at night. I even went to the doctor and got an ultrasound because I was sure there was something going on with my left ovary. But I'm guessing it's probably a spastic colon or similar instead.
>
> So now I'm taking a lot of Metamucil. What else can be done for constipation due to meds? What do you guys do, when it appears your meds are causing constipation? Do you think the amounts of meds I'm on are causing this? Does one ever consider changing meds due to constipation? Personally, even waking up at night with gut pains is preferable to depression/anxiety. Thoughts?
>
> Thanks!
>
>
>
>
>
Posted by cgd092 on February 23, 2007, at 23:17:56
In reply to Re: Okay, let's talk constipation!, posted by alienatari on February 23, 2007, at 16:24:54
Chris wrote, "Seroquel gave me bad constipation. Was treated with Laxatives."
Thanks, Chris. So, it's probably the Seroquel mixed with the Lamictal. I faxed the subject to my Pdoc and she suggests going down on the Seroquel, since that's what she wanted to do with me anyway, and stay on the Lamictal. I tend to like the sedation with Seroquel.Found on the net: "Other medications causing constipation include iron supplements, some antacids, antidepressants, antispasmodics, diuretics, and anticonvulsants for epilepsy."
I'm taking two of those, and also an atypical antipsychotic. My guess is all of them together are causing this extreme slow-down.
I, too, thought about colon health and colon cancer, in regards to chronic constipation caused by meds. I'm wondering if my pain isn't a diverticulum or something like that.
Posted by Larry Hoover on February 24, 2007, at 8:23:50
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
> So now I'm taking a lot of Metamucil. What else can be done for constipation due to meds? What do you guys do, when it appears your meds are causing constipation? Do you think the amounts of meds I'm on are causing this? Does one ever consider changing meds due to constipation? Personally, even waking up at night with gut pains is preferable to depression/anxiety. Thoughts?
Sorry for the tardy reply. My brain is constipated.
My pharmacist told me that psyllium fiber supplements like Metamucil can possibly makes some people more constipated, not less so. He told me just after I corked myself right good with the stuff. Anyway, opiates are the king of constipators, and I learned a few things.
First, is prunes. They contain something that is not found in plums. Something about the drying process changes the constituents. Prune juice or whole pitted prunes have a stimulatory effect on intestinal contractions, keeping you more regular. Other fiber sources do not have that stimulatory effect. My pain doctor used to always say to me "one pill, one prune". I kept California's prune producers in Mercedes, methinks.
Next on the list are stool softeners, such as Dulcolax. They're minor irritants with lubricant properties.
There are also osmolyte laxatives such as Ex-lax or magnesium salts, but these should only be used occasionally. They draw water into the intestines, but in so doing, they play havoc with blood chemistry. Okay once in a while, but not daily.
And finally are stimulant laxatives such as the herb senna. I finally settled on an herb blend called Metab-herb, which has a few more besides the senna.
My bowel had become quite painful from the chronic constipation from my painkillers, and it was the prunes and herbs that finally set my right. My doctors believed it to be the most benign intervention.
Lar
Posted by Phillipa on February 24, 2007, at 19:14:35
In reply to Re: Okay, let's talk constipation! » cgd092, posted by Larry Hoover on February 24, 2007, at 8:23:50
Lar so my taking 125mg of magnesium is not a good idea? Love Phillipa
Posted by Larry Hoover on February 25, 2007, at 8:46:56
In reply to Re: Okay, let's talk constipation! » Larry Hoover, posted by Phillipa on February 24, 2007, at 19:14:35
> Lar so my taking 125mg of magnesium is not a good idea? Love Phillipa
If enough magnesium is taken to induce loose stools, that's when the disruption of electrolytes occurs. It's a threshold effect. You're fine at that dose.
Lar
Posted by Declan on February 25, 2007, at 18:40:03
In reply to Re: Okay, let's talk constipation! » cgd092, posted by Larry Hoover on February 24, 2007, at 8:23:50
I have found berries to be a little helpful.
You need to eat lots.
Posted by yxibow on February 26, 2007, at 2:45:31
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
> What, constipation isn't a fun topic? :)
>
> I'm taking:
>
> 50mg/day Lamictal
> 40mg/day Celexa
> 75mg/day Seroquel
>
> All of those have constipation as a possible side effect. And I have had bad constipation for quite awhile now. With accompanying abdominal pain that sometimes wakes me up at night. I even went to the doctor and got an ultrasound because I was sure there was something going on with my left ovary. But I'm guessing it's probably a spastic colon or similar instead.
>
> So now I'm taking a lot of Metamucil. What else can be done for constipation due to meds? What do you guys do, when it appears your meds are causing constipation? Do you think the amounts of meds I'm on are causing this? Does one ever consider changing meds due to constipation? Personally, even waking up at night with gut pains is preferable to depression/anxiety. Thoughts?
