I have been feeling constipated, although I still go everyday. I think I just need to 'clean out', I eat fiber,

[sistergoldenhair]

however cannot go crazy on water because of ascites which I take water pills for. Any ideas?

[Val02]

Lactulose is a safe laxative. You can adjust the dose to suit your needs. Have you tried this?

[sistergoldenhair in reply to Val02]

Thank you but I am really trying to avoid lactulose, my aunt and a few other people I have known are on it for other liver conditions and all they do is sit on the toilet and I have never heard anything good, other than it does make you go. I just am not ready for that yet, but I appreciate the help.

[Cristina_Romania]

It's most likely because you don';t drink enough.

What I am telling you is not my personal opinion, but the result of al lI have read about fibers and constipation ( I kind of work in that field), so I'm telling you from many trials and medical articles, you can also check many online.

Fibers is VERY good for you (cholesterol, glycemia, blood pressure, cardiovascular protection, not to mention digestion and bowel movements. VERY GOOD. BUT you HAVE to drink , as the bulky stuff that is formed by the fibers cannot do their job if yo udon't drink.

The idea that you have to drink very little because of ascites is WRONG> Ask your doctor. IT's an absolute must that you drink, evne more as, with a sick liver (liver = chemical plant in your body with major detoxification tasks) you need to help your body a bit more to naturally detox. So that's no issue, even more as you eat the very beneficial fibers. If you retain water in your tissues, that is another problem and has to be addressed by the doctor through proper medication and diet recommendations. But please do not make the mistake of saying "I cannot drink too much as it brings me ascites", this is totally wrong. IT's also what you can read in the competentn PBC COMEPNDIUM of the PBC Foundation.

Remember, water is vital for detoxiufication, especially when a main detox organ, the liver, isn't functioning at its best.

You can find numerous studies on liver, water, detox and esp fibers online (pubmed, for ex, is a very good sourse of authorised info about trials), and I'm pretty sure no competent doctor will tell you to cut down on water. There needs to be a balance, of course, and water retention needs to be meedically tackled, of course. But stick with the fibers :).

All the best.

[sistergoldenhair in reply to Cristina_Romania]

I did think about the water intake, my PCP is the one who said I should slow down on water because of the fluid retention, which I had not heard of but sort of made sense. This has been hard on me because I always feel 'dry or thirsty'. I am going to see my gastro doctor tuesday and will talk to him about it. I do eat alot of fiber, I wouldn't say I go crazy, but probably over the RDA. I really do believe it helps although it makes you feel full fast, and I am at a point where I really can't eat alot at one meal so I sort of eat all day. I know the ascites and bloating are part of PBC, it's just hard to get use too. I feel huge when in fact I have only gained a total of 12 pounds since this started and the doctors do not want me to lose weight because of transplant surgery, when the time comes. It is just uncomfortable:/ I am going to work on the water drinking though. I appreciate your answers. Thank you.

[mumofthree]

Hi sistergoldenhair

I occasionally have this problem too...I swear by liquorice...it certainly works for me. My mother on the other hand (she also takes water tablets) has faith in fresh orange juice with hot water or tinned pears in syrup. There is the obvious high fibre but then you have to drink plenty of water which may be problematic for you. Personally high fibre doesn't work for me even if I drink plenty.

Have you checked out one of the past comments made by 'toohey' messaged 'miri' 14/09/12 re the use of 'Livetone' which she says is good for sluggish bowel..I don't know anything about it other than what I have read in the comment but its worth checking out -- you'll find the comment if you click on your picture/profile... then click on the message starting 'This is for peridot.....' alternative medicine.....then scroll up through the comments.

Hope it helps.

[sistergoldenhair in reply to mumofthree]

I love licorice, so this might be an easy try

[Magnolia in reply to sistergoldenhair]

livestrong.com/article/3686... I have read that the real true black licorice can be dangerous for you, so I found this site.

Magnolia

[sistergoldenhair in reply to Magnolia]

Thanks Magnolia, I did look this up and glycyrrhizin which is found in the root of black licorice has a side effect of edema, bloating, nausea and more. No licorice for me:/

[Cristina_Romania]

Respectfully, latulose is not a solution but for a very short period. Especially with the digestion and bowel problems of PBC people, you want to get a balanced digestion and bowel movement on the long run. Plus remember that PBC atients have problems absorbing certain vitamins and other nutrients. A laxative, used for more than really needed, can deplete the body form even more minerals and important substances.

Do not use Senna or Alder Buckthorn, these are anthraquinonic laxatives that force the bowel movements, and in time (if used on the long run) irritate the lining of the intestin and the colon.

Diet (and laxatives only if need be, for a very short period of time) is your best option. Consult your doctor about fibers, but do some reading too, you'll find many studies and authorised medical articles confirming what I wrote above.

[Val02 in reply to Cristina_Romania]

Sorry to disagree Cristina. But no matter what I eat, 5x a day, 3 litres of water I still suffer from constipation at times. I have been assured by my gastro that lactulose long term is not a problem unlike other laxatives, as the effect of lactulose is to simple attract more water into the intestine. Like many people with PBC I have a sluggish digestive system that just needs a little help.

Obviously there are certain foods you can eat that help: like beetroot, dates, figs, liquorice etc that achieve much the same effect. But there is really no difference.

[Cristina_Romania]

Isn't it LIVATONE? Seems good, from what they say it contains.

