# Anyone Try Amitiza?



## CinNJ (Mar 6, 2004)

I just received a scrip for it and my pharmacist says he has it now - anyone try it yet? Please report in!


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## SpAsMaN* (May 11, 2002)

Thanks!!!You are the first one to get the scipt.







http://www.sucampo.com/


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## 20708 (Mar 28, 2005)

CinNJ,Lucky you! Please let us know how it works out.


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## 20708 (Mar 28, 2005)

Looks like I'm next in line to get this! Finally! I just talked to my gastro doc, and they said it should be available here very shortly. I don't know if you remember, but when I told them about this drug in Feb and March, all they told me was "we haven't heard of it". Hmm, seems now they have! Funny how I 'heard about it' here so much in advance of the Dr. office.Anyway, I get it when it gets here, so I'm happy-in-advance.


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## SpAsMaN* (May 11, 2002)

Anita,i was wondering if you can send me an e-mail.I may want to cross the border to see your doctor.


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## CinNJ (Mar 6, 2004)

Ok I filled the scrip and took my first one late last night. It says twice a day so I'll take another one at lunch. I'll keep you all posted! I had a little nausea after taking the first one - apparently that is a symptom - it wasn't too bad as I took the pill with dinner.


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## SpAsMaN* (May 11, 2002)

Does it help the motility while reducing sensitivity/pain?







What is the name of the drugstore you bougth it?


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## 14978 (Feb 12, 2006)

hmm I wonder if this is the drug my doctor was talking about, she doesn't know what to do with me at this point and said there's a new drug coming out but not till next year, I guess it's coming out sooner than she thought--I live in NY, I'd think if it's available in NJ it must be here too?


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## 16692 (Dec 17, 2005)

I called my gi and they had not heard of it yet. I also called the pharmacy and they have it but it is 98.00 a pill unless your insurance pays for it. My insurance doesn't as of now. How is it working for whoever is taking it? Let us know.Jean


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## 16692 (Dec 17, 2005)

By the way, I live in IndianaJean


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## SpAsMaN* (May 11, 2002)

> quote:I also called the pharmacy and they have it but it is 98.00 a pill unless your insurance pays for it.


98$ one pill?Are you sure?That's crazy!!!


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## 16692 (Dec 17, 2005)

That's what walgreens told me and i even questioned it. I hope she made a mistake. I counldn't believe it either.Jean


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## SpAsMaN* (May 11, 2002)

CinJN:Would you please give an update?


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## CinNJ (Mar 6, 2004)

I'm not sure what to report as of yet. I stopped Zelnorm and started Amitiza but found myself with a lot of C the first two days. Not sure if it was my body being so used to having Zelnorm for so long. In any event, I now am taking both of them at the same time - and it's kind of like the Amitiza super-charges the Zelnorm (which has never been as effective as what it was when I first started). What does this mean? A lot of urgency and large volumes of liquid D. To me that's not that bad because at least things are moving. But the urgency means I have to take it at night and in the A.M. before work - I used to get the urgency when I first started Zelnorm - the kind where you wouldn't want to be stuck in your car. In any event, I'm continuing to monitor and will report back. Hopefully the combo will get things running again and then the bacterial load will eventually subside. The antibiotics (rifax/neomy) didn't do much for me at all - apparently they really work better for D. I wish they would just find a superbiotic that would target the bad bugs that cause a C problem and just get rid of them once and for all. All in all, the initial Amitiza nausea that I had has gone away - so I'd recommend that others try it and see if it works for them.


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## CinNJ (Mar 6, 2004)

One more thing - so far there is no effect on the gas - in fact it may be worse - but that may be because the D is screwing up the equilibrium for now. Also, my symptoms are constipation, gas and bloating - never any pain issues. More discomfort and constant leaky gas.


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## SpAsMaN* (May 11, 2002)

THANKS!!!My symptoms look like yours minus the LG.I just stop Zelnorm coz of head aches now back temporarly on Dulcolax my favorite Laxative to induce D.However i need an alternative quickly.My worst problem is the descending/sigmoid junction.


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## SpAsMaN* (May 11, 2002)

CinNJ:Can you tell me the price it could cost witout insurance?


