Celevac & Enterosgel for IBS: anyone have experience of these insoluble nonfermentable bulking agents?

[EOLHPC]

As i understand it, the basic forms of the ingredients in both Celevac & Enterosgel are commercially used as thickening agents/stabilisers. These are both silicone based organic polymers (in food stuffs they have E numbers)...they are used in loads of manufactured products...from paint to puddings. Celevac is Methylcellulose. Enterosgel is specifically Polymethylsiloxane polyhydrate (a gelly-like polymeric organosilicon compound with absorptive properties). Celevac is a pink tablet, Enterosgel comes in gel form or in a sachet. Both can be bought over the counter eg from Amazon, but Celevac seems to be a lot less expensive per treatment dose. As far as i can make out, only Celevac is prescribed by the NHS. Celevac treats both constipation & diarrhea, depending on the amount of water you take with each dose. Entersogel isn't a "laxative" but neither is Celevac! my suspicion is they both can help with slow transit dysmotility when taken with enough water & a nighly stimulant

Celevac has long been a fully approved treatment in official NHS Care Guidelines for both IBS-C & IBS-D. When my chronic slow transit dysmotility IBS-like constipation responded negatively to the osmotic laxative Movicol, i was prescribed daily Celevac (2 tabs a.m. & p.m.) long term (along with an ultra low fibre diet & 1/2 an Ortis cube nightly as stimulant).

So far Celevac seems to be helping me ok...i started taking it in February this year. I am a 63 years old, and diagnosed with many very early onset comorbidities (immune dysfunction & connective tissue disorders, including Ehlers Danlos Hypermobility, Systemic Lupus, Sjogrens, Hypogammaglobulinaemia). I try to understand the risk:benefits of all the prescription meds i'm relying on.

There are 2 other insoluble nonfermentable bulking agents: cellulose & sterculia. But because i'm having immune reactions to the 'natural' fibre in fioodstuffs, my consultants have gone for Celevac methylcellulose....they insist this stuff is totally benign

Recently a friend who has a lot of experience of both IBD & IBS found adverts in uk media promoting Enterosgel for IBS. So she gave me the Enterosgel website address. Turns out Entersogel has been available OTC for over 10 years. Seems to me, the online entersogel publicity info makes the same sort of claims I've read about Celevac....except the type of Polymethylsiloxane used in Entersogel has absorptive properties active in the gut in special ways. I found 2 HealthUnlocked posts about entersogel when I searched. Now i'm wondering does anyone here have experience of Enterosgel &/or Celevac?

🍀🍀🍀🍀 coco

[Jane2510]

Hi there

I gave enterosgel a trial a few months back and it really didn't do much with my ibs d - I spoke to my gp about it - showed her the box and basically she raised her eyebrows and moved on the conversation.

Everything I read made it sound the wonder cure for even holiday tummy upsets.

Maybe it will work for someone but not me and at £12 a tube from boots it's pretty expensive too.

[EOLHPC in reply to Jane2510]

Thanks v much! my impressions fit with your reply

I think enterosgel is a controversial product, so I am going to ask my gastroenterology nutrition+dietetics clinic & my gastroenterologist about it

Although entersogel isn't a "laxative", i cannot see why enterosgel couldn't also be effective in constipation cases when taken with enough water, just like Celevac...because they are both insoluble nonfermentable bulking agents ...my suspicion is that entersogel's "so-called" absorptive properties are viewed as "iffy" by the health system... so the shorter the time entersogel lingers in the gut the better. If i were to try it, i'd increase my nightly Ortis cube dose a bit to make sure my motility is efficient as poss. But i will not try entersogel unless my gastro team approves

[Fruitandnutcase]

I've used celevac. It was ok, I was given it years ago by a doctor who thought it would be gentler than Fybogel. It was ok but I hated that my teeth turned pink when I chewed the tablets, plus it sort of stuck in my teeth.

I was recently given Normacol which I think it probably similar. Sterculia granules. When the pharmacist handed me the bag with it in I felt like he had handed me a wrapped up housebrick - same size, shape and weight.

When I got it home and opened the box it was similar to a type of cat litter we used to use - white granules. This stuff smells of vanilla, you take two 5ml teaspoons twice a day and wash it down with a lot of water. In actual fact I found it easy and pleasant to take and it worked for me.

[EOLHPC in reply to Fruitandnutcase]

Thanks v much for your reply! I love that sterculia can look like cat litter & smell like vanilla! It's great sterculia helps you. I wish i could try it...maybe i will be able to some day...but my immune dysfunction has become hyper reactive to almost all "natural" plant fibre...and sterculia comes from a plant....so i'm instructed to avoid it. Sterculia is classed as an insoluble nonfermentable bulking agent

Yes, Normacol granules contain 62% w/w sterculia, which is a vegetable gum from the karaya tree...a type of mallow

Fybogel is mainly isphagula husk and is classed as an intermediate soluble fermentable fibre (bulk forming) laxative. Others in the same class are oats, psylllium etc. I respond badly to this because it is both soluble & fermentable, whereas celevac is insoluble & nonfermentable (making for less "gas")

I have spent my lifetime coaxing GI slow transit dysmotility along via high fibre diet (combined with a low FODMAP antiinflammation diet). So the past 22 months of having to face up to excluding plant fibre from my diet has not been an easy surrender....but surrender i have...and 5 months on am realising this is definitely right for now....

The best & most current official research paper i've found on the role of dietary fibre was produced by Rome Foundation Study Group: Fibre & Functional Gastrointestinal Disorders by Eswaran, Muir and Chey and published in 2013 in the American Journal of Gastroenterology. This brilliant eye-opening paper classifies the fibre/bulk forming treatments we've been discussing here. In case you're interested & haven't read it, this link should take you to this paper:

pt.scribd.com/mobile/docume...

Oh my: celevac's pinkness is simply shocking...i've had to work hard at figuring out how to avoid the pink teeth thing...🤦🏼‍♀️

[Fruitandnutcase in reply to EOLHPC]

Poor you, IBS is hard enough when youre like me and can take pretty much any of the 'cures' offered but to have limits set on what you can take must very hard for you. It's such a weird condition too, some people are ok with fibre whereas it's so bad for others. I can actually take fibogel but my GP at that time felt it would be too harsh. I had all the tests over thirty years ago.

My gut is mostly settled but stress is my big problem and right now I've got major stresses in my life - husband (big operation coming up at end of month) and two sons (one made redundant and no sign of a job and other one in Oz about to have a major back operation two weeks before husband)

Off to read your paper now, thank you. I always say you can't ever read enough about your conditions.

[EOLHPC in reply to Fruitandnutcase]

You have a lot of really tough things happening ....am wishing you & your family every best wish 🍀🍀🍀🍀