Ever since my Flecainide was increased to 150mg twice daily I have suffered with never-ending constipation causing very impacted and large hard to pass stools. Naturally I have tried all sorts of remedies (have always consumed prunes every day together with a high fibre oats/wheat-bran/toasted wheat/berries breakfast but these dont seem to change things) I am currently taking Dulcoease stool softeners with no real improvement and even tried glycerine suppositories - as a last resort have tried dulcolax or senna. Being very personal for a moment despite what I try I still end up with the initial huge hard stool to get rid of first which involves a great deal of effort & straining -sorry to be so graphic! I am fearful that all of this straining will cause either piles, the resurgence of an old enemy-anal fissure or something more serious.
Does anyone have any suggestions or similar experiences please??
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Flecainide (same dose) has similar effect on me. I take 2 Coloxyl in evening (doctor's recommendation) but still need to eat enough veg and keep hydrated otherwise still a problem.... similar to you.
Daily Miralax and stay hydrated. Forget all the bran supplements/foods as they can be counterproductive and eat more cooked vegetables. Give the Miralax at least a week and cut out stool softner, which have questionable value esp with Miralax. You can also add 200 to 400 mg of magnesium citate per day if stools not too soft. Titrate up and down depending on consistency. This is what his worked for me and what was recommended by a gastroenterologist and nutritionist.
I agree , the bran could be counterproductive causing irritation in the gut
My father had serious problems with constipation and I remember him take paraffin oil, orally, in little quantities. It is not digestible, so it remains as the greasing additive in the digested food. Seemed to work for him, so it may help you too. Personally, I take the animal fat as the greasing medium. None of us is able to digest this fat as it should be, so it retains its greasing ability and "la vie est belle".
I found the info videos etc by Dr Sanjay Gupta of York Cardiology re the importance of the Vagal nerve incredibly useful when I was 1st diagnosed in 2018 . Helpful folk here sent me the links, but I don’t have them to hand atm .
I’ve learnt to treat digestion issues carefully and gently . Hydration is vitally important as is adequate rest
We make Porridge from organic oats ,add a little water , few mins in microwave , so slightly undercooked, cool mixture a bit , if too thick , a bit more water , then add in some organic bio yogurt to thin the mixture , cool a bit , then add in handful of blueberries 🫐 & banana ( or whatever you find suits you ) works a treat for an unhappy gut/ digestion . That and drink plenty of fluid. & gentle stretching exercises daily etc .
Hope that might help ? I’d definitely ditch the bran - it can irritate the gut for many ppl
Hi! Thank you very much for the recipe! Being my father's son, I also had constipation problems, from the age of 32, so very early... I have found a solution different from my father's, but very much like your solution. During the past 40 years, I was regularly consuming boiled wheat grains, which I consumed a a whole when my teeth were in better condition. Lately, I mill the grains, add some white sugar (it is not so deadly as expected, lol), add some milled walnuts and cinnamon, for the taste. I consume it, little by little, every day, so that it gets evenly mixed with the rest of the food. It is natural, efficient and there is no getting used to it. From time to time I add to my food some bacon, fat, prunes,... All in all, despite very poor start at 32, I have had relatively normal life. Even more! Wheat grains are known to contain vitamin E, which is known as good for the health and ageing. It is maybe the reason that I, at the age of 71, look much younger than my generation. In 2019, while in Greece in a holiday, a tourist from Germany has said to me:" What to say, when a man with 68 yo, looks as being 48 yo!?"
Hi, it sounds like you are doing everything you can.
I have been on Flecainide for nearly 5 years - 150 mg a day too. I have had on/off bouts of constipation and the odd fissure. The latter combined with Edoxaban did present a small trace of blood as well, on a few occasions. Needless to say, the latter was initially throughly investigated for something more sinister and thankfully it wasn’t. On reflection, getting this end of my body checked out for the first time in my mid-50s was not a bad idea either.
