IBS Constipation

[Gardener]

Anyone advice on my constipation problem, I feel I need a stool softener, but anything I try massively increases bloating and pain. As everyone knows on here it’s hard to live with. Thanks.

[Luisa22]

Have you tried dealing with some of it at least from 'the other end' (a suppository)? I often find if I have constipation and am struggling to pass a bm, a suppository helps a LOT! I appear now to have IBS -mixed or alternating, rather than the 'D' I was diagnosed with!

I just use glycerin suppositories.

But I imagine you have probably tried that...

[Gardener in reply to Luisa22]

yes, I use suppositories more and more lately, even then it is still incomplete. I agree they do help tho, it’s grim isn’t it, thanks for replying. Ros

[Luisa22 in reply to Gardener]

Yes, it can be a bit grim having to fight with your gut every morning. I am extremely lucky to have periods of time when I have neither D or C. Just normal.

But I now eat different things depending on what my gut does on any given day. The plus is I can now eat more fibre and have more of a choice with vegetables, and even fruits again sometimes, and that does seem to help me. But it's like a see-saw game.

I always have a pack of glycerin suppositories just in case needed, and sometimes don't mind using one. Once I had to use two.

I always lie down for about 10 minutes after inserting one to let gravity help. I just listen to music on the radio while waiting. But I'm fortunate again to be old and retired and my mornings are my own.

I'm not good with suppositories. Once wet they are slippery and a few times one has shot out of my gloved hand across the bathroom! At least it made me laugh in my misery. The things are bullet shaped and that just made me laugh -shooting my bathroom up.

[Merlinjardin]

I use micro enema micro lax and if I don’t go sometimes use senna tablet. I found stool softener did not help much my stools are hard lumps hard to pass. Have some coffee in the mornings and water to help move it.

[Edgar77 in reply to Merlinjardin]

I use fybogel. It's just a high fiber drink. It does not work straight away, you must take it regularly for at least a week. My doctor prescribed it. You can buy over the shelf but it's expensive.

[casares8]

I use dulcoease and sometimes milk of magnesia, they dont normally cause bloating like fibre products do. I have heard a spoonful of olive oil can help too

[xjrs]

It is probably best to try to improve constipation with diet in the first instance.

What is your fibre intake like? To improve constipation in the short term you can try ground flaxseed on your breakfast, starting at 1 teaspoon and increasing at 1 teaspoon every 2-3 days - you'll need to consume extra water with it.

These foods are also high fibre:

8-9 Prunes

2 tablespoon chia seeds (soaked for 10-15 mins in milk or non dairy milk with cereal or water)

Shredded wheat (or if GF: Nutribrex)

60g Quinoa

Wholewheat bread

75g Whole grain pastas (if GF: Buckwheat)

2 Hard pears

5 Dried apricots

90g Raspberries

1 orange (contain a natural laxative)

2 kiwi.

I find that I need to have 1 orange or 2 kiwi a day and then another high fibre fruit later in the day to help with BMs. Introduce new foods and any fibre increases slowly, starting with one new thing at a time, waiting for 2-3 days for a response and keep a food diary. You may not need to consume as much fibre as I do.

For breakfast I make a porridge of 4 tablespoon of oat bran and 4 tablespoon all bran (wheat bran), 2.5 small cups of water and microwave for 10 mins. I then mix in 2 tablespoon of chia seeds and 1 tablespoon ground flaxseed and leave to stand for 15-20 mins since the chia seeds need to form a gel. On top of that I place 8 prunes and eat. The best thing to do is to start with normal oats in similar quantities and, if needed, replace one of the tablespoons of oats with oat bran for a couple of days, carrying on doing this every couple of days until you get to 4 tablespoon of oat bran and 4 tablespoon of oats. Then start replacing with wheat bran in the same manner. You can then add the other ingredients one at a time. You might find you do not need the complete 'recipe' to have a BM. All these individual components are down to tolerance e.g. you may not tolerate wheat (see later about Alflorex), so it is best to keep a food diary (I do this on a spreadsheet) recording symptoms for up to 2-3 days after each change.

I also take 30 drops of ginger extract before bedtime to aid motility. You may need to work up the dose to say 7 drop increments each night.

Exercise can help with BMs. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving.

You need to ensure that you are drinking enough fluids (2 litres of fluid per day).

