Constipation

[Travzw]

Afternoon! I just wanted to ask what you all do to treat your constipation? I just can’t find a great way of keeping it at bay. I feel like I have to go all the time but nothing! Enemas have been the best way I’ve found but I can only do it once a week or so! So I usually only go once a week! I also use miralax daily.

[JasonHarnum]

amazon.com/s?k=swiss+kriss&...

this helps me a lot..

[monkeybus]

I drink plenty of water, go easy on the meat, and eat All Bran.

Nothing keeps me regular like All Bran. Even then, not too regular.

[tieaknot]

Prunes...6-8 a night. I prefer the dryer non-sorbate ones (from Trader Joe’s in the US).

Milk of Magnesia most nights occasionally alternated with Sennakot

Or “smooth move tea”

Water!

A very scheduled morning with coffee, warm water and walking or stretching.

If I miss my “window”, things won’t happen and it’s a rough day and throws the rest of the week off. (It seems like a snowball effect). I sometimes feel like a baseball player, almost superstitious with my “routine” but it often works. I got tips from reading the spinal cord injury sites regarding scheduling etc.

If desperate, 1-2 bottle of magnesium citrate and don’t leave the house! (Basically coloscopy prep). Daily probiotic.

Travel and staying in a hotel or different house really messes me up.

Miralax never helped me and always seems to make things worse for me but it’s the first thing every doctor wants me to use (I won’t use it anymore).

And finally yes...enemas when absolutely necessary. (Water or soapsud water, not the “bottles” from the pharmacy).

Good luck! My grandma was so right when she’d sing the praises of a good BM and we would LAUGH!!! Who’s laughing now Grandma...you win!

[LauLauM4]

Hi there —

I take care of my husband (AMN with Cerebral involvement) and I make sure he gets 70 ounces or more of water a day, plus other drinks; a probiotic, two fiber gummies, a strawberry and banana smoothie I make (the bananas are natural poop softeners) And I alternate between Colace at night and MiraLAX in the morning. Using this technique I had him on a every other day BM schedule.

It’s a little out of whack now because he’s had an infection and minor surgery very recently, but I find that these things working together really help. Plus, gravity. He can’t walk much but we stand him up for several minutes 10 times a day on the Stand Aid.

[COwithAMN Administrator AMN EASIER Volunteer]

This is a common problem for AMNers and also for the general population.

The previous comments are really helpful and I would agree in particular with the point about water.

I also think that it’s worth remembering how the gut works. I apologise if this sounds like a know-it-all lecture, but I think it’s important.

Basically, as food travels from the stomach, the walls of the intestine are extracting nutrients and water. The digested food is pushed down and slowly changes from a soup-like consistency to something more solid. The key thing is that water is being removed so that our bodies are being hydrated. If we are dehydrated anyway, then our intestines will extract as much water as possible to keep us well. If we are well hydrated then the intestine won’t need to extract so much water. The rate at which the intestine moves food along its journey is probably pretty constant. The net result of this is that if we are generally a bit dehydrated then there is a good chance we are going to be constipated, because the intestine has extracted every last bit of water from the food.

You don’t need to go overboard - I am not one of those “bottle-suckers” you see everywhere, but you do need enough.

(This gut process is called peristalsis. When we take Immodium for diarrhoea what it is doing is slowing down the peristalsis for a while.)

I agree we need enough roughage in our diets. I eat a lot of fruit - apples, bananas, berries. And breakfast is sugar-free oat/wheat flakes with some nuts.

I have got a few other theories/thoughts about the opposite problem, one that I have had recently - loose bowels - which I will post another time.

Cheers, Chris

[JasonHarnum in reply to COwithAMN]

Chris, your 'know-it-all lectures' are appreciated

thanks

[quilling]

How does everyone drink enough water/fluid when there is urinary issues? I have to stay near a bathroom when I drink and even then have accidents . I wear undergarments but even if I want to take my buggy outside I can't drink because I won't make it in in time. If I go to a doctor's appointment or someone takes me somewhere I can't drink any liquid I was taken out the other day and not home until 2 . Felt like garbage then realized I had only enough liquid to take my pills So I am always dehydrated. Can't win.