Whether the Flecainide is the root cause is difficult to say. I’ve had conversations in the past with my GP about correlation of events/symptoms and causation. Is it the meds or are these things just part of the ageing process. I had a similar conversation with my cardiologist too. He said patients often think their ‘heart medication’ is somehow targeted when in fact, it affects any smooth walled muscle in the body.
I am not sure I will get to an answer. However, I do know the Flecainide is keeping my Afib stable, which is the main thing. With respect to my bowels I just follow the standard guidelines - hydration, diet (fibre) and exercise. The gastroenterologist said take a laxative too, if you need it. The Edoxaban has been withdrawn (below the threshold for anticoagulantion), which is helpful too.
I was on Flec for a few years. Personally I did' not expence these problems but we are all different. I'll put a copy and paste which may/may be not be useful to you.
Paul
Consult Your Doctor: The first and most crucial step is to consult your doctor about your symptoms. They can evaluate your situation, take into account your medication (Flecainide), and suggest appropriate adjustments or alternatives.
Hydration: Ensure you're drinking enough water throughout the day. Hydration is essential for maintaining soft stools and preventing constipation.
Dietary Changes: Consider increasing your intake of dietary fiber. Along with prunes, incorporate a variety of high-fiber foods like vegetables, fruits, whole grains, and legumes into your diet. Fiber can help soften stools and promote regular bowel movements.
Exercise: Regular physical activity can help stimulate bowel movements and improve overall digestive health. Even a short daily walk can make a difference.
Laxatives: If over-the-counter stool softeners are not effective, your doctor might recommend a different type of laxative. However, it's crucial to use these under your doctor's guidance.
Monitor Medication: Check if any other medications you are taking might contribute to constipation. Your doctor can evaluate this and make adjustments if necessary.
Toilet Habits: Make sure to respond promptly to the urge to have a bowel movement and avoid delaying it. Also, ensure that you are sitting in a comfortable position on the toilet.
Pelvic Floor Exercises: Consult with a healthcare professional about pelvic floor exercises, which may help with bowel movements.
Toilet Habit - I was told instead of bearing down with pressure towards your back passage; sounds odd but hopefully you know what I mean. Instead, take a large breath in and breath deeply into your belly. This is a less aggressive way of stimulating a movement; it does appear to work.
Pelvic Floor Exercises - I’ve been looking into this recently. It’s often mentioned a lot in respect to female health but not as much for male. It does appear to have benefits for men too with respect to prostate health.
I’ve been on Flecainide for several years and intermittently have your same problem with constipation. I agree with the exercise and hydration connection as well as lots of cooked vegetables. When I fulfill those elements, I have more regular bowel movements.
I too have struggled with constipation. Tips: 10 steamed prunes every night. Dinner includes a variety of beans ( eg garbanzo beans) Lentils frequently included. Vegetables such as chard and Brussel sprouts. Magnesium glycinate ( recommended by cardiologist for my PVC’s) seems to soften my stool.
Keep up prunes but nuts are great plus fruit. I was prescribed 'COLOFAC 135mg".
1 hour before breakfast take 1 full tall glass of water with 1 Colofac whole.
I 'go' before breakfast.
To start you off you may need x3. ... before breakfast, lunch, tea/dinner.
How it works it relaxes your colon/rectum.
I have had constipation 6 weeks post operation. Always after operations.
An Australian surgeon who did my colonoscopy said "you have the longest colon in the smallest space I have ever seen!"
It's my go to. With R Shoulder repair I haven't been able to massage rectum with my right hand.
Have you had a colonoscopy? A elderly 80 man complained for years. Eventually he had one and was found to have a colon tumour. Everyone was getting at him to eat better and with fibre.
Just checking. I had one rectum check under NZders 70-75 year olds. All clear.
I hope this helps. Apparently some meds remove hydration from the colon. I take Diltiazem 120mg.
That’s a very high dose of Flecainide - 300 mg is the absolute maximum daily amount! I find taking 100mg twice daily has virtually put an end to my episodes of AF and as well as the 5 prunes and glass of prune juice daily (and plenty of berries and other fruit with my morning muesli) I have found a teaspoon of prebiotic powder taken 90 minutes before bed has worked for me and hope it might do for you too though, of course, we are all different. Plus, drink plenty of water!
