# Ibs - C & Chronic Laxative Abuse



## prttywmn (Jun 4, 2010)

I had my colonoscopy done on Tues. Awaiting biopsy results (due in 2 weeks). Dx: colonic atony due to chronic laxative use for the constipation. I also have diffuse Melanosis Coli caused from the senna in the laxatives. I found my old Sitzmark records (which documented I failed the test)from 2000 and documentation from the GI surgical consult I had back then that recommended a complete colectomy. I did not want to do it at that time as I had just gotten married and they used the open procedure and colostomy bags back then. The GI surgeon I saw then has since retired so I am going to take my old records to the new GI surgeon for my operative consult on 7/15 and hopefully he will agree with doing a colectomy laprascopically. The only thing the doc that did the colonoscopy had to recommend in the meantime was taking Miralax and Amitiza twice a day. The Miralax doesn't work and the doc knows that but told me not to take any laxatives. The laxatives with the Amitiza is the only way I can go but it is like he just won't listen to me or offer me anything else ! I was so upset with him. He did not even have me properly sedated when he did the colonoscopy and I was awake and felt almost the entire procedure. I was screaming at the top of my lungs and became combative at which time they finally knocked me out. I was sooo upset - UGH !!! My colon is coming out one way or the other - even if I have to cut it out myself !


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## nowandthen (Jun 17, 2010)

How awful -colonoscopies are bad enough without being partially awake.I cannot imagine that. Good luck and I hope you have a good surgeon to discuss things with you in mid July.


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## Mary5 (Apr 17, 2006)

Sorry to hear about your bad experience with the colonoscopy. You really didn't need to suffer at all!I am concerned about the issue of colonic inertia due to laxative abuse. My gastro says that nowadays the theory is that you should take whatever you need to take to go and that the theory of laxative abuse has been discredited. Perhaps because the old laxatives contained an ingredient that I know was banned years ago by the FDA. And I totally understand you about the Amitiza and Miralax! The Amitiza worked a couple of times for me than stopped and the Miralax has never worked for me regardless of how much, when etc!Currently back to Dulcolax (Fleet brand, or Carter's Little Pills, bought at CVS) but even that does not work consistently so like you I wish I could just make a hole and let everything out, always in pain and with a huge stomach. Anyway, keep us posted on what your new doc says. Good luck.


prttywmn said:


> I had my colonoscopy done on Tues. Awaiting biopsy results (due in 2 weeks). Dx: colonic atony due to chronic laxative use for the constipation. I also have diffuse Melanosis Coli caused from the senna in the laxatives. I found my old Sitzmark records (which documented I failed the test)from 2000 and documentation from the GI surgical consult I had back then that recommended a complete colectomy. I did not want to do it at that time as I had just gotten married and they used the open procedure and colostomy bags back then. The GI surgeon I saw then has since retired so I am going to take my old records to the new GI surgeon for my operative consult on 7/15 and hopefully he will agree with doing a colectomy laprascopically. The only thing the doc that did the colonoscopy had to recommend in the meantime was taking Miralax and Amitiza twice a day. The Miralax doesn't work and the doc knows that but told me not to take any laxatives. The laxatives with the Amitiza is the only way I can go but it is like he just won't listen to me or offer me anything else ! I was so upset with him. He did not even have me properly sedated when he did the colonoscopy and I was awake and felt almost the entire procedure. I was screaming at the top of my lungs and became combative at which time they finally knocked me out. I was sooo upset - UGH !!! My colon is coming out one way or the other - even if I have to cut it out myself !


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## nowandthen (Jun 17, 2010)

I have read and read about this and I have found enough placesthat say what your gastro doctor told you - that the colonic inertiawas there in the first place and that is why the person had to take the laxativesinitially. Not that the laxatives caused the colonic inertia. For some people, there is just no other option. I hate more than anythingtaking them, but nothing else works.My theory is that for some of us, Miralax and Amitiza and other things don't workbecause they draw water in the bowel, and then the bowel has to work from there.If your bowel functions properly, those things will work for you. If yours doesn't, thenit won't work. I need a stimulant unfortunately and Miralax and Amitiza are not stimulants.