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## 19739 (Mar 3, 2006)

I went and saw my dr. today to ask him about Amitiza. I came prepared with print off's from the website but low and behold, he not only heard about it as well, he actually had some samples. Talk about good timing. He told me to take it with zelnorm ( I am currently on zelnorm and take dulcolax reguarly) and I should not have to use the dulcolax any more... At the farmacy they informed me that my regular insurance does not cover it but fortunately my temporary additional insurance does ( due to our family's military status we have temporary secondary insurance that will cover what the regular insurance wont) The good news, I will be able to pick it up tomorrow.. the bad news, in a couple of months this insurance becomes obsolete. At least I will know by then whether is works for me and who knows, maybe by then my regular insurance will cover it.....Having that said, I am planning on starting the combination tomorrow (zelnorm without food and amitiza with food) I will keep you posted..... by the way, I take zelnorm twice a day (6mg)and dulcolax every3/4 days(up to 6pil dosage now, which really worries me).Most of the time I follow a strict diet of no wheat, nothing from a cow (milk, cheese etc)no tomatos, no fried stuff, no refined sugar, no pork or red meat, no salads or any raw vegetables (acids)no citrus fruit etc. I take pancreatine with all my meals and I try to eat small portions ( difficult) and work out reguarly and drink enough water. Doing all of this and taking the zelnorm has made a huge difference, hardly any pain attacks but I still deal with the C- hopefullyl this will help with that part.....


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## 17176 (Mar 31, 2005)

Hello and welcome sterredeezee


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## 19739 (Mar 3, 2006)

I just got my prescription filled. I made sure to ask for the price without insurance since some of you have asked about this. The price is absolutely not $98 per pill. It's still not cheap though.... it is $3.0375 per pill and for the total of 100 pills you would have to pay $338.99. I received this information from my CVS pharmacy. I live in Michigan (detroit area) which is not too far from the Canadian border..... hope that helps


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## SpAsMaN* (May 11, 2002)

Thanks


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## 19739 (Mar 3, 2006)

> Originally posted by CinNJ:In any event, I now am taking both of them at the same time - Hi CinNJ - I started amitiza yesterday in addition to the zelnorm and I wanted to double check if you were actually taking these at the exact same time (since zelnorm is to be taken on an empty stomach and amitiza with food. Right now I take zelnorm on empty stomach and hten an hour or so later, the amitiza with food. I did not experience any nausia but did feel very tired. I did not have a BM at all the first day but this morning after taking the zelnorm at 8am, then the amitiza at 9 with two cups of coffee and at 10am I had one BM (large volume of liquid with). I experience some gas and bloating last night as well.. How are things going with you so far?Thanks!


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## 16692 (Dec 17, 2005)

I swear that is what the pharmacist assistant told me about amitizia, that it was $98.00 a pill. I am so glad she was mistaken.Sorry about the misinformation....Jean


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## 19739 (Mar 3, 2006)

No Worries Jean, I just saw a newsprogram where they talked about huge price differences between farmacies in the US, so who knows.....


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## badfoot (Oct 5, 1999)

It's available in California, but I haven't tried it yet. I will very soon. The price here is roughly $100 for 30, $3 a pill more or less. peace.


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## 16522 (Apr 6, 2005)

I have a problem with constipation. I was told that I have IBS and colonic inertia. I'm not sure that I really have colonic inertia as I do have bowel movements and pass gas. I just don't seem to be able complete the bowel movement. I had pelvic floor dysfunction and I thought that maybe this was causing the problem but the therapist for this disorder says my pelvic floor is fine now. I started this whole thing with urological symptoms which are fine now. I think something is wrong that noboby is picking up because I have extreme abdominal pain and have difficulty eating. It also seems that if I go just a little bit that my pain starts. I feel like I'm al filled up with gas and that is what is causing the pain. The funny part is I'm not distended.I have lost a lot of weight. Has anyone heard of small bowel inertia? My doctor finally decided on me having a upper G.I.and small bowel series. The zelnorm helped a lot with the bowel movements but caused me a lot of abdominal pain after being on it for a couple of months.It seems I was very disappointed because I thought it was helping. I live on Long Island in New York and am very asscessible to New York city. I can't find a doctor on Long Island who is willing to give me a prescription. They all say it is too new. Anyone else have bad abdominal pain. Laxatives and plain water enemas help but I get a lot of pain afterwards. Anyone have any suggestions about finding a doctor in NYC who will prescribe this medicine. I don't know if we are allowed to post names of doctors. If so, I would appreciate any help. I have tried every diet for the IBS and nothing seems to make a difference. I'm at my wits end and don't know what to do anymore. Thanks anyone for their help.


