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Monday, June 17, 2013

Laxatives - Friend or Foe for Gastroparesis

Laxatives and My Story

As always, do not try laxatives or anything without first consulting with your GI/Motility Doctor to make sure that this is the right course for you. According to Wikipedia, "Laxatives are foods, compounds or drugs taken to loosen the stool, most often taken to treat constipation. Certain stimulant, lubricant and saline laxatives are used to evacuate the colon for rectal and/or bowel examinations, and may be supplemented by enemas under certain circumstances. Sufficiently high doses of laxatives may cause diarrhea. Laxatives work to increase the movement of feces along the colon. Some laxatives combine more than one active ingredient. Laxatives may be oral or in suppository form."

I always see questions about laxatives when it comes to Gastroparesis. The most recent question that was asked by anonymous, "Does anyone use laxatives to manage their GP?"

From my personal experience, the Mayo Clinic doctor I saw told me to use Milk of Magnesia nightly. There are many different flavors of it, so I could pick and choose which one I wanted to take. In the end, I chose cherry. The image source can be found by clicking HERE.


After trying laxatives for about a month, it helped somewhat. My advice, if you are just starting out using laxatives to help constipation with Gastroparesis, try a low dosage first. Then, gradually increase the dosage until something happens. You don't want to start off with a huge dose and suffer for hours in the bathroom, which I'm ashamed to admit has happened to me before.

But, my body has the issue where nothing seems to really move down but everything comes back up. With the Milk of Magnesia, I was able to have a bowel movement maybe once a week and a half which is more than what I was doing before. However, my Mayo doctor wasn't impressed with that and had me up the dosage. I take it nightly but since I barely eat, nothing really comes out. My specific problem is that almost everything I eat or drink comes up, instead of going down.

So, I posed a question to the Gastroparesis Page on Facebook (www.facebook.com/greensnoteasy) and Gastroparesis groups on Facebook to ask about different people's experiences and results with Laxatives. I received an amazing amount of responses.

Jax replied, "I have a laxative regimen for severe slow transit constipation - Movicol liquid 40ml 4 x a day (easier than sachets) I take Paraffin Liquid 3 times a day - Glycerin Suppositories twice a day - Docusate 3 times a day - microlette micro enema (daily) - Bisacodyl (my colo-rectal Specialist swears by that) and various other stool softeners. However none of that moves by bowel so I need it removed. Even pre-op bowel cleaning meds/bowel wash outs don't work for me, I was admitted for a week to have them all to try and kick start the bowel with no success at all. The large amounts I take do cause me to have more nausea/vomiting at times. Some aren't too pleasant to taste and the volumes I take don't sit well. Sometimes I get the crampy feeling that I'm about to have diarrhea but it never happens as I'm so impacted (except overflow after a few months). Before it all got this bad, I simply used Senna (Senokot) 8 a day and they helped provide gentle relief."

Alison says, "Hi Emily. I have to use laxatives every day or else nothing occurs. I have found the best ones for me are bisocodyl (ducolax is the counter name). I have to take a minimum of 6 a day if I take less nothing happens & wen I need to take more then its a stay nearer to toilet facilities than usual. If I take just the 6 I go once any less than 6 I won't go at all. The only issues I get are cramping sometimes but that's usually if they haven't worked the day before. Tried picolax & a dissolvable sachet one before but they didn't do anything so ended up compacted. Not nice lol. It helps but adds extra stress of having to take extra meds but thanks GP is all I can say to that is lol."

Brittany responds, "I live on Miralax daily, take laxatives very often, and do enemas and suppositories also very often. This isn't related to my GP though. I've always had chronic constipation and if I don't take anything, I just don't go. I've been diagnosed with colonic inertia (slow transit colon), and there are talks of having my colon removed in my future."

Brandy says, "I used to before I started using 2 body by vi shakes as meals and just eating one solid meal/small snacks. I haven't had to in months now."

Jami replies, "I was diagnosed with colonic inertia around the same time I was diagnosed with GP. We realized I had been severely constipated my whole life after I developed a rectal prolapse (at age 21). Medtronic has another pacer that's the same as the gastric pacer except that its implanted in your back and helps to stimulate your colon. I got that. It didn't help with my colon (but helped my bladder issues tremendously, so we kept it in). I ended up having to have a colectomy (3 surgeries in one: colectomy, rectal prolapse repair, & pelvic hernia repair). That helped me so much. I never knew what it was like to have a BM everyday. Before the surgery I had a bm maybe once every 2-3 weeks (but I didn't know that wasn't normal bc I've never had a discussion with anyone about the frequency of BM's and because I've only gone once every 2-3 weeks for as long as I can remember). The biopsy of my colon showed that over half the cells weren't functioning at all, which basically means that my colon barely worked and that it might be paralyzed (possibly GP related)? I still have to take Mirolax occasionally but that surgery made my life much easier."


So are Laxatives a friend or a foe? Well, with Gastroparesis, they can be both. I usually view them as a foe because of all of the pain they cause - the cramping, waiting around, and pain. But, there are times that laxatives can be useful. So, I'll let you decide which camp you fall into - friend or foe.





1 comment:

Juliep said...

It's all I have now, years into GP and stuck without options I use 3 a day. I eat no meat or bread or cheese. They are so painful to use. My intestines are so sore and I have anal prolapse, food is not fun at All.