# What are your long term experiences with actual use of Senna and Ducolax?



## oceannir (Mar 6, 2012)

So over the past 6 months i've been forced to take stimulant laxatives just to get some kind of bowel motion so I felt emptied. Previously my routine had involved getting up somewhat early and sitting around drinking coffee and water waiting for my bowel to maybe movie, the reactions to this were some times effective but unreliable. Any sort of routine change or stress caused my body to entirely shut down. Due to working long hours I have found that taking Senna based laxatives have helped me clean my body out. They are not effective if I take them one day, but if you take them 4 consecutive days you get adequate emptying, which is usually fairly aggressive diarrhoea. Its nice to feel empty and despite the fact you still get bloating and cramping from them it is a stark realisation just how backed up you have been for such a long period of time. These do actually make my bowels work somewhat well, as in i'm eating dinner and I suddenly need to go to the toilet, I go shopping come home and suddenly need to go to the toilet, like a somewhat normal person does.

I know that despite the fact my GI doctor sees no harm in using these that the common consensus that they lose effectiveness and damage your colon even further must have some basis of truth. What is the general view of how long this takes?

I know its bad to second guess the GI doctors, but despite the fact that these drugs are giving me a relatively normal life currently, I do have fairly bad reservations about the future problems they may inflict.


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## wigglesmom (Dec 12, 2002)

I took senna for about 4-6 weeks (Constipation Stop by Renew Life). It worked great for a while and got me through a very busy time in which I was working two jobs and in grad school. Then, it completely lost its effectiveness. Since I stopped taking it, I have found that I am having even more difficulty having a bowel movement, so I am a little concerned that it may have done some damage. In retrospect, I wish I have not taken it though I am not sure how I would have gotten through that time without it. I have found a nice alternative to be malva. You can buy it in tea form in most Asian grocery stores.

For now, I am getting an average of one colonic a week because I am just unable to fully evacuate on my own now. I hope that changes soon.


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## annie7 (Aug 16, 2002)

oceannir--since you and i have already discussed this at length i won't go into it all again but one thing--i do think that some of this--the part about if the meds quit working-- depends on what the cause of the constipation is.

in my case i have a mild form of mitochondrial disease--my cells don't make enough energy. so a lot of my bodily functions are out of whack--slow colonic transit for example. the neuro doc explained it all to me but since i'm going by memory here i may not have all the terms etc quite right but when a person has a neurogenetic disease often meds quit working --or don't work at all--due to autonomic dysfunction, dysautonomia--in other words, the disease trumps the med. so in my case many constipation meds like zlenorm, linzess, amitiza either never worked at all or quit working on me. and exlax (senna) quit on me after about 4 years. dulcolax still works. so does milk of magnesia. and cascara sagrada.

we're all so different in how our bodies react to meds and supplements etc....

then, too, i've read that with a lot of people constipation just tends to worsen for many reasons as time goes on--the digestive tract can slow down with age and/or perimenopause, menopause with women, reduced physical activity, altered diet ---also outlet problems such a rectocele, rectal prolapse or pelvic floor dysfunction can develop--and you don't have to be older to have outlet obstructions happen either--they can happen at a young age-- other diseases can slow things down, medications, etc.etc. so then it's more a matter of the constipation getting worse but it's not the laxative that's causing that.

and i do know of people who've stayed on the same constipation meds and/or laxatives for years without any problems at all. and those are the people who often times don't come back to post on here anymore because they've found a solution and no longer have a need to come back to the board for answers..

good luck with everything. wishing you all the best...