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## SpAsMaN* (May 11, 2002)

I would try Dr.Nicholas Gonzalez.I know this doctor care coz he does pancreas cancer research in New York.I don't know the number of his office however.:/


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## CinNJ (Mar 6, 2004)

I typically take Zelnorm on the way home from work and then again at 5:00 AM (I wake up early to take Zelnorm and Synthroid). With Amitiza I've been taking that on the way home from work (45 minute ride) as well - I know about the with food/without food stuff but I sometimes take things when I can. My Amitiza is twice a day - sometimes I try to take at lunchtime - I'm still trying to figure out what works best for me. How is Amitiza going for everyone else? It definitely supercharges the Zelnorm effect - so it has primarily a D effect for me - and typically three to four trips to the bathroom once it gets going (this is when I take it on the way home from work which is late) so if I take it at about 8:30 PM things really start "moving" at about 11:00 - sometimes earlier, sometimes later. Definitely not the type of stuff where I want to be going out. The times when I take it mid-day as well I don't seem to have the urgency issues - I think this is because the night-time activity really gets most of what is in the system out - and maybe the mid-day one just pushes the other stuff down the tubes.That's the update for now! Feel free to ask more questions. I still haven't been able to get the price here without a prescription - I'll see if I can get that.


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## 21979 (Apr 22, 2006)

Hi Cin


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## 16522 (Apr 6, 2005)

CinN,Can you tell me the name of the doctor that prescribed the Amitiza for you. I live on Long Island and all the G.I.'s say it is too new.I could start calling doctor's offices in NYC. Could you tell me the name of the doctor who prescribed it for you. Do you find taking both med(Amitiza and Zelnorm) caus too many spasms?he Zelnorm worked for the constipation but I still had some pain and then I started getting bad spasms. I think I incresed the dose too much. Thanks again for any help and good luck.


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## SpAsMaN* (May 11, 2002)

> quote:"moving"


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## 19739 (Mar 3, 2006)

> Originally posted by CinNJ:How is Amitiza going for everyone else? ~ Hi CinNJ,I have been on Amitiza for about a week now and I agree it does get things moving better.. unfortunately the "increasing the intestinal fluid secretion" is something that I am actually am able to hear = loud, loud gurgling sounds
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## 2btrue (Jul 22, 2003)

CinNJ,Does your doctor know you're taking both Zelnorm and Amizita together?







Have you tried taking half a Zelnorm tab instead of the whole one? Maybe you wont have so many symptoms by taking half because each medication may increase negative side effects of each other. I thought it would just be an idea worth trying?!


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## 19739 (Mar 3, 2006)

This is SterreDerZee; my dr recommended I take the amitiza with zelnorm. I have never had a problem with zelnorm so I would probably keep that those. As of today though, I have stopped taking the amitiza... I am not sure if it was too much that I had taken dulcolax twice since I started the amitiza but last night my feel felt very uncomfortable and when I looked they were incredibly swollen. This morning it was not much better. It freaks me out, they are very swollen... I left a message for my dr. and am waiting to hear back from him.........


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## SpAsMaN* (May 11, 2002)

Sterreder,why do you blame Amitiza?







I got extrem bloat from Dulcolax yesterday.After the trapped bloat finally moves,i've got explosive gas.





















After i had D then today i'm OK.So Dulcolax CAN makes you extremly bloat at least for few hours.


