Astovastatines and constipation?

[ABoyHasNoName]

Can astovastatins cause/worsen constipation? I have to regularly take paracetomol/codine mix as routine pain management . . but since a mild heart attack July 2020 I've been told to take 80mg of Astorvastatin a day. Since that time, I've had tummy rumbling, increased wind and occasionally very bad constipation. I know codine causes constipation, but I've managed that for 15yrs. Could it be a side effect of statin drugs? Puzzled

[Activity2004 Administrator]

Have you talked to your doctor about the issue? Did they say that the medication they put you on would have any side effects like constipation before going on the statins?

[ABoyHasNoName in reply to Activity2004]

Hi there . . Thanks for your reply. Yeah I have and I've immediately been locked into a bowel cancer screening testing regime. Now I understand that that will have to run its course, but seeing as I had a screening two years ago that was clear . . and this constipation has turned up since starting heart attack meds, I'm just trying to get some wider experience on whether the Astorvastinin could cause/worsen constipation. Docs will always test for the worst, but the issue might be much simpler and nearer to home.

[Activity2004 Administrator in reply to ABoyHasNoName]

What type of food do you usually eat during the day/evening?

[ABoyHasNoName in reply to Activity2004]

Hi again. Well thats another big change since the "wake up" call of the heart attack last July. I took the advice to heart (excuse the pun) and dropped all salt, all sugar, loads of the carbs and stodge and upped the veg, fruits, high fibre and switched to low fat alternatives. Over a stone lighter (over 7 months - so gradual) now and feeling much better, apart from this very erratic constipation. I know alot of things have changed over last 7 months, I just wanted to explore if the meds (especially Astorvastatin) could be causing/worsening constipation?

[Activity2004 Administrator in reply to ABoyHasNoName]

It's okay. Some changes to a diet is okay. Did your doctor say to try that-- lower the carb. intake? Some fruits/vegs. have more carbs. than others. You can also try lower salt vegetables in a can.

I take blood pressure medications and I'm also on two types of insulin for Diabetes (type 1). I also count carbs. and use a CGM ( Continuous Glucose Monitor) system for tighter blood sugar control. I also have been on a gluten free diet for almost 6 years because I have a wheat/gluten intolerance.

[Midori]

Probably best to talk to your doctor, but Codeine can cause constipation.

[Subtle_badger]

I doubt the statins are the cause. As Midori says, codeine causes constipation. Also, it's a common side effect of changing to a low carb diet, I was tormented by it for months.

But the other possible cause is missing electrolytes, eg salt. The colon is a semi-permeable membrane. If you have fluid on either side of such a membrane, fluid will be drawn through the membrane to equalise salinity. If the contents of your colon is less salty than your blood stream, fluid will be drawn out of your colon and into your blood stream. The main electrolytes here are sodium, potassium and magnesium.

When you go low carb, you stop eating processed foods, the main source of salt in most people's diet, plus insulin holds salt in the body. So if you have cut out processed foods and gone low carb, you may actually be getting less salt than your body needs. The main issue with dietary salt is blood pressure, so if your blood pressure isn't elevated, then you don't have to restrict your salt. Since I went low carb I have started adding salt to everything (even coffee!) and my blood pressures is now in the normal range without drugs.

Get yourself a blood pressure monitor so you can understand what your body is doing. If your blood pressure is good, you can relax about salt - and increase it with confidence knowing the BPM will tell you if it's becoming a problem.

Bring it to your next face-to-face doctor or nurse appointment so they can check it's calibrated correctly.

[ABoyHasNoName in reply to Subtle_badger]

Thanks very much for your comments. Everything you say adds up and it is the kind of experience/advice from others I was looking for that could really help. I just wish I'd had some advice like this to work with before the doc threw me into "the big machine" which is now putting me through an "emergency" sigmoidoscopy . . probably for no good reason. Now I know that there is a chance it could be the Big C . . but its more likely to be a massive change in diet coupled with veritable concoction of strong drugs post stent insertion and the fact that I have internal hemorriods. I had a routine bowel screening two years ago which confirmed I was clear of issues but did confirmed internal hemorriods.

In over 8 months since a heart attack and stent insert, my GP has never reviewed my condition or meds or asked about diet/lifestyle changes I've made. I know I may have not got the "diet mix" exactly right and I've probably "over compensated" and caused some issues. I just feel very let down at the moment by a "risk adverse" medical system that appears to be punishing me for trying to do the right thing and for asking for advice.

I did wonder about the "salt" as soon as I saw that its a main constituent of the Cosmocol constipation solution recommended by my local pharmacist. BTW . . I monitored my B.P. fastidiously for 4 months post op and weekly since then. It is top notch (maybe even a bit on low side because of the high level of meds) . . but what do I know . . I only live in this body!

Cheers once again for your helpful pointers. Once this "process" is out of the way, I'm gonna get some better advice on diet and meds. I might even get another GP if he's not even gonna read my history or inform himself before following a tick box mentality.

See you all again sooon.

[ABoyHasNoName]

Well folks . . just as I thought. After going through a very unpleasant whole weeks routine to last Fridays sigmoidoscopy, everything is perfectly fine down there . . even the internal hemorriods have shrunk to nothing. All this has been a monumental waste of time, energy and resources of the NHS, not to mention the mild pain and worries I endured. It has shaken my faith in my current GP, who appears to have a tick box mentality to my healthcare.

I'm gonna have to think what to do long term with the GP, but I just wanted to thank everyone here for your help and support, especially Subtle_badger on salt levels v BP v constipation. I will aim for a more "balanced" approach in diet and look to increase activity levels now we're getting some nicer weather.

Thanks once again and best wishes to everyone.