[wilburlois15]

This is my specialist topic, for the reason below. Here goes:

I have been constipated for all of my adult life and from well before I started to get any noticeable AMN symptoms, although with hindsight, constipation was probably my first symptom. I'd go once every 3-4 days and when I had to go, I really had to go. This was a regular problem when I did a lot of running in my 20s.

I think the main problem was not making time for it. Going was always lower priority than whatever else work I was doing and most of the time I could just put it off. That wasn't helped by my work which involved getting up very early and getting to work early so there was no real time in the mornings.

However, since I gave up commuting and started working from home, my bowel life has revolutionised. Mornings are slower as I now wake early, eat and then get the kids ready for school. At some point before I leave the house to take them to school, I go to the toilet and have a poo. Having a routine like that really works. It took 2 years or so to establish properly but even after a month or so, things began to change.

Now that I'm in this position I am loathe to give it up. I eat a lot of fibre, mostly in the form of fruit and dried fruit, especially figs. I just munch on them in the mornings while working at a computer. I eat a lot more fibre than anyone else in my household and probably anyone I know but it definitely helps. Bladder reasons mean I can't keep as hydrated as a normal person but I'm happy to have to wake 2-3 times a night to have a pee if that means my bowels do their job.

Finally, I raise my feet when on the toilet. I read something about this changing the angle and making it easier to defecate, so I just stick my feet on a small stool which raises them 6 inches or so off the floor. I also find that if nothing is happening but you feel the need to go, standing up and walking around the house a bit before going back to the toilet likely hurries things up a lot more than just sitting and waiting.

So, time and routine are my advice. And large quantities of fibre!

Good luck.

Angus

[monkeybus in reply to wilburlois15]

I squat on the toilet seat. Much more natural way to go.

[SongStream in reply to monkeybus]

Designed for that purpose: amazon.com/dp/B00ESKVN7W/re...

[monkeybus in reply to SongStream]

Squatting is the only game in town. A friend of mine recently gave birth to her children, squatting in a birthing pool.

I actually go like this -

en.m.wikipedia.org/wiki/Def...

Takes a bit of getting used to after a lifetime of sitting, but I'll never go back. My son is 14 now, he has copied me since he was a toddler. My gift to him - Healthy, regular toilet habits. He eats a lot of meat though, just a matter of time.

[SongStream in reply to monkeybus]

That might be difficult for some to maneuver such a posture. Lord knows we wouldn't want any of us to be unable to get down from there (I'm afraid of heights <g>) or injured. Just imagine trying to explain to your doctor or someone else how you fell from a toilet seat. Or breaking your toilet seat. A safe way is the squatty potty:

amazon.com/dp/B00ESKVN7W/re...

(You'd think I have some affiliation with this company for the 3rd recommendation I had given it.).

[tieaknot in reply to SongStream]

I just laughed out loud...I can picture myself getting stuck up there like that and then falling off and getting a concussion hitting my head on the sink and breaking my wrist or something...ha!

[SongStream in reply to tieaknot]

Another AMN belly laugh! (These feel so good!)

Imagine the fire department rescuing you like a frightened kitten in a tree.

[tieaknot in reply to SongStream]

Songstream...I think I’d rather just skip the Fire department and take the fall! lol (I used to be an EMT on an ambulance squad and have seen a lot! People certainly do get into embarrassing and precarious situations! )hahahahahahaaaa

[monkeybus in reply to SongStream]

I have slipped off quite a few times. But it is a price that's well worth paying. I've been doing it since before my symptoms flared up. Second nature to me now.

[Hillary in reply to SongStream]

Works brilliantly

[Travzw]

Thanks for all the insights. Seems everyone has a different approach. I have seen Gastro several times and they have no clue how to improve constipation. You would think being that’s the worst gastro problem they’d do more research. My current regime has kept things easy to manage.

[Rosita5]

NATURE'S SUNSHINE Cascara Sagrada Capsules, 100 Count amazon.com/dp/B000WQFBHO/re...