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## 19739 (Mar 3, 2006)

Well, I have been on zelnorm for a long time without any problems. I have been using dulcolax for years and I am familiar with how my body reacts to it (some times extreme bloating before relieve). Since I just started the Amitiza this was the only thing that I have done differently since the new symptoms started. I have had severe bloating (it was in even much higher up than where I usually am bloated) and stomach pains. It was not until yesterday that I noticed that my ankles all over sudden were very swollen. It has not gone done and they are tingling and hurt as well. Now since the Amitiza is the only thing that I have done differently it's the only thing that I can come up with that could have caused this. Now, I am not sure if this is from the amitiza on it's own, whether it is the combination with zelnorm, dulcolax or both but I felt the only thing I could do was hold of on the amitiza for now. My dr. finally called me back and I am going to see him tomorrow morning. Hopefully we will be able to narrow down what the actual reason is why my body is retaining water this severely (I feel it in my legs and fingers as well now). It just scared me and since i have had some other side effects as well with amitiza I felt that was the only thing I could do..... I did not mean to blaim amitiza but with all the info I gave above that was the only thing I could think of that could have caused it. I will let you know how my apt goes tomorrow.


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## 2btrue (Jul 22, 2003)

If you have had good results from Zelnorm why are you taking all the extra drugs?







Wouldnt it be best just to stick with Zelnorm?


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## 2btrue (Jul 22, 2003)

If Zelnorm is working well for you, why are you taking all the extra drugs?







It would probably be best to just stick with Zelnorm then you may not have all the problems and wont need to see your doctor?!


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## 19739 (Mar 3, 2006)

Ok, let me clarify; when i say I had not problems with the zelnorm, I meant I had no side effects with the medicine. What zelnorm did do for me it relieve my pain attacks which I am very grateful for. Unfortunately it did not eliminate my C-.... So for that i have been taking dulcolax. Since dulcolax is rather aggresive and I have had to increase my dosis over the years I am always looking for something to replace that ( I have tried all the other suggestions, magnusium, miralax etc.)I also follow a very restricted diet ( f.e.wheat free, dairy free)so that is where amitiza comes to play.. hope that explains it better.


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## 19739 (Mar 3, 2006)

> quote:Originally posted by 2btrue:If Zelnorm is working well for you, why are you taking all the extra drugs?
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The Zelnorm only relieves some of my IBS Symptoms. I still have severe C-. For this I am not taking "all the extra drugs" I am only taking amitiza for this... I had to take dulcolax twice because I was in so much pain and was so incredibly bloated, nausiated etc. it was either that or go to the ER. I do not take medicine lightly and truly wish that I did not need any of it......


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## SpAsMaN* (May 11, 2002)

> SterreDerZee,HOW MANY DULCOLAX DO YOU TAKE???I usually use "only" one when needed but i'm thinking of taking 2.
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## 2btrue (Jul 22, 2003)

Sterrederzee,Thanks for clearing up the confusion, now I understand more clearly whats going on. I am sure by now you've seen your doctor - please keep us posted and let us know what happened. Hopefully he did some blood work to check your kidneys and other things because your feet swelling should not occur. I was just wondering if you could possibly open up the Amizita capsule and just take half and also play around with the doses of the other meds. So much is trial and error and only your body can tell you what you need - everyone is different. I've learnt to expect the unexpected. Please keep us posted. Please feel free to e-mail if you like. By the way, where do you live?


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## 19739 (Mar 3, 2006)

Quote: I was just wondering if you could possibly open up the Amizita capsule and just take half and also play around with the doses of the other meds~~~~~~~~~~~~~~~~~~~~~~~~~~~Unfortunately it is not a capsule with powder, it is a liquid capsule so I am not able to play around with individual doses....







by the way, I live in Michigan


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## 19739 (Mar 3, 2006)

> Originally posted by SpAsMaN*:
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> > SterreDerZee,HOW MANY DULCOLAX DO YOU TAKE???Oh my.....you only take one? How often do you take one?Well to my defense, i have been using dulcolax for many years since this was the only medicine that could alleviate my C- (before zelnorm I was on bentyl for my pain colics)when I first started with dulcolax I took 3 at a time ( every so often) but over the years my dose went up to 5. The zelnorm allowed me to cut down initially but now I am back to 5 pills at a time. Before Amitiza I would have to do this once or twice a week...