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## Dreamcatcher32 (Nov 12, 2013)

I notice you have to 'switch out' things so your body does not become 'used' to something. I wouldn't use anything consequentially, I would always rotate. I would also not assume that your bowels are going to get worse - you don't really know that unless you've had extensive testing that would tell you so. (not sure that exists)

I would be sure to try psyilium husk, magnesium citrate (800mg), molasses, olive oil and take a lot at once if you have to. Drink at least half your body weight in water. Drink before, inbetween and after every single meal! Get into a routine where you drink a warm glass of tea and take whatever you need to make yourself go in the morning. You need to sit on the toilet for 30 minutes after eating a meal and train yourself to go at the same time every day. Morning is best because that's when things kick in. REmember, you could have PFD which would make it difficult for you to eliminate anything. So relaxation exercises and breathing are very important. Have you tried biofeedback? Concentrating on pooping and looking to 'sense' for when that urge is present is highly important. You need to truly focus on your bowels and the physical sensations of evacuating.

I wouldn't take laxatives unless you are forced to. If you take something, try MOM and stay away from the more 'addictive' laxatives like Senna. Though if you are desperate, try Intestinal formula #1 and see if that helps you. I would also rotate and use enemas. Buy your own bag on amazon and use salt in each one. The bag should be a 2 quart and it will hit almost all of the colon. Only do an enema once a week, no more than that. You could also try colonics if you are desperate but I have not gone this route yet. There are TONS of things you can try and it's probably going to work better than what a doc would perscribe. The trick here is that you need to learn to go on your OWN. I have read about numerous cases/people who are able to fully regain the urge to go the bathroom. I have been very successful in doing this the past few months. Don't believe all this crap that somehow you're STUCK. You're not! You need to visit docs, see exactly what you have, follow their advice and also do your own re-training. I would be sure to do biofeedback and physical therapy with someone who knows what they are doing (important!). I am about to start this and very excited to learn how to get those muscles back in shape.

Also - one thing that works for me is lots and lots of grapes. They are low fodmap and do give me gas but big whoop - they help a person poop! Raisins are also helpful, as are prunes. These are 'natures' laxatives. You have to find the foods that work for you. Give up gluten and give up breads. Chips are okay here and there but don't do them a lot. Eat a lot of fish and take A LOT of fish oil. Eat avocados because you need your fats to poop. Use coconut oil by the heaps and this will move things along. Be easy on your system for a few months and track what you eat and the results each day... it could also be that you have some food intolerance's contributing to the problem. Btw, do you have a squatty potty? Very important to get this, as it will remove your need to strain horribly. Squatting is a natural strain. If you follow all of these things and give it time (months) you will see results.


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## Sean (Feb 8, 1999)

Oceannir,

I would not take it as a given that stimulants, properly used, eventually lose effectiveness or damage the colon. You and I have chatted a bit about this privately in the past. My colonic inertia/chronic idiopathic constipation is bad enough that I rarely have any kind of spontaneous b.m. I have used Dulcolax for years now as one of my go-to remedies and it still works well for me. I find it to be more effective and predictable than senna, and, at least for me, produces less cramping. Kathleen has referred in the past to several studies that show that long term use of stimulants to treat chronic constipation is safe and effective. I recently had a routine follow-up colonoscopy and specifically asked my gastroenterologist if he could see any effects from the long term use of laxatives. He told me that the lining of my colon looked healthy. He basically told me to do whatever I needed to do to empty my bowel on a regular basis.

I think that using Dulcolax has been successful for me because I have been careful how I use it. I don't take it every day. I use it no more than twice a week. I take enough (3 tablets) to ensure adequate emptying. If I take that dosage at bedtime on an empty stomach with three glasses of water, I get a pretty aggressive bowel action before noon the next day 99% of the time. I just turned 40 and I have been doing this since my mid-20's. I don't perceive the laxative as losing its effectiveness over time. Another thing that I believe that has helped me is rotating the stimulants with other remedies. Osmotic laxatives do absolutely nothing for me. Even colonoscopy preps are virtually useless as I found out a few months back when the prep for my recent colonoscopy completely failed. The prep solution just filled my colon and sat there. However, I do sometimes use Dulcolax in suppository form. It is usually effective in roughly 30 minutes. I also use enemas sometimes. Microlax and Fleet both work, although they seem to lose their effectiveness for me if used too often. With these other remedies, I can sometimes take a couple of weeks off from the Dulcolax tablets. I am convinced that helps counteract any tendency for my body to build up a tolerance.