I have had the same problem and have associated symptoms that sent me to my GP who prescribed Movicol recently. This was incredibly fast working and I had to limit the dose! I hope you can get some relief as this is a constant worry until solved.
I have had some constipation on Flecainide 100mgs x2 daily but not currently. I would focus on trial and error diet changes with an experienced Nutritionist's or Medical Herbalist's help and not buy these OTC treatments or GP prescriptions.
Flecainide had this effect on me too. I tried Fybogel, though it has aspartame so i wasn’t keen. So I bought some psyllium husk instead. Like eating sawdust. I took this in the evening, sprinkled on a small amount of granola with plenty of skimmed milk. (Needs lots of fluid.)
This seemed to do the trick after breakfast the next day. Breakfast also fibre rich. Now on Bisoprolol and I find that i can skip the psyllium husk, but still find that small evening snack helps.
I know it goes against the ‘don’t eat in the evening’ advice, but my gut had other ideas.
I found that even a lower dose of Flecanide as disrupted my regularity it tent to use a couple of spoonfuls of Chia seeds. In my porridge in the morning that seems to work wonders
I have struggled for years with this (not caused by any drugs. I have tried all available remedies, I feel sure. The one I use now is a particular variety of prune juice that is uniquely produced by Sunsweet in California. No other prune juice works as well, so do avoid the cheaper supermarket brands which are watery. I find the cheapest source is Holland and Barrett and look for when they have offers.
Sunset Prune Juice works well, rather too well if excess is taken, but generally it works comfortably and within 2 hours or so. I drink a glass each morning and it rarely fails. On the rare occasions it does, then a glass of magnesium salts will never fail. Andrew's Liver Salts are based on Magnesium Sulphate or I use Milk of Magnesia, and both have laxative dosages on their packs, but absolutely any form of magnesium will work, if the dosage of Mg++ is sufficient.
Magnesium salts are perhaps one of the best laxatives available and used to be the standard in the past before the commercialised and expensive Dulco/lax/ease... and lactulose took over. Magnesium works naturally by drawing water into the large bowel and does not, so far as I know, cause dependency (i.e. a need for it for the bowel to work). That said, I would not use it daily, whereas I do use prune juice daily. If you have any kind of renal impairment (i.e. kidney failure), of course, your doctor's advice is always needed as, even though only small amounts of magnesium are absorbed, this is cleared by the kidneys.
I had a very similar experience to this, which was caused by taking Verapamil for my AF. Both Flecainide and Verapamil are both anti-arrhythmic drugs which, not only slows your heart rate down, but also slows down your whole bowel system. It got so bad with me, as I already have piles, I was bleeding quite a lot each time I had a bowel movement. After a visit to the doctors and trying various treatments, in the end the thing that works for me is Laxido orange flavoured sachets, of which I take one first thing every morning. They are pleasant to take and I have a good bowel movement after breakfast every day. They don’t purge you and don’t give you cramps. I’ve been assured that I can take them long term. I highly recommend them. Happy Christmas 🧑🎄🎄
Try movecol. I have chronic constipation because of 30 years on opiates which slow down transit. I have spinal damage which had massively reduced my ability to "push". Movecol is a stool softener; a powder you mix with water. You may need quite a high dose at first but used regularly it really does work and , unlike stuff like senna it doesn't cause abdominal pain . I take one sachet a day at bedtime.
I forgot to add that I still make sure I’m hydrated, that I eat fruit and vegetables, and wholemeal bread; otherwise I still get occasional constipation, but nothing like it was.
Make sure you are sufficiently hydrated when you increase your fibre intake, otherwise it will have the opposite effect. What works for me is 4g psyllium husk fibre in 300ml slightly warm water first thing, at least half an hour before eating, and adding 5mg ground flaxseed (not whole) to my meals which is 3x daily, making sure that I have at least 200ml water with each meal. This is in addition to everything else I drink throughout the day. None of this will prevent you from taking any OTC or prescription laxatives (except fibre supplements eg Fybogel, which is really psyllium anyway).