"As well as the leading liver herb, Milk Thistle, Livatone Plus also contains:

• ALL the B vitamins (including folic acid, inositol and biotin) in fairly high doses, so you will not need to take any extra B vitamins

• Selenium to provide 100mcg daily – now that’s an effective dose to support immune function! I am a great fan of selenium, as viruses can replicate much more easily in selenium deficient people

• Antioxidants – vitamin C 210mg, vitamin E 400 IU and natural carotenoids, to reduce inflammation and enhance detoxification processes. This is important as chronic inflammation can lead to scarring

• The most important sulphur-rich amino acids – namely taurine, L-cysteine, glutamine and glycine. The liver detoxification pathways have high requirements for sulphur-rich amino acids. Those with poor digestive function often have trouble digesting and absorbing protein which contains these amino acids.

• Livatone Plus also contains glutathione and broccoli powder for extra liver support"

Mumofthree - LIQUORICE is a smar tchoice :). Is one of the herbs with a tradition for liver and gallbladder related conditions, also helps with high cholesterol.

[Hidden]

I too have felt constipated since starting on urso almost 2yrs ago. Prior to this I never was.

I at present have no other problems with PBC except abnormal bloods.

Still being menstrual I find that I still do follow a certain pattern where I can go as regular as clockwork prior to the start of my cycle and then after I am back to spending the time in-between feeling constipated.

I do drink enough liquid but that seems to have not made much difference to me there. I then end up having high fibre breakfast cereals and do eat a lot of fruit and veg and cooki with wholegrain flours but I have noted a definite change since starting the urso.

I don't really want to submit to taking any medicatons for relieving constipation as I personally do not think it is the right way to go but at the same time I also think that eating far too much fibrous foods also (as in excess) could perhaps cause the system to sort of flush out much quicker and maybe then possible to start losing other valuable nutrients that can be a problem (ie B12, Vits D, E, etc) with PBCers.

I too love liquorice but please be aware as I read not so long ago, if you have high blood pressure use with a bit of caution as it can raise it a bit. (I love to have an aft drink of liquorice myself tho' I love eating it as a treat.)

[Hidden]

The more water I drink the worse I feel, I begin to feel waterlogged and bloated so drinking more does not always work as some people like myself can't take it, I have read them saying so on here.

[Cristina_Romania]

Don't believe me, check with specialists and your doctor - drinking is A MUST. You need to help liver &kidneys detox. Bloating and water retention are issues you must tackle together with your doctor, but they do Not mean you should cut on the water you drink daily. You may have no idea (but can research, authorised information in out there) how many serious complication of numerous conditions can occur if you are not properly hydrated and what that does to the natural detox mechanisms in your body. There needs to be a balance, of course, but do drink, for your health's sake.

Drinking enough water (1,5-2 liters a day for an adult) can help with chronic fatigue too, among many other things, according to liver specialists and the PBC Foundation Compendium.

[Cristina_Romania]

Lactulose needs, like any other drug, some special care. For example, overdose is to be avoided, just as much as the intake by people who are lactose intolerant.

Then again, I just found it does help for the liver, more than just with constipation - news-medical.net/news/2007/...

Still, diet remains one of the most important things one can do again digestive and bowel movement problems. Another idea, too simple not to try it, for anybody interested - wheat bran is a popular constipation here (though, just like many other things, may not work for 100% of those who try it), soaked in a glass of water from evening til morning, then you filter and drink the fluid.

[sistergoldenhair in reply to Cristina_Romania]

Wheat bran is a good fiber, I haven't tried it the way you are talking about though.

[Cristina_Romania]

Psyllium is even better source of fiber, just as much as flax seeds (which have phytolignans, aka natural vegetal hormones, which might require a bit of care for some, though there are studies showing great benefits for esp menopausal women).

[Hidden]

Flax is a good provider of fibre and it is gluten-free so perhaps better if you are cutting down on wheat intake. (My packet isn't the seeds as we'd think of, it's milled flaxseed so looks like airy particles and it is apparently organic and branded Linusit from a company called granoVita UK Ltd. It is apparently rich in Omega-3 essential fatty acids, high in something I've not heard of called lignans and is high fibre plus great for following low cholesterol diets, veggies and vegans alike. You have to store it in the fridge on opening and it then has a usage of 3-4mths so to me economical in use. Reading further on the packet, it has to be used with sufficient water/fruit juice. I have actually thrown some in my own-made juice and it can be added to yogurt.)

I have a packet of it that I bought to try out and throw it in with flour when making pastry (not something that we eat much of) and it is also good to add to instant porridge too.

With regards to fluid intake, we apparently only need 8 glasses of water a day and tho' I've tried several mths ago to drink plenty of water during the day all it did for me was make me run to the loo too often! If one has fruit and veg plus various other foods, it has to also be noted that they contain water also and it all adds up.

[Hidden]

Just to add further, I have also switched some time ago to buying oat bran as opposed to wheat bran as I think that might be a better option than the wheat bran sistergoldenhair. I think it is slightly dearer than wheat bran but you'd actually not really know the difference in use to wheat bran. It is good for mixing in with our branded Ready Brek for breakfast.

Also if you drink milk, that again has a high water content so it all adds up.

[littlemo]

Hi there just to add I find that drinking plenty of water (1-2 litres a day I always aim for personally) does help with preventing constipation another great thing is porridge with prunes(unsweetened with stones taken out) in the mornings really good for moving the bowels. The water may make you go to toilet more often but that is good as getting rid of thee toxins and personally I have found over the years it has helped with the itch I suppose by flushing out the bile and therefore the chemicals in the bile that are thought to ause the itch. Also drinking water as opposed to caffeine or fizzy drinks improves the elasticity of the bladder as opposed to the latter which irritate the bladder if taken in large amounts.

[NFTom]

Miralax every night before bed.