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## annie7 (Aug 16, 2002)

mary--have you tried the brand name ducolax pills-the "real" ones made by boehringer ingelheim? previously i had always used the store brands--cvs brand bisacodyl, etc--and they worked but not always consistently, like you said. carters and correctol never worked for me for some reason. recently i tried the brand name ducolax and boy was i amazed at the difference! really works well and consistently too. it's a lot more expensive than the store brands but it's well worth it.and yes i agree with what both mary and nowandthen said about stimulant lax use--it's the older brands that were harmful and they have been removed from the market. my most recent (although unfortunately for me now retired) gastro doc said the same thing mary's doc said and told me it was ok to take stimulants if they are what i need to go. he also said that melanosis coli is no longer considered to be a serious condition. http://www.ncbi.nlm.nih.gov/pubmed/8234421prttywmm--good luck with everything. i totally understand what you mean. there are so many many days i would just like to cut that nasty ol colon out myself and be done with it.


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## prttywmn (Jun 4, 2010)

Thanks for all of your compassion and support ! I felt as though I had the colonic interia first as well which caused me to have to take the laxatives, but the doc actually has implied almost as if I asked for it because I damaged my colon from the laxatives. I have to take stimulants to go. The osmotics that draw water into the colon do just that - but then the colon doesn't move and I am left even more bloated and miserable ! UGH







It is so good to hear from other people who actually understand what I am talking about ! I really appreciate all of you and will let you know what the GI surgeon says on 7/15, and the results of my biopsy if it comes back in the interim. I will also be praying for all of the IBS suffers out there. God bless you all







Love & hugs, ~ Pamela


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## annie7 (Aug 16, 2002)

Pamela--you are so right--you did have the inertia first and you had to take the laxatives to deal with it and not vice versa.. shame on your doc for blaming you! he's going by the old-school ways--he needs to update his medical education. docs like that make me so mad.and oh yes do i ever know what you mean about osmotics. they just sit there inside me slushing around but not going anywhere. i need the peristalic push that the stimulants provide to get it out.hugs back and God Bless...annie--- and thanks for keeping us posted. wishing you all the best.


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## claire_louise (Dec 8, 2009)

annie7 said:


> mary--have you tried the brand name ducolax pills-the "real" ones made by boehringer ingelheim? previously i had always used the store brands--cvs brand ducolax, etc--and they worked but not always consistently, like you said. carters and correctol never worked for me for some reason. recently i tried the brand name ducolax and boy was i amazed at the difference! really works well and consistently too. it's a lot more expensive than the store brands but it's well worth it.


Annie, can you tell me a bit more about this? I never realised there was another type of Dulcolax apart from what you can buy OTC (standard Dulcolax pills, Dulcolax pearls, suppositories etc). Is there any way we can get hold of the 'real' ones in the UK do you know?


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## Kathleen M. (Nov 16, 1999)

I think if it says "Dulcolax" that is the brand name (real) stuff.Anything that is a store brand with the same ingredients but a different name would be the generic.In theory the generics (like store brands that are often a lot cheaper) should have the same effectiveness and dose and all that. Some people sometimes find one or the other is more effective. Isn't always the brand name that works better, but they are from different manufacturers and may have different fillers and coatings and various things that may effect someone who is sensitive to slight variations in dose and a few milligrams makes a difference for them.


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## annie7 (Aug 16, 2002)

claire louise--so sorry for the confusion. like kathleen said i was talking about the pills that say "ducolax" on the box--the "real" ones made by boehringer ingelheim. i had been taking the cheaper store brands like cvs, meijer etc.