If what you are passing is hard, that suggests a lack of water in the colon, so pay attention to your fluid intake. You might be helped by an osmotic laxative eg Macrogol, but they don’t work for me at all. They do work for many people, though. If it’s a persistent problem, see your GP (if you can!) or a practice nurse who can prescribe and see if you can work out something that helps. It could be a combination of strategies. By all means keep up with the prunes and keep your overall fibre intake through your regular foods. It all helps, just remember that glass of water with your meals. Every time.
Prunes and prune juice are well known remedies for constipation. While high in fiber, the main "poop effect" of prunes is due to, not the fiber, but the compound sorbitol (15gm/100gm). Sorbitol is classed as an "unnatural sugar"-it has a different configuration than the other sugars (glucose, fructose, etc.), and it is digested quite differently in the body. Sorbitol is also commonly use as an artificial sweetener in some chewing gums.
The various products of the sorbitol digestion act on the gut to a) promote infusion of water into the gut and b) increase peristalsis in the gut, and thus the laxative effect!
The "bottom line" is that, as is well known with other laxatives, repeated use will build up a laxative dependency, and the effects of the sorbitol will be blunted.
Personally, I drink prune juice only on occasion, sort of as an "emergency" measure if I get "backed up" for 2+ days. 8 ounces prune juice works within 2 hours, 16 ounces (mistake I made once) gives results that are a little too dramatic!
As an aside, when it comes to fiber, I've found that one Bartlett pear will supply 24% of daily fiber recommendation! Wow! Taste good, too!
This was my main reason for getting off Flecainide,,,,the resulting constipation then caused rectal bleeding which became dangerous due to being on Eliquis, the blood thinner,,,,filling the commode with blood was rather horrifying and almost landed me in the ER more than once,,,after a 2 week endurance,,,that was the end of flecainide for me,,,my doctor agreed,,,and I stayed with metoprolol
I do not have this problem with flecainide but setting aside what foods and chemicals you choose to take, hydration and exercise are the key. I also on behalf of husband, bought a cheap version of a "squatty potty". A pile of books for you to put your feet on works equally well,as it straightens out the exit dept making stools more easy to pass. The other thing is to try and develop a regular habit. I poop first thing in the morning even before morning tea and it's a good idea to "try" at the same time each day 😅.
I’m just going to say what works for me to keep me ok. I realise there will be many ideas and that will give you lots to mull over and experiment with
Oat bran. Three dessert spoons each morning mixed with plenty of milk. I use Koko milk. The super one with added vits. But your milk of choice is fine. Cook as per pack or microwave, checking consistency frequently as it soaks up a lot of milk
I stir in a dessert spoon of raisins or sultanas before cooking and add fresh or tinned fruit I have after cooking. A mixture of half a banana. Either sliced or mashed and mixed in. Grapes. Easy peelers. Pear (very good for constipation) 5 pitted prunes sometimes. Anything that takes your fancy. I top with two desert spoons of Greek yogurt and two soup spoons of Yeo Valley Kefir yogurt.
Start with a small amount of kefir yogurt and build up. Maybe try the oat bran first and Greek yogurt and then if it suits you add the Kefir yogurt
I’ve found it keeps everything smoothly operating.
You just have to find what works for your body.
I hope you can do that it sounds very unpleasant
I eat my breakfast at least one hour after taking my tablets, but more usually about two hours. Some report that flecainide and milk should not be mixed at the same time
I also take levothyroxine and you have to wait before eating with that
I have the same problem. I take two extra strength Senokot 3 times a week. That seems to help me after trying everything. Food types don't seem to help much.
I take 2 sachets of Fybogel every day, drink lots of fluids and eat as much fruit and vegetables as I can. My doctor prescribes Fybogel for another condition. Constipation is awful, I hope this helps.
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