Cáscara sagrada (tree bark) works well for me. My family has been using this for years. It’s natural and very easy to take.

Also, do you have a squatty potty (or small step stool)? When you elevate your feet a little, it allows you more “leverage.” Please check around the internet for more info on this. Very helpful!

[SongStream]

amazon.com/dp/B00ESKVN7W/re...

[SongStream]

Bowel dysfunction is common with neurological diseases which affects motility. What has helped me is a diet high in whole grains, fruits and vegetables. Upon waking up, I drink plenty of water since I do not drink any during the night because of nocturia.

Addison's Disease Alert: Drinking too much water may reduce your essential sodium levels. I found this out during a morning blood draw and my sodium levels were low. Took it again without drinking much water and levels were back to normal. If you do drink lots of water, be sure to increase your sodium.

Try to establish a morning routine just as you would when establishing a good sleep hygiene (Go to bed at the same time each night and get up at the same time each morning, including on the weekends.) I can't over emphasize exercise! Even though it's uncomfortable to exercise, go for a walk. Anything. Just move. I must say missing one day is very uncomfortable for me and it can greatly sour my day. Let us know what works.

[tieaknot]

Since this topic in general is already TMI, I hope you don’t mind my adding a different angle. So...I have the problem where I’m “constipated” but it’s not a “hard/dry” issue...it could even be too soft but it’s like my bowel and ummm...exit muscles are paralyzed at times or won’t or can’t work together to open the door and get it out. I don’t know how else to describe it. So all the water and fiber or miralax or colace in the world doesn’t help me...I have to add in a stimulant like the senna to force things through when that happens. Very frustrating!!

[COwithAMN Administrator AMN EASIER Volunteer in reply to tieaknot]

I not sure there is TMI! I've got to the age where nothing shocks me anymore! And the subject is one of the things we all struggle with so the more the better.

[SongStream in reply to COwithAMN]

As Bette Davis and my Dad used to say: Growing old isn't for sissies.

It's quite humbling but rich in blessings, life altering experiences and wisdom.

Of course, quite much can be said about growing old with AMN.

[Travzw in reply to tieaknot]

I am the exact same which is why I use enemas. They are far more comfortable than using laxatives that wake you up at 4am to go! I’ve had a doctor tell me to take 5 at a time. Do not try that!! You will feel like you have the flu the whole next day!

[SongStream in reply to tieaknot]

How timely for me to receive in today's email my Harvard Medical School Healthbeat newsletter with today's topic "Tips for better bowel control". I think this would help your situation and others greatly who are on the opposite spectrum which is fecal incontinence: "Damage to nerves or muscles can also lead to fecal incontinence. You may experience damage from rectal surgery, inflammatory bowel disease, multiple sclerosis, stroke, childbirth, or diabetes, for example."

health.harvard.edu/staying-...

[COwithAMN Administrator AMN EASIER Volunteer in reply to SongStream]

Thanks for posting that Harvard Health link. I subscribe as well but have missed it in my inbox - too many interesting things to read! It's a really good article.

There is some interesting research going on in this area, but not nearly enough, due, I guess that it's not a sexy subject. For example, in the U.K, I came across this research group called, improbably, IMPRESS (Incontinence Management & PRevention through Engineering and Sciences impress-network.com/ If you browse around you will see plenty of things that give some hope. I also came across this PDF of a big worshop in this area. theurologyfoundation.org/im...

The one big thing that comes across that is needed is a big public conversation so that we stop feeling embarrassed to talk about it in the wider public arena. We have become used to big TV fund-raising events for breast cancer and more recently for prostate cancer. Maybe, hopefully, continence management might be next.

[COwithAMN Administrator AMN EASIER Volunteer]

Have you tried anal sphincter exercises? Try and build up that muscle by alternately tightening and relaxing, several times a day. It's just another muscle. Maybe you would then be able to relax the sphincter when you need to go? Just a thought.

I do this for the opposite reason. I get an urge to go and sometimes can't get to the toilet in time. I have found that squeezing just when the feeling comes on can slow things down enough to stagger to the toilet.