>
> Thanks!
>
>
>
>
>Only the Celexa seems to be at a fair clinical dose; the Seroquel is just above placebo level and is mostly an antihistamine at that dose, I'm not sure about the Lamictal. I haven't heard about those medications being constipative one way or the other but I can appreciate that; although I would long to be toward that way than what medications usually do to me.
At any rate, continuous use of laxatives and stool softeners will cause dependence and may theoretically additionally cause a drain on the system of certain nutrients. They're not good alternatives except for the occasional worst blockage. Depending on how much fiber in your diet you have, and whether you're mostly a meat eater or a vegetarian, some people can take up to 4 days to do #2. Now, greater throughput is obviously good for colon health as we know of course.
Metamucil tends to be somewhat harsh, although there are harsher fibres. Wheat bran mixed with cereal is a pretty fast way of getting rid of that problem. But with either, using enough water is important as the system bulks up.
While frightfully expensive, CVS offers a slightly cheaper store brand (some others might too) of Citrucel, which is a nonsoluble fibre I used to use when I first started Remeron. They even have it sugar free. Basically its expensive processed microcellulose waste from the citrus juicing industry I think. But its fairly effective, and unlike Metamucil, its non-bloating. Its available in the sugar free powder that you mix (and use plenty of water) in a glass -- its sort of like faintly gritty orange soda. If you prefer, its also available in even more expensive tablets -- but you must be sure to take those with enough water too because it expands inside your stomach.
I prefer non-bloating fiber, although for good colon health you need a mix of soluble and insoluble fiber; but for this purpose, I would give it a go -- I think it would be less uncomfortable.
Posted by platinumbride on February 26, 2007, at 20:03:13
In reply to Re: Okay, let's talk constipation!, posted by alienatari on February 23, 2007, at 16:24:54
Stool softeners saved my life while I was on nardil, above 60 mgs.
That, and drinking a lot of water and herbal tea.Interestingly, metamucil was recommended to me for fixing the opposite problem when I was on lithium.
Diane
Posted by cgd092 on February 28, 2007, at 1:04:53
In reply to Okay, let's talk constipation!, posted by cgd092 on February 23, 2007, at 11:55:05
Here's an update on me:
Went to the emergency room two days in a row. The second time they admitted me to the hospital. Did a full CT scan of abdoment with contrast, said they could see nothing wrong other than some "significant constipation." Today I'm back home and having the same painful constipation feeling I had that sent me to the emergency room in the first place. I'm taking 1/2 of my normal Celexa, just enough to ward off withdrawal headache/nausea, and cutting out the Seroquel and Lamictal for now, until I can pass some poops. I get this feeling there's a clog in there. Once I get past this painful clogged feeling, that's been going on for two or more weeks, I can start eating a better fiber diet. I think I practially have paralytic ileus, altho the docs at the hospital don't say much.
Posted by yxibow on February 28, 2007, at 1:30:47
In reply to Re: Okay, let's talk constipation!, posted by cgd092 on February 28, 2007, at 1:04:53
> Here's an update on me:
>
> Went to the emergency room two days in a row. The second time they admitted me to the hospital. Did a full CT scan of abdoment with contrast, said they could see nothing wrong other than some "significant constipation." Today I'm back home and having the same painful constipation feeling I had that sent me to the emergency room in the first place. I'm taking 1/2 of my normal Celexa, just enough to ward off withdrawal headache/nausea, and cutting out the Seroquel and Lamictal for now, until I can pass some poops. I get this feeling there's a clog in there. Once I get past this painful clogged feeling, that's been going on for two or more weeks, I can start eating a better fiber diet. I think I practially have paralytic ileus, altho the docs at the hospital don't say much.
Perhaps in this case, though I don't think it should be used in the long term, and should be consulted with a doctor, you could use magnesium citrate. It is used to evacuate the bowels so a prostate and colonoscopy exam can be done. It is available readily OTC as in solution bottles. Otherwise you might have a consultation for RX barium, though that is even more powerful than magnesium citrate.
Even if the human body is never given food, the constant shedding of the intestinal walls and natural evacuation will still occur and produce small quantities of #2 eventually.
Nothing wrong with talking about #2. I wish you ... good luck-- tidings
Posted by Larry Hoover on February 28, 2007, at 6:32:18
In reply to Re: Okay, let's talk constipation!, posted by cgd092 on February 28, 2007, at 1:04:53
I'd suggest you consider a Fleet enema. I can get a genrric for only $1.87, so I'm sure it won't set you back much. Only to be used infrequently, I'd suggest this is one instance where it should help solve your problem. The next day, if you're still feeling full (sorry, but there is a problem being full of sh*t), then I'd go with the oral route, with a magnesium flush. First, you have to deal with the stale feces in the lower bowel.
This post just set a record for topical content that I've ever posted.
Lar
This is the end of the thread.
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