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## claire_louise (Dec 8, 2009)

Ah I see, no problem Annie (and please call me Claire!). There I was wondering if there were some super-strength Dulcolax that I'd never come across before...wishful thinking on my part!!


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## annie7 (Aug 16, 2002)

claire--oh i do so much agree--about hoping to find something stronger out there. and i'm sure it's like kathleen said about the "real" ducolax actually being no different than the generic. the "real" stuff has worked extremely well for me so far--i've taken it three times--but who knows if that'll continue. even so, i am going to try all the other brand names of the senna laxatives--the "real" senokot and exlax-- just to see if they work better--even if only temporarily--than cheaper generic store brands i've been using. leave no stone unturned in the fight to manage c...


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## wildbabycatzz (May 14, 2010)

annie7 said:


> even so, i am going to try all the other brand names of the senna laxatives--the "real" senokot and exlax-- just to see if they work better--even if only temporarily--than cheaper generic store brands i've been using. leave no stone unturned in the fight to manage c...


I am leary of store brands. Just wanted to say I have had good experience with Equate (WalMart) vegetable laxative which is their equivalent to senokot.


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## annie7 (Aug 16, 2002)

thanks--we don't have a wal-mart out here but i'll keep that in mind if they ever decide to build one close by. or maybe they sell it online..i'll have to check.


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## Mary5 (Apr 17, 2006)

I think most long-sufferers will agree with me...while the main ingredient -for example, bisacodyl en the case of brand "Dulcolax" -is the main ingredient, each brand puts the pills together in a certain way and each one of us will have a different experience with each of the brands. This is one more tactic in this war, to try different brands of the same chemical. As an example, I tried Walmart's brand of bisacodyl and nearly had to go to the emergency room. So I am back to bisacodyl brands "Carter's little pills" and "Fleet".Again, my gastro has confirmed on many occasions that you can take stimulants as needed.I will be seeing him soon and will ask him about a prescription for Resolor, amongst other questions. I am not too hopeful since I doubt any doctor will give out a prescription for a medication not approved yet by the FDA. Still, doesn't hurt to ask!


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## nowandthen (Jun 17, 2010)

Sometimes it's the "inactive" ingredients that make the difference.I just wish I didn't have to take so many. How many do you take onan average week? (anyone can reply) I take them every day, and more than the packagedosage advises, but I don't know what else to do. One of these daysI'll probably do what prettywoman is doing, but for now I have too much going on to even consider that.Part of me thinks that maybe the senna is better because it seems to be more natural than the bisacodyl.I am so worried about my appointment in Sept with my new gastro doctor.I dread her asking me how many senna tablets (15 mg each) I take per day.Oh, well.


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## Mary5 (Apr 17, 2006)

[I usually take 2 5mg bisacodyl. However, it is not doing a complete job, that is, whatever is nearest to the exit will come out. But the stuff left behind, on it's way, lodged along the way results in much pain and incredible discomfort. Can hardly breathe and can't find a comfortable position.So tonight I will take 3 of 5mg. If it's of any comfort to you, both biscodyl and senna have been around forever, my grandmother and my great aunts all used bisacodyl and senna many years ago. And they do seem to be the most effective stimulant pills out there.


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## annie7 (Aug 16, 2002)

i take laxatives almost every day. i either take 3 5mg bisacodyl or 4 25 mg senna. i also take 3 tbl milk of mag nightly--makes the lax work better (miralax didn't work for me). this is all with my former gastro's approval since nothing else would work and after forty-plus years of ibs-c i was getting pretty desperate.and then once or twice a week instead of the laxatives i take 12 mg tegibs--generic tegaserod (zelnorm). zelnorm never worked for me when i took it daily--nada results--so now i take it like a laxative. i know tegaserod is not a laxative--it is supposed to sort of regulate the bowels like resolor-- but it never had that effect for me. mary--i know what you mean about that discomfort with the stuff lodged higher up--i get that too at times--some days are far worse than others.


