Slow Transit pain and possible Nortriptyline success

[Orchid99]

So I have bitten the bullet and now taking low dose Nortriptyline as recommended by my Gastro to help with the pain and spasms I get with my colonic inertia (slow transit) that effects the left section of my colon. I had been putting this med off for months because of fear and I'm not one who likes to take medications anyway. Well I can honestly say I wish I had done it sooner because I'm on my third day and I don't feel the yukky washing machine feelings I normally get, I've had no drowsiness at all, but I am however experiencing increased constipation despite taking my daily dose of movicol which I I've been on for a long time and was successfully having a morning bowel movement, this morning is the first morning I have not had one. For anyone who has slow transit and been on either amitriptyline or Nortriptyline, did your gastro/doctor give you any other medication to counteract this like prucalopride or linzess? it would be a shame to have to stop the Nortriptyline if it's working for me on the discomfort level, I need this med to be able to start eating properly again because I'm so underweight.

[Kim_Hazell]

Hi Orchid99, yes I take amitriptyline and movicol twice a day and also 1 bisacodyl. My movements are ok probably every other day. I was prescribed senna aswell but at the moment Iv not needed them. Maybe just up the movicol until you have some movement. Hope it works for you xx

[Orchid99 in reply to Kim_Hazell]

Hi, do you find the Amitriptyline helps you, do you have slow transit?

[Kim_Hazell in reply to Orchid99]

Hi, Iv only been on amitriptyline for 4 weeks and tbh not noticed a difference with the pain but I was told this could take a few months to notice a difference. I have been diagnosed with predominant IBS-C, I have a functional problem. It’s slow and I have spasms so I can’t release anything. Pain can be unbearable so just have to keep taking the tablets and hoping for good results xx

[xjrs]

Nortriptyline is a tricyclic antidepressant which has the side effect of constipation. Have you tried or has your gastro discussed with you Linaclotide? It is for slow transit (IBS-C) and for pain. For me it just works on the pain, though for others it also increases transit.

Another thing to consider if your pain has a gut bacterial imbalance element, is Alflorex probiotic which has been scientifically studied for IBS. It helped me greatly with the pain too.

[Orchid99 in reply to xjrs]

Hi, my concern with the linaclotide is that a lot people say it puts them on the toilet for hours and it's hard to get a pattern with it, that would be difficult for me as I work

[xjrs in reply to Orchid99]

It's one of those things that tends to settle in time into a more normal pattern, but as you say there is a risk of unpredictability in the beginning. Unless you are able to work from home until it settles, I understand your concerns.

[Orchid99 in reply to xjrs]

Is it something you can take with nortriptyline?

[xjrs in reply to Orchid99]

Not sure. Something you would need to ask your GP or gastro. The idea would be that the Nortriptyline may not be needed if the Linaclotide works for you. The beauty with Linaclotide is that it only works within the gastrointestinal tract and not on the entire nervous system like the Nortriptyline does.

[Orchid99 in reply to xjrs]

My slow transit is only in the left section of my colon, I just want something to help stop the spasms and cramping of the overflow attacks. Some people with constipation do have success with nortriptyline, it may well be that the increased constipation could be a temporary side effect until my body adjusts

[xjrs in reply to Orchid99]

Fingers crossed. Good luck with it.

[edwangy]

I too have slow transit and pain , I've been prescribed pregablin for pain and to help me sleep as amitryptiline didn't do anything for me. Pregablin also causes constiptation so I take 15 ml of milk of magnesia in the evening after my meal.

[Orchid99 in reply to edwangy]

Hi, have you been on movicol yet for your slow transit? Does the pregabalin help and what dose do you take? It's day 5 of nortriptyline and I feel its helping a bit but I'm still getting the gurgling as though diarrhoea is going to happen but then it stops.

[edwangy in reply to Orchid99]

I take 25 mg at night it helps with sleep as pain causing sleepless nights. I've tried cosmocol which is same as movicol but that seemed to create more gas and bunged me up even more. It's early days with pregablin but I'll keep trying for a while. Not helped much with pain yet though it helps me get a few hours sleep