Hang in there. I think you are doing the right thing by taking the senna. You are feeling much more like a normal person. And, I don't think you have that much to wory about long-term if you use it properly.


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## oceannir (Mar 6, 2012)

wigglesmom said:


> I took senna for about 4-6 weeks (Constipation Stop by Renew Life). It worked great for a while and got me through a very busy time in which I was working two jobs and in grad school. Then, it completely lost its effectiveness. Since I stopped taking it, I have found that I am having even more difficulty having a bowel movement, so I am a little concerned that it may have done some damage. In retrospect, I wish I have not taken it though I am not sure how I would have gotten through that time without it. I have found a nice alternative to be malva. You can buy it in tea form in most Asian grocery stores.
> 
> For now, I am getting an average of one colonic a week because I am just unable to fully evacuate on my own now. I hope that changes soon.


God those Colonics seem like such a process to go through. That must be very rough for you to deal with on a weekly basis.



annie7 said:


> oceannir--since you and i have already discussed this at length i won't go into it all again but one thing--i do think that some of this--the part about if the meds quit working-- depends on what the cause of the constipation is.
> 
> in my case i have a mild form of mitochondrial disease--my cells don't make enough energy. so a lot of my bodily functions are out of whack--slow colonic transit for example. the neuro doc explained it all to me but since i'm going by memory here i may not have all the terms etc quite right but when a person has a neurogenetic disease often meds quit working --or don't work at all--due to autonomic dysfunction, dysautonomia--in other words, the disease trumps the med. so in my case many constipation meds like zlenorm, linzess, amitiza either never worked at all or quit working on me. and exlax (senna) quit on me after about 4 years. dulcolax still works. so does milk of magnesia. and cascara sagrada.
> 
> ...


Thankyou Annie. Yes, this is absolutely a question I have indeed pondered in past. I think I was just preparing myself for the inevitable -- life getting in the way and having to move to this. This is the first time i've actually had to take stimulent laxatives, but the life situation pushed me to that breaking point with them.

Like you said, it seems to be a chicken or the egg issue with them that scientists can't really work out which comes first. I also don't think there is much good research. It sucks that in a disease that is already so hard to deal with our one option for actual care has the capacity to make it worse doesn't it?

I wish I was at the point I could just trust what the GI Doctors say and be like "They know what they're doing" but if my experience learned here is anything its be informed in of yourself. But i'll report back to the doctor what i've found, I think its all they can really offer me.



Dreamcatcher32 said:


> I notice you have to 'switch out' things so your body does not become 'used' to something. I wouldn't use anything consequentially, I would always rotate. I would also not assume that your bowels are going to get worse - you don't really know that unless you've had extensive testing that would tell you so. (not sure that exists)
> 
> I would be sure to try psyilium husk, magnesium citrate (800mg), molasses, olive oil and take a lot at once if you have to. Drink at least half your body weight in water. Drink before, inbetween and after every single meal! Get into a routine where you drink a warm glass of tea and take whatever you need to make yourself go in the morning. You need to sit on the toilet for 30 minutes after eating a meal and train yourself to go at the same time every day. Morning is best because that's when things kick in. REmember, you could have PFD which would make it difficult for you to eliminate anything. So relaxation exercises and breathing are very important. Have you tried biofeedback? Concentrating on pooping and looking to 'sense' for when that urge is present is highly important. You need to truly focus on your bowels and the physical sensations of evacuating.
> 
> ...


Unfortunately MOM is banned in Australia, which is a shame as i've heard good things about it from the states, we simply can't get it here. I've never found the osmotics 'that' effective. I wish you well with the biofeedback, it certainly would be a help if you have evacuation issues and i've read good stories about it. Unfortunately i'm more aware mine is based around slow colonic transit, so the outlet obstruction treatments won't work and I find the mild laxatives are rather limited in their effectiveness for me. Not to say they're completely ineffective.