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## Mary5 (Apr 17, 2006)

Annie7, I still can't believe you have been able to live this way for so long! This problem started for me about 8 years ago but it has become really bad for the last 2 years/meaning pain and discomfort every day, and every day more and nothing, nothing works properly and consistenly. Cant remember the last time I felt "ok". I used to run and do kickboxing and eat delicious things...now, can barely manage a short walk, the rest of the time is devoted to trying to get comfortable and thinking of what to take that night. It is a nightmare. I am seeing my gastro this coming week and want to ask him about prescribing Resolor but I am not too hopeful since the FDA has not approved it. Also will ask him what is the next step that could be taken. A friend said exploratory laparoscopic surgery !!!!!! I just don't know anymore.* Anyway, wanted to ask you about the MOM dosage, is that teaspoons or table-spoons? The last time I tried MOM, several months ago, it woke me up with such pain, and didn't work.* What success, if any, have you had with regular magnesium (oxide or citrate) ?* Does your doc prescribe the "emergency" zelnorm or do you get it from overseas like other people, and how much to you take?Thanks !


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## Mary5 (Apr 17, 2006)

Also, has your doctor ever proposed an SSRI, like Zoloft


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## annie7 (Aug 16, 2002)

hi mary i sympathize, empathize with what you're going through..oh yes chronic c is a nightmare...and it severely affects one's quality of life. i wish the docs would get that!i take three tablespoons mom--sometimes four--and i drink about two cups of water with it too. you want to be sure and drinks lots of water with it. sorry it didn't work for you..we're all so different in how we react to stuff. does miralax help at all?i never had any success with magnesium citrate or oxide pills. tried lots of different brands, dosages.when i take tegibs, i take 12 mg (2 6 mg pills). i get tegibs from inhouse pharmacy, an online pharmacy located in the south pacific. tegibs is made in india. although someone recently posted that she read that india may stop making tegibs soon. and i also drink lots of water daily (don't we all), eat a bowl of fiber one for breakfast and eat healthy in general--lots of fruit and veggies, take 2000mg vitamin c in the am, and use a footstool to elevate my feet when on the potty---helps promote a more complete evacuation. and i meditate daily to reduce stress--too much stress always makes c worse. and i exercise a lot. oh and like someone else mentioned in another thread--i always take a magazine into the bathroom with me..reading helps me to relax, not strain..helps things move along. and yes my current doc did give me a script for citalopram (celexa) to try. i took it for a few days. it didn't help my c much and it did make my insomnia a whole lot worse--unbearable-- so i stopped taking it. although i know they do help a lot of people, i really do want to stay away from antidepressants because of all the side effects and also because of the problems in stopping them--serotonin discontinuation syndrome--although i do know tapering off is supposed to help with that. i guess it's just because i personally know a lot of people who have taken/are taking them and i've heard far too many negative things about them. although i don't mean to discourage anyone from taking them..we all react differently to meds and anything is worth a try .


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## prttywmn (Jun 4, 2010)

I have been reading about all the posts re laxatives. I have taken the Equate (Wal-Mart) brand which has senna - like Senokot - only it is cheaper ($4 for a box of 100). I have to take 25-50 a day (I usually take them at night) just to initiate my bowels to move - that is along with 2 24 mcgs capsules of Amitiza a day. I didn't have to take that many Equate at first but built up a tolerance and over the years have increased the amount on my own. PLEASE use caution with the use of laxatives ! Especially the stimulant kind - like senna. They have caused nerve damage to the lining of my colon and I am laxative dependent now on very on high doses. My colonoscpy biopsy revealed melanosis coli. I have taken so many they have stained the normall pink mucosa of the intestinal lining to a brown color which I have heard can predispose to colon cancer later (controversial literature out there re this). As I mentioned in previous posts - I am scheduled to see a GI surgeon on 7/15 to discuss a complete laparoscopic colectomy - hopefully with minimal incision and no "poop bag". I am going to probably get a 2nd & 3rd opinion after that - depending on what he tells me. I already know I am having the surgery though as I cannot live with this much longer. I will let you know what the GI surgeon says. Unless you have colonic inertia/colon atony where the colon will not work at all on its own - please use caution with the laxative stimulants !


