# Laxative question, I need your advice!



## Aidara (May 9, 2014)

Hello everyone. I really need your advice. Since I couldn't solve my constipation with dietary changes, I finally took my doctor's advice and had been taking Movicol (Miralax) for 8 months. I was absolutely fine while taking this medication - I was regular, had no bloating, I completely forgot my bowel problems. That was just a miracle. I was taking 1 sachet, but once or twice a week 1,5 or 2 sachets, mostly on weekends. I was also taking a glass or two of prune juice. Unfortunately, 1 sachet stopped working to my great disappointment  As I didn't want to increase the dosage, I decided to alternate Movicol with something else. So I gave a try to fybogel (ispaghula husk) and lactulose. I am taking 2 sachets of Fybogel and 40ml of Lactulose daily. Also 250mg liquid magnesium. I started with lower dose and then kept increasing it gradually. It is working to my surprise more or less. I stopped Movicol, stools are soft and I am getting regular. Which is great! The only problem I have is - EXTREME BLOATING. It's been a week now and bloating is not getting any better. Is this normal? Should I continue with this combination? I am keeping my fibre intake down, especially insoluble fibre (as I was advised by some of you on this forum). I also make sure I am drinking tons of water. Does it mean I should find some other laxative combination? I must have some osmotic laxative, cause if I don't my anal fissure is going to reopen and I am dreading that. I was thinking to try milk of magnesia, but on the bottle says that prolonged use could cause dependence and I don't understand why as this is not a stimulant laxative. We don't have Colace in the UK, but there is Dulcoease tablets (100mg sodium docusate). Shall I try them instead of lactulose or fybogel or eve replace them both? I would appreciate any advice, thank you.


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## Dreamcatcher32 (Nov 12, 2013)

All of the things that you are taking will cause bloating. The liquid magnesium will esp do it because it can be irritating to the colon - any magnesium can. You might want to lay off of that and everything else and let your body do the job. This is probably going to require a huge diet change, though.

I also notice water bloats me up. I have the same issues and I have heard that it's muscle coordination that can be the problem. So your muscles tense and spasm whenever you put something in your body. It also happens if you don't go to the bathroom - those without IBS problems don't have this. Lucky us! lol. Low fiber will help you out but you also need to keep a diary of the foods you eat and keep careful note of which ones bloat you up. You may be sensitive to one type of yogurt, one kind of veg/fruit, etc... it's very precise and tricky to figure out. Also keep track of your cycles, this could be a contributor. You can also chart certain foods that make you 'go' for sure.

One thing you could do is try anti-depressants for your bloating. I know if I'm on a high dose of Fluvoxamine, the bloating decreases. I have stomach discomfort with it but it does become reduced. I'm also just going to flat-out look into a pair of spanx... lol. Most important thing is to not freak out or stress out about your IBS, that will make your bloating worse.

Lactulose does nothing for me, just makes my colon go all crazy. I would stay away from laxatives unless you haven't gone for 3 days or so. I was told by Mayo at that point, it's best to just take 4 cap fulls miralax and then use an enema. Everyone with IBS keeps wanting to have those daily BM's to alleviate discomfort. But no one goes every single day - just gotta tough it out.


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## Aidara (May 9, 2014)

Thanks a lot for your reply. When I miss at least one day there is the risk of my fissure and haemorrhoids coming back, which is very painful condition. If I stay away from laxatives, I still go to the toilet, bet with dry painful stools. So I must have some stool softener daily ( food on its own doesn't help me at all) and I absolutely hate it. I honestly tried so many things with my diet, I just given up, cause nothing makes a difference. ( I just don't know what else to do. If I stay away from insoluble fibre I have no problems with bloating. I know for sure that it is lactulose and fybogel making me bloating, but I need to replace Movicol with something else, cause I am getting immune to it, that is why I want to give it a bit of break. I just wonder will this bloating ever pass? If not, what else would be an option to take instead of Movicol? Or should I keep on taking higher dose of Movicol even though I know that in a half a year or so I might need to increase it a bit more? I would appreciate any advice, thank you.


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## Benzo Belly (May 21, 2014)

I find that I have to alternate between a wide variety of laxatives to maintain effectiveness. My repertoire includes magnesium citrate, stimulant laxatives, Miralax, Milk of Magnesia (magnesium hydroxide), Emergen-C (vitamin C supplement) and others I'm probably forgetting. Every last one of these has negative side effects of some kind, so I try not to use them unless absolutely necessary. Lots of water is required to keep the bowels functional in general but is extra important if you take any type of laxative.

As for gas and bloating, there's not much that helps me. Chewing fennel seeds and anise seeds is sometimes helpful, as they're carminatives that help expel gas. Avoiding gas-forming foods is also good. If your bloating is caused by water retention, a diuretic like Diurex may be of some help.


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