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## 19739 (Mar 3, 2006)

So I went to my dr yesterday (he called wed and wanted me to come in the next day so he could ceck it out). My dr is a PCP but an internist as well). He checked me out but did not take any blood or checked my kidneys.. He said that he found out that a small percentage of people had this problem when taking amitiza, so no need for worries. Since I have a low salt intake and my blood pressure was normal (108/80)he said I was fine. Although I had stopped the Amitiza he encouraged that I continue but take it once a day instead of twice...I am not sure if it was because the swelling had gone done since I stopped the amitiza and it did not look bad anymore but again, he said that it was not unusual what had occured. he also said that there could have been a chance that the dulcolax had aggrivated the amitiza symptoms but he somewhat doubted that, He said I should try the one a day for now (in addition to the zelnorm, which I have continued taking..)Sigh... I don't have to explain the worries and discomforts of "trying to work with dosis and new medication; natural or prescription" because I am sure you're all very familiar with that. But just like eveyeone else am I worried how it is going to effect me.. Last week was very difficult but at least I was blessed to be able to work from home..I am not able to work from home for now so that will mean I have to call in sick, if the pain gets bad again.. Anyway, enough of that, I have to be positive!







So I have not yet started amitiza again, I felt my body needed a break - too much stuff in my system. So I stayed on the zelnorm and had a day of fluids only (wed) and yesterday I only had one light meal and my swelling is almost gone, my stomach is not that bloated as it was a couple of days ago ( I was able to exercize somewhat yesterday which I think helped my swelling go down as well, although it was still painful).I might give it another day or so, before I start me Amitiza again and I will stick completely to my diet this time which will make the change of having to take dulcolax smaller.Sorry for the long report, thought you would appreciate the details...I am however somewhat concerned that he did not do more testing, again I am not sure if this is because my symptoms were less, or because he is an PCP/Internist and not Internist only... do you guys have some suggestions of test that I could have asked for?Usually when I ask for specific things (which I usually do after doing research) he will do it if he agrees ( he just does not take a lot of initiative..)Thanks so much for "thinking with me"








Any suggestion or advise is always very welcome!


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## SpAsMaN* (May 11, 2002)

I'm gonna take 2 probably.One is not enough anymore.I need to drain the stuff completly around 8PM.So i take around 2 oclock to be drain by 9PM.Stere,when do you take it?


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## 19739 (Mar 3, 2006)

I always take it at night but I do have to make sure I take it at a certain time, so I can eliminate before I go to work.... It usually depends on how bad my C is and how much I ate that day but it usually takes about 8 hours...I have only taken it once in the day time and I was horrible so I only take it at night now...hope that helps


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## 2btrue (Jul 22, 2003)

Sterre,How has Amizita been working for you taking it at night.You mention when you take it during the day that it's horrible - what type of side effects are you having. Also, is it working at all and how long does it take to work. Is it best taken with food or on an empty stomach - maybe one needs to experiment with it.Please let us know how you're doing.


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## SpAsMaN* (May 11, 2002)

2btrue,the last post was about Dulcolax.Sorry we've been off-topic.


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## 2btrue (Jul 22, 2003)

Sorry,The title of this thread says = "Anyone Try Amizita" so I assumed it was about Amizita.


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## 19739 (Mar 3, 2006)

Hi 2btrue.Yes this is a thread in regards to Amitiza but SpAsMaN and I had a side conversation about dulcolax, which I cannot take in the day time...I have not started Amitiza again.. I have decided that I am going to have my blood checked to see how my mineral (magnesium, calcium, potasium) levels are and any other levels they can take from my blood before starting the amitiza.. I have not been feeling like myself for the last couple of weeks, so I have been holding of. I am planning however to start back up again. I will keep you posted when that happens and how things go....Thanks!


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## 13338 (Oct 27, 2005)

Hi, I started taking Amitiza three weeks ago. My Dr. also has me taking Zelnorm three times a day with it. First week I was hopeful and went a little each day. Forget that now. Back to having to take a laxative once a week. I am so disappointed. Don't know what I will do now. I put all my hope into this pill.


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## 19739 (Mar 3, 2006)

Hi Debbie2005,Would you mind sharing what laxative you used and what dose? Also did you have any side effects with amatiza and did you notice any different or increased side effects when you took the laxative with the amatiza?Sorry for the 20 questions but I had somewhat of a simular experience. Thanks so much for sharing!!