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## Guest (Jul 9, 2010)

Mary5 said:


> Annie7, I still can't believe you have been able to live this way for so long! This problem started for me about 8 years ago but it has become really bad for the last 2 years/meaning pain and discomfort every day, and every day more and nothing, nothing works properly and consistenly. Cant remember the last time I felt "ok". I used to run and do kickboxing and eat delicious things...now, can barely manage a short walk, the rest of the time is devoted to trying to get comfortable and thinking of what to take that night. It is a nightmare. I am seeing my gastro this coming week and want to ask him about prescribing Resolor but I am not too hopeful since the FDA has not approved it. Also will ask him what is the next step that could be taken. A friend said exploratory laparoscopic surgery !!!!!! I just don't know anymore.* Anyway, wanted to ask you about the MOM dosage, is that teaspoons or table-spoons? The last time I tried MOM, several months ago, it woke me up with such pain, and didn't work.* What success, if any, have you had with regular magnesium (oxide or citrate) ?* Does your doc prescribe the "emergency" zelnorm or do you get it from overseas like other people, and how much to you take?Thanks !


Hi Mary, I came across this thread on the forum when I was looking for other people who were mentioning Resolor. I have asked my regular physician and a gastro about the drug but they had no clue what I was talking about. I have an appointment in a month with a new gastro doctor and I'm going to ask the if he has heard anything about resolor, or if he can tell me what the next step would be in finding out more information. I'm hoping that if more and more people begin asking their doctors about this drug, there might be more of an effort for the doctors to educate themselves on it and help bring it more attention. It is so frustrating knowing there is a drug that could potentially make a huge difference in our lives, and we can't have it!So if you ever find anything out about it, please spread the word! I'll be sure to do the same, I'm searching for new information about it every day.


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## nowandthen (Jun 17, 2010)

Prttywmn - I agree with you and appreciate your warnings on the overuseof senna. I too have melanosis coli. I am going to a new gastro doctorin September to see what she advises me to do. In the meantime, I'm watchingyour story to see what the surgeon recommends for you and how it works out.I wouldn't be doing that surgery for a long time, but if I have to ever start takingmore and more of the senna, I would consider it. Fortunately, I haven't hadto continually increase the dosage.


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## annie7 (Aug 16, 2002)

oh yes prttywmm--thanks for the words of caution. you are so right--it can be risky to overdo the stimulants.good luck with everything!


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## Lisab (Nov 11, 2004)

Mary5 said:


> Annie7, I still can't believe you have been able to live this way for so long! This problem started for me about 8 years ago but it has become really bad for the last 2 years/meaning pain and discomfort every day, and every day more and nothing, nothing works properly and consistenly. Cant remember the last time I felt "ok". I used to run and do kickboxing and eat delicious things...now, can barely manage a short walk, the rest of the time is devoted to trying to get comfortable and thinking of what to take that night. It is a nightmare. I am seeing my gastro this coming week and want to ask him about prescribing Resolor but I am not too hopeful since the FDA has not approved it. Also will ask him what is the next step that could be taken. A friend said exploratory laparoscopic surgery !!!!!! I just don't know anymore.* Anyway, wanted to ask you about the MOM dosage, is that teaspoons or table-spoons? The last time I tried MOM, several months ago, it woke me up with such pain, and didn't work.* What success, if any, have you had with regular magnesium (oxide or citrate) ?* Does your doc prescribe the "emergency" zelnorm or do you get it from overseas like other people, and how much to you take?Thanks !


