Constipation

[DiamondLizzie]

I am at stage 3 CKD and I eat a plant based diet. Recently I am experiencing constipation. My nephrologist recommended Miralex. Does anyone have any experience with this issue and CKD.

[Ladybug_05]

Hello DiamondLizzie!

I had chronic constipation for the majority of my life, and as my CKD progressed it only became worse. Miralax is usually used because it is a gentle stool softener that can usually work in a few days. Have you tried over the counter stool softeners before? Ducolax or any generic stool softener can work as well as long as you drink plenty of water and give it time to work. I usually will take it before bed and it works by morning. If this becomes a chronic issue, you might need to use a stool softener of some kind regularly to keep up with it, which is easy to do once you know your body's needs.

Also, don't be afraid to titrate your stool softeners and take a stimulant if needed. I didn't know that I was able to until I saw a GI doc who explained that sometimes you need a bolus dose and then go down to a maintanance dose as needed. Sennakot is a vegetable based stimulant that typically works overnight. Personally for me, Miralax doesn't work well because it relies on the body's natural peristalsis in the intestines to move stool, and I have nerve issues from my other medical issues that disrupts that pathway. It can work wonders for you, but don't be afraid to talk to your doctor because it is considered more for maintanance and not for occasional relief. I hope this helps!

[DiamondLizzie in reply to Ladybug_05]

Thank you

[lowraind]

Have you tried a small amount of prune juice? I know it is high in potassium, but a small amount will not hurt you unless you have a potassium restriction. I have diverticulosis and almost died from diverticulitis. After a few visits to the er because of constipation, they sent me back to the surgeon who had performed my colostomy and reversal. He told me to drink a glass of prune juice, which is way too much for me. Four small sips have kept me out of the er for two years.

Good luck!

[DiamondLizzie in reply to lowraind]

Thank you

[curleytop1]

Hello DiamondLizzie and Ladybug 05,

I have had this constipation problem for many years (long before being diagnosed with stage3 CKD) but have learned to drink more water (especially hot water) to overcome the problem. Very occasionally, if I realise I have not had enough roughage, I add a teaspoon of finely ground flax seed to my food instead of fruit or veg. and drink as much hot water with the food as I can (I have to watch my potassium intake so don't usually eat the vegetables containing the most fibre, like beans and peas, lentils etc. though I love them). But flax seed is very high in potassium and phosphorus so anyone who has to restrict these should take this into consideration, and consult their renal advisor if they have access to one. I am in UK and this product from Linwood Health Foods is the only thing I have found that lists potassium and phosphorus on the back of the pack.

facebook.com/linwoodshealthfoods

also on twitter @ linwoodsfoods

I am also aware that I need privacy and to be relaxed for my bowels to work regularly, and if I am unable to control these parts of my life, then the constipation will occur no matter what I eat. So then I do the extra drinking etc. I avoid taking any medications as I find they cause severe stomach discomfort. Obviously, my solution to drink more water will not be suitable for anyone who has a restriction on how much liquid they are allowed to have so it is very important for them to seek proper advice from their renal specialists.

[DiamondLizzie in reply to curleytop1]

Thank you

[Bassetmommer NKF Ambassador]

This is a pretty common issue with CKD. I also have to take iron which can cause constipation. I also was taking a potassium binder which was like drinking mud and blocked me up like cement. My solution is a stool softener when needed. I also found that if I take magnesium with my iron pill and drink a cup of hot lemon tea ( just water and a few slices of lemon and a packet of stevia) I am in the go...if you get my drift.

Be careful, because you can create an issue if you strain while on the pot.

google.com/search?rlz=1T4LE...

Although it is tempting to take a stronger laxative or even an enema, they can be dangerous for CKD patients

kidney.org/atoz/content/ora...

ncbi.nlm.nih.gov/m/pubmed/7...

[Kidney777 in reply to Bassetmommer]

Like the link, thx

[DiamondLizzie in reply to Bassetmommer]

Thank you

[Barbee44]

I also have chronic constipation, but at 75 if I take anything to soften it, it gets too soft and the rush to the bathroom isn't always on time. I live an active life, so I'd rather not have to worry about bathroom rushes, so I live with it. I don't like it though. I wish there were a milder solution.

[orangecity41 NKF Ambassador in reply to Barbee44]

I am 78 and have constipation issue. I tried adding all bran and bulgar wheat to my regular meals and it seems to work. I do have linzess to use if needed. I also increased my water intake.

[DiamondLizzie in reply to orangecity41]

Thank you

[DiamondLizzie in reply to Barbee44]

Thank you

[curleytop1 in reply to Barbee44]

Hello Barbee44, Just seen your post to DiamondLizzie. I would try drinking more water, if you have no restriction on the amount of liquid you can have. I find its more effective if it is hot as it relaxes the body more. I also use v. finely ground flax seed which can be bought (I live in UK) from big supermarkets or healthfood shops. The brand is Linwoods and they are on line. Unfortunately flax seed is v. high in potassium (which I have to restrict) and possibly phosphorus, so I use just a small amount when I really need it. Hope this helps you - Curleytop1.

[Barbee44 in reply to curleytop1]

I try to drink water during the morning and afternoon. I can't drink a thing after 6 pm. As it is I'm up peeing every 2 hrs all night long.

[curleytop1 in reply to Barbee44]

Hello again Barbee44, You have my sympathy for both problems, getting up so frequently during the night must be very difficult to live with. I have found that going to bed later and taking a catnap or two during the day (if I have to) can help with my flagging energies even though I usually only have to get up once during the night.

Two other things I have found to help with the constipation difficulty, if you don't do them already, are: -

Try drinking water before the meal, while eating, and after it (as I do not make gravies or sauces very often, the water intake at this time helps with digestion and transit through the digestive system).

Taking some exercise (I usually choose a v. large supermarket to walk around as I hate walking round our hilly neighbourhood). Hope these suggestions can help you - Curleytop1.

[Barbee44 in reply to curleytop1]

Thank you.

[Pappy58 in reply to curleytop1]

If you're going to use flax seeds opt for cold milled flax seeds so you get the benefit of the omega 3 oil. Unless it specifically says "Cold Milled" then it's been exposed to heat and the omega 3 oil has been stripped from the seeds. The oil is perishable and refrigeration or freezer storage is best to extend the shelf life but isn't necessary if you use it before the expiration date. If it smells like turpentine throw it away.

[Krazykatlady]

I use an OTC product called Swiss Kriss. It's an herbal tablet, and seems friendly to me and my kidneys, and the other meds I take. The instructions do suggest discussing it with your doc, of course. But if any of you remember Correctol, "the women's laxative" that was supposed to be be gentle... well, it wasn't, for me! This one, was. Last I checked, Walmart has it.

[DiamondLizzie in reply to Krazykatlady]

Thank you

[RhenDutchess123]

Magnesium Malatte...taken daily with lots of water

[Momofson]

Dont get started on a laxative that is going to get you dependant on it. Ask your doctor about getting on a nightly dose of magnesium probably 200 to 400mg a night. Also great to help you sleep. That is a very natural help...and it works like magic! Talk to your pharmacist, he will have more I fo than most doctors about this, but also ask your doctor to make sure he knows you are taking it since you have medical problems.

[My_Kidneys]

I have also have stage 3 CKD. My doctor suggested "Smooth Move" (SM) laxative tea. SM tea is supplied by Traditional Medicinals and comes in in two types, senna and chamomile (traditionalmedicinals.com/p.... A good website on laxatives and CKD (bcrenalagency.ca/resource-g....

[My_Kidneys]

Good website for constipation and kidneys (bcrenalagency.ca/resource-g....