I'll give your views on natural fats a try, unfortunately this diseases makes you have low appetite so my diet isn't fantastic.



Sean said:


> Oceannir,
> 
> I would not take it as a given that stimulants, properly used, eventually lose effectiveness or damage the colon. You and I have chatted a bit about this privately in the past. My colonic inertia/chronic idiopathic constipation is bad enough that I rarely have any kind of spontaneous b.m. I have used Dulcolax for years now as one of my go-to remedies and it still works well for me. I find it to be more effective and predictable than senna, and, at least for me, produces less cramping. Kathleen has referred in the past to several studies that show that long term use of stimulants to treat chronic constipation is safe and effective. I recently had a routine follow-up colonoscopy and specifically asked my gastroenterologist if he could see any effects from the long term use of laxatives. He told me that the lining of my colon looked healthy. He basically told me to do whatever I needed to do to empty my bowel on a regular basis.
> 
> ...


Sean, thankyou for the reply. Yes, I have taken it onboard that you prefer the Ducolax variety. It sounds like bad reasoning but I simply tried the Senna because I had a box in the house from the last colonoscophy I had to have. I'm not very adventurous with medications like that. But you're right, there is certainly an element of cramping and trapped gas to it which i'm not entirely used to. I find that tends to happen when building up and coming off the effectiveness.

I find i'm getting with you regarding the effectiveness of osmotic laxatives. All they seem to do is produce smaller, wattery stools. They actually for me may make me feel like i've gotten less out then if I just let my body form its own bulk.

It sounds like you have an effective symptom and while I know you go through periods of increased suffering you do seem to have periods of increased normality from it. I'll just continue with using the stimulents when I otherwise don't feel i'm getting enough out. I still have some success on the days I don't take them, but the amount of emptying is getting increasingly reduced.


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## annie7 (Aug 16, 2002)

oceannir---yes it can be a struggle trying to decide when it's time to start using stimulants even now when the advice on them has changed and the more up-to-date gastro docs advise them. i'ved had c problems for over 50 years and have only been taking stimulants for the last six. i struggled on and on for all those years without them because back then all the docs said they were a no-no. and i was so relieved when the dangerous stimulants were removed from the market (i remember when that happened) and a new safer versions replaced them. and then the studies came out saying they were safer now etc etc and more up-to-date docs changed their advice.

so i know it's hard...but please please try not to worry (i know that's hard too). worrying about the future doesn't help-- just makes things worse and saps you of the strength you need to deal with today... and continue with your treatment plan since that it what is working the best for you--and yes you have tried everything-- and enjoy the good days when you have them!









wishing you all the best, always....


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## wigglesmom (Dec 12, 2002)

Oceannir-I actually LOVE the colonics. My practitioner is fantastic. Without them, I'd be in some serious trouble. Last night, instead of my colonic taking an hour and 15 minutes, it only took 40 minutes. I'd like to think that's progress.

I am taking an oxygen based magnesium cleanse currently. I am hoping it's effective.


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## Sean (Feb 8, 1999)

Wigglesmom,

I can see how the colonics would be quite effective - sort of like an enema on steroids. However, doesn't the cost start to mount up? The last time I checked online, they were going for about $90 US a session where I live. Assuming that I needed one twice a week, I would be looking at $800 or $900 a month just to relieve my constipation. Then there is the time required. I don't think I could find that much time out of my schedule every week, especially when I am traveling for business. How do you make it work?


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## wigglesmom (Dec 12, 2002)

Great question, Sean. I recently took a much lower paying job (I couldn't continue with my stressful job and the severe constipation). My practitioner took pity on me and is doing the colonics at a very low cost. I am very fortunate because without them, I'd be in bad shape. Normally, I only need one or two a month-just lately, I have needed many as I always get quite sick after Thanksgiving. I would think that even one per month would be beneficial. It has been for me.


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