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## Lisab (Nov 11, 2004)

Somehow I didn't know you could still get Zelnorm overseas. Could you tell me exactly where? That stuff tended to work for me.


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## annie7 (Aug 16, 2002)

Lisab--you can get zelnorm and also tegibs-- a generic form of zelnorm--from foreign online pharmacies. medsmex--an online pharmacy in mexico-- sells zelnorm but i'm not sure i'd recommend them at this point. someone recently posted that they were having problems with medsmex--order not received--not sure if that ever got resolved. i used to order from medsmex but about three years ago they hacked into my credit card number so i switched over to inhouse pharmacy--they sell generic zelnorm--tegibs.important note: if you do order from medsmex (or any foreign online pharmacy)--be sure and protect your credit card number- people have reported problems with fradulent charges on their credit cards after placing orders with both medsmex and inhouse. i use a virtual credit card number--bank of america's "shopsafe" program-- when ordering from inhouse. or you can do what some other people have done and use one of those debit/credit cards that are linked to a checking or saving account and only deposit enough money in the account to cover your order or use a visa gift card or, if you're ordering from medsmex, a money order.http://medsmex.com/store/home.phpfor the last two years or so i have been ordering tegibs--generic zelnorm--from inhouse pharmacy. tegibs works as well for me as the real zelnorm did. it's also a lot cheaper than medsmex zelnorm--$80.00 for 100 6 mg tablets. tegibs is manufactured in india by torrent pharmaceuticals. inhouse pharmacy is located in vanuatu, an island in the south pacific.here's the inhouse link. http://www.inhousepharmacy.com/generics/generic_zelnorm.htmland of course i feel there's always a certain amount of risk that goes with dealing with any foregin online pharmacy. but so far inhouse has been terrific. great fast service--they ship it out right away-- and they give you a shipment confirmation number which i've found does have a limited amount of tracking available through the us post office website. my last order from inhouse was placed feb 28 and i received it march 8. my other orders from them have taken about ten days to two weeks.if you look back on this board and the constipation meds board you will find more posts about medsmex and inhouse.


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## annie7 (Aug 16, 2002)

oh i should add that there are other foreign pharms who sell either zelnorm or tegaserod--tegibs/generic zelnorm. i've not tried any of them but maybe other people will post their experiences with them...


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## gin37 (Oct 20, 2010)

nowandthen said:


> Sometimes it's the "inactive" ingredients that make the difference.I just wish I didn't have to take so many. How many do you take onan average week? (anyone can reply) I take them every day, and more than the packagedosage advises, but I don't know what else to do. One of these daysI'll probably do what prettywoman is doing, but for now I have too much going on to even consider that.Part of me thinks that maybe the senna is better because it seems to be more natural than the bisacodyl.I am so worried about my appointment in Sept with my new gastro doctor.I dread her asking me how many senna tablets (15 mg each) I take per day.Oh, well.


If you don't mind me asking, how many do you take roughly each day? I am new to this site and find it a little comforting to know that there are similar people out there to me. I usually feel so alone with this problem and not one you can talk about freely, people will understand or the most part, care!


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## nowandthen (Jun 17, 2010)

Gin37, here's my story. I was taking 12-16 senna tablets per day. Then I saw the new gastro doctor at Emory University in Atlanta Ga.She told me I had to stop taking the stimulant laxatives because Iwas damaging my muscles and nerves. (especially at those high dosages)Then, she told me HOW to take the Miralax. Because she gaveme specific instructions, it worked this time after two failed tries,so now I am off all the stimulant laxatives and just take the Miralax.She did tell me however, if the miralax alone didn't work, we would have to add in something else, but she didn't tell me what.She told me to give it at least two weeks, and not to expect the miralaxto work the first week. She said to keep taking the senna the first week,and taper off the second week. She said to take 3 doses at night and 3 doses in the morning, but I foundthat was too much so I have cut way back from that.I am getting used to the miralax now and it seems to be working.


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