There is some good advice about constipation here:

theibsnetwork.org/constipat...

theibsnetwork.org/constipat...

There are also medications that help IBS-C (constipation dominant IBS). I suffer from IBS-C and have been prescribed Linaclotide for it. I also take Alflorex probiotic which has made me more tolerant to taking in the extra fibre I need for a BM.

Failing dietary measures, you can try Optifibre, which needs to be worked up to a dose according to instructions. You may not need the full dose - watch out for gas and increment to a level that is acceptable for you.

Some people are more prone to constipation due to their intestinal anatomy. Through colonoscopies I have been told that I have a long loopy (redundant) colon. This means that food takes longer to pass through and in the mean time the intestines have more time to suck out water from the stool, drying them out and causing constipation. I have found that I need to consume much more fibre than other people to have regular BMs.

I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly. I also find the larger meals help to push things along better than drip feeding through snacking.

Note that the FODMAP elimination and reintroduction diet is for IBS, but if you are constipated it may make constipation worse, since it reduces the amount of fruit and vegetable fibre reaching your colon. In the first instance you could try increasing your fibre intake as described above. If this causes you more problems, you could then try Alflorex probiotic, which might make you more tolerate to FODMAPs and fibre, since it helps to shift your gut bacteria towards more good bugs than bad. It is the dominance of bad bugs that can give symptoms by feeding them FODMAPs, which can result in excess gas, bloating and pain. Failing that you could try a high fibre version of the FODMAP elimination & reintroduction diet - you'll need a dietitian referral from your GP to take you through this. These articles may help:

todaysdietitian.com/newarch...

todaysdietitian.com/newarch...

[Dottieeadie]

as hard as it is you hv to carry on taking softeners,work your way up to an high dose,the cramping bloating is the softeners working,after a week of softeners take a stimulant alongside the softeners as taking stimulant without softeners at first that will cause pain,as it’s trying to move the hard stuff

[Gardener]

Thank you all, for so much advice. I already do quite a lot of the suggestions, but will try some of the others. Strange how some of these symptoms go in phases. That’s IBS!

[Bralorne]

if you eat a couple of kiwi fruit every day the issue will disappear without distress.

[Evonne02]

You need to tell your gp of any changes to your bm asap. Important if the colour changes, or you've lost, or are losing weight without trying. I've had those same issues, been tested, admitted to hospital, etc. Have ended up doing self irrigation and just this week been told to increase Macrogol laxatives by the hospital.

[Spaceboy_60]

Have you tried Linaclotide??

[Smithyd78]

Hi Gardener, I've recently been in a similar situation with my IBS C (although just going through tests etc to confirm) I found a product online called Fybogel Mebeverine which not only helped with the constipation but also the painful spasms / bloating in my stomach .... you have to take it for a few days at least twice a day before meals but it definitely got things moving again. You may want to check with the doctors as well although I didn't. I found it online (Dr Fox) doctorfox.co.uk/news/fyboge... and you simply go through a few questions and answers and then their doctor will prescribe for you .... they can even let your doctors know so it's on records as well. I've had alot of issues recently and tried lot's of different things to see what helps.... mine flares up mainly due to stress of my job. Currently I'm using Alflorex (probiotic) On my second 30 day supply and also a high strength peppermint supplement which I found on Amazon and I can honestly say they make a difference along with regular exercise and plenty of water...... Good luck

[binks]

Laxatives are the devil incarnate! I have to take a Movicol sachet every night due to pelvic dysfunction and also IBS C. Without it I would be unable to go - but it makes me bloated and gives me cramps sometimes. It also means I end up going to the loo several times a day without doing much! I've tried all sorts and none of them are great. Diet alone does nothing if you have an underlying problem (I had a rectocele repair and hysterectomy 12 years ago).

I know all the things to do - and my diet is good, but the bottom line is I need to take a laxative every day. The colorectal guy recommended Movicol as safe to take long term. I HATE it though! Senna is only for the odd occasion, and lactulose is hell for IBS sufferers as it causes more wind and bloating. This is no help to you I know - just know there are lots of us in a similar situation and it's rubbish xx

[heartmatters1]

Hi

Along with a satchet of Laxido or Movicol a day prescribed by GP, I have a high fibre diet. I read that 2 kiwis a day are excellent for constipation, which seems to work for me. Also prunes or prune juice is great. Of course plenty of fluids too, as dehydration is a big factor In constipation.