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## 16522 (Apr 6, 2005)

Hi, I was on Zelnorm and it helped with the constipation but only somewhat with the pain. I went to a new doctor today who gave me a prescription for Amitiza and he said it wouldn't help with the pain. He suggested either taking Cymbalta or a low dose of Pamelor which many doctors don't feel will be constipating in a low dose. I really have a problem with laxatives. Either they don't work or if I take more I get bad pain. I also seem to get pain everyday between 3-6p.m. and it makes it hard for me to eat any dinner. This all started after about a month on the Zelnorm. I blamed it on the Zelnorm, but now I'm not sure.Does anyone else get pain at a certain time of day or with laxatives. I'm a little lerry of the Amitiza. I took my first one and right now in the evening I'm in pain and feeling bloated. Spasman, does Ducolax give you any pain? It gives me real bad cramping and pain. I also have a motility issue and pelvic floor dysfunction so when I get constipated I get urinary symptoms like a urinary tract infection, but I when the urine test is done, I don't have one. I did take two courses of antibiotics for the bacterial overgrowth along with probiotics and nothing changed. I'm losing weight like crazy. I'm really scared. I feel like I'm starving to death. I also used to sleep okay at night. Now I'm waking up with pain. I could try a low dose of Zelnorm again. Wonder why after a month, I started gettin those horrible spasms at the end of day. They take my breath away. Any suggestions from anyone? Thanks.


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## SpAsMaN* (May 11, 2002)

> quote:Spasman,does Ducolax give you any pain?


Yes and i like that.My bowel is usually too silent and too sleepy.Pain with Dulcolax means movement.


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## 2btrue (Jul 22, 2003)

Roberta,Do you have a good doctor that you are working with and able to share these things with him/her. I just hate to know you are struggling so much all alone because I know what its like. What type of testing/followup have you had since your surgery? Have you been to a pain clinic or are you seeing a GI? Maybe getting more than one opinion, or several may help?Know that I am thinking of you and please keep us posted


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## 16522 (Apr 6, 2005)

2btrueI e-mailed you yesterday. Let me know if you received it. I saw a new doctor today and will tell about what he said tomorrow as I am so exhausted right now and of course in pain as I always seem to get at the end of the day, of which noone can give me an explanation except an alternative practicioner, not a doctor who said bacterial overgrowth. Laxatives give me horrible pain. Do they work for you or give you any pain? I wish I didn't get such bad pain after a laxative. Mineral oil is the only one that isn't too bad, but doesn't always work. I've been told I have bad visceral hypersensitivity. How are you feeling? Let me know if you got the e-mail. I got yours. I thought I accidently deleted it, but I didn't. Thanks for thinking of me. Take care and feel good.Will add tomorrow what the new g.i. said. Too long and complicated and different from what others have said. It gets too depressing. Roberta


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## 2btrue (Jul 22, 2003)

Roberta,Thanks I did get your e-mail. I apologize, I am really in a bad place right now and am struggling to function on the most basic level. A lots going on


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## 19739 (Mar 3, 2006)

2btrue,Just wanted to say ~Hang in there~ if you ever want to vent in email, let me know. I am here for you


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## 2btrue (Jul 22, 2003)

Sterre,Thanks so much for your good wishes and support, it really means so much to me. I will e-mail you as soon as I have enough pain relief to stay out of bed.Thanks sooo much.


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## 2btrue (Jul 22, 2003)

CinMJ,Are your still taking Amizita? Have you had any luck with it.I think it may take time to take effect - I dont think it works immediately like Zelnorm but I dont know much about it. Are you taking it with food to avoid nausea?


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## 2btrue (Jul 22, 2003)

Does Amizita take time to work - does it have a build up effect?Does one have to take it for a few days before having any effect?I have taken it twice, once in the morning and once at night and it didnt do anything (I wasnt able to go at all) - the positive though was I had no side effects.Just wondering if one needs to take it for a few days to see results??


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## ABNormal (May 24, 2006)

Thanks to all for info about Amitiza. My doctor wants to put me on it and I'm very curious to see if it works. Zelnorm does not work at all for me. (Okay, it worked the first week I took it and then nothing). I've stopped taking it because it seemed futile.I cannot take Dulcolax because I was addicted to it years ago.