Best wishes Ally

[Harley1020]

hello, I have found a kiwi fruit on an empty stomach before breakfast does help with my constipation.

A dietician on a television documentary mentioned having 2 kiwi fruits a day on an empty stomach for constipation but I find the one kiwi fruit is enough for me.

I also have cornflakes with a handful of all bran.

Hope this helps and you find a way to resolve your constipation problem.

Take care.

[Kaspinallsgr8]

not sure where you’re living because that might make a difference as to the name of med to recommend but during my painful days the only ones that I felt helped and didn’t add more grief are Docusate Sodium, USP 100mg which is a stool softener if hard stools are your issue. Must drink a good amount of water with this.

But if what you’re wanting to do is get it moving then that’s when I tried Movicol powder sachets. (contains: potassium chloride, sodium chloride, sodium bicarbonate, macrogol 3350) You have to be aware that this is not a stool softener but is a laxative.

Movicol helps you to have a comfortable bowel movement even if you have been constipated for a long time. Movicol also works in very bad constipation called faecal impaction. It does work fairly quickly, meaning take it at home. Only supposed to use it for short periods so check w your doctor what is ok for you.

The Movicol sachets are mixed with a lot of water which you drink overs specific amount of time. Comes in flavours or plain (the plain is the only one I could stand because the others all contained aspartame, that gives me migraines)

Although those were the best remedies that I could handle, I got tired of various side affects that didn’t really make me content with continuing to use them on a longtime regular basis.

As for fibre you have to realise that many of the suggested powdered mixtures are difficult to handle for IBS sufferers. I couldn’t deal with Fybogel, the ispaghula husk wreaked havoc on my guts. The general thought was you need to bulk your feces to get the bowel to move it better but that doesn’t work very well for most IBS sufferers.

It’s easier on irritable bowels to try whole grain oatmeal porridge in terms of grain types it’s has a calming effect being a soluble fibre.

There are other grains that are ok depending on what causes issues with your bowels

Other helpful fibres come from fruits and veg. .. these are great but sometimes they also cause problems for some folks. Here’s a few that I’ve found ok but it varies for each person.

Cooked veg because raw usually causes gas and gas = pain. Many are suggested to remove seeds and skins to keep them from causing issues.. personally I usually eat them with the skins but cut it up or put thru food processor : My favourite are green peas (I use them cooked whole from frozen), broccoli, green and yellow squash, butternut squash, parsnips, celeriac, aubergine (aka eggplant .. skin and seeds removed ), carrots, cauliflower, mild cabbages (not kale types) onions if well cooked, garlic purée, sweet potato, mild red or yellow peppers (no skin or seeds) .. no green peppers (cause gas), turnip or swede (same family definitely cooked to avoid gas), yams, pumpkin. Here are a few from the eat if it doesn’t bother you insoluble fibre category (irritant fibres that can’t be digested and usually goes through healthy bowels without a problem ): green beans, tomatoes the skins can irritate and tomatoes, pak choi, bean sprouts, and others these are the fibrous plants and ones with seeds and skins that are hard to get through your innards sometimes.

Unfortunately for me green salad with lettuces like romaine that I love send me straight to hell w pain. So depending on your own bowel issues lettuces could not be so great.

Fruits: black seedless grapes (my favourite … black grapes are rich in polyphenols, namely anthocyanins and resveratrol, which provide strong antioxidant properties that may help fight oxidative stress and prevent chronic diseases) , kiwi, fresh pears, apples, apricots, melon, mango, papaya, peaches, nectarines, plums, fresh figs, stewed prunes, other: processed or stewed fruit and berries without the skin or pips these are what bothers some people (try to eat ones that don’t bother you)

Keep up your water intake it helps everything including BMs add flavour with fruit juice but try to limit sugar and sweeteners (many bother some people like myself.. it’s aspartame and stevia)

Advice: try foods one new at a time so it’s easier to figure out the ok ones .

Other related topics for IBS :

Have a read on soluble v insoluble fibres.

Also for IBS but I found impossible: FODMAP Food List ibsdiets.org/fodmap-diet/fo...

Nightshades .. of the Solanaceae family contain alkaloids like solanine and can be at issue if consumed before fully ripened. These are nightshades: tomatoes, aubergines, potatoes, bell peppers, goji berries, etc. and are plants that bother some people, and also interesting information. webmd.com/diet/what-to-know...