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## 2btrue (Jul 22, 2003)

ABNorman,It sounds like a good idea to try Amizita -you'll never know if it works until you try.Have you tried Miralax, MOM or lactulose?I agree with you about Dulcolax it is very irritating and can weaken the system, & probably be harmful longterm. It may be helpful to use Zelnorm once or twice a week. Sometimes it works best to give your system a break from it. It seems some people build up a tolerance quickly. Its like our system goes back to "default".Please keep us posted re Amizita?


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## SpAsMaN* (May 11, 2002)

> quote: I cannot take Dulcolax because I was addicted to it years ago.


ABnormal,LOL.In the constipation world you do what you need to do to get the stuff moving.Addicted or not.


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## 2btrue (Jul 22, 2003)

Spasman, not when it stops working or causes you to take/need so much that it is detremental to your health. Why do you think addiction is so harmful?


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## ABNormal (May 24, 2006)

SpAsMaN*, I should have explained further. I was addicted AND it didn't work any more. 2btrue, that's what I thought also, that continued use wouldn't be any good, but as I explained above, Dulcolax stopped working. Yes, I used lactulose for about 15 years. It worked sometimes. Zelnorm doesn't do anything. I haven't tried Miralax, really don't know about it although my Gastro Doc mentioned it in passing. I have an appointment on 19 June to discuss the Amitiza. I'll let you know.


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## Kathleen M. (Nov 16, 1999)

If I may interject.There is some recent info that the stimulatory laxatives may not be as harmful as some of the warning labels say.It appears many constipated people can take normal doses of these laxative pretty regularly and never run into trouble.The problem is there are always a few people on this board that have done the taking more and more to get the same result until it stops working at all, and even when they go off them they are in much worse shape than before they started. Now how much is that they would of gotten colonic inertia eventually anyway with or without stimulatory laxative I don't think anyone knows. I do think that the recent "it isn't as bad as we thought" doesn't translate to take it freely and with great abandon because there will be no consequences for anyone so what if you are addicted to them go ahead anyway the more the merrier kind of attitude.Yep, you need to get stuff moving if you are constipated, but you do want to be careful about how you do it, and if the constipation gets worse, or the what used to work doesn't at the same dose anymore, get evaluated to find out what the issues are (pelvic floor, colonic inertia, etc.) rather than just taking more and more laxatives.K.


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## 19739 (Mar 3, 2006)

I would like to add that my "new" GI mentioned the same things that Kathleen mentions..My regular dr. recomended that I go see a GI and have another colonoscopy done (at had been 10 years) so I did. My new GI actually advised me that dulcolax is not as bad a it is made out to be and shared the same info that Kathleen referred to.. After having no success with Amitiza







( I tried it twice for two weeks at a time) I am now starting with adding miralax to my zelnorm (twice a day). After my colonoscopy yesterday (in which he could not see anything abnormal just that they are very long and have a lot of curves)he advised me to add fibercon. Since we had only met one time before I going to have another apt with him (this was right after the procedure) to remind him that wheat, dairy and a lot of high fiber foods irritate my bowels so i had to cut out my diet, before I start adding the fibercon. I am also going to read up on the board on fibercon ( not sure if it is like metamucil which made things worse for me).I read that lorilou has great succes with the combintation of zelnorm, miralax and mom so that is what I am trying next. My GI did say that I could use dulcolax every other week (so far have been taking this twice a week and my current dose is 6 pills) but if the new mix will allow me to only use it every other week, it will put me at a much lower risk dependency for duloculax. So I see where ABNormal is coming from since I have been using ducolax for so long that I am now at 6 pills twice a week which I am hoping to change with my new combination. My goals is to use dulcolax to support this and only having to use it everyone once in a while as opposed to relying on it by itself..... sorry for the long text....Good luck with the amitiza, let us know how this works out for you


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## 2btrue (Jul 22, 2003)

ABNorm,Have you been tested for colonic inertia? Usually the sitzmarker test is used, depending on where you live. There are more advanced tests that can be done but only in about 3 states. The sitzmarker test is a pretty good test to start with. Maybe you could mention this to your doc. Few doctors voluntarily come up with this. I think the fear is that it will come out positive. Anyway Miralax is certainly worth trying - perhaps you could call and ask if you could try it before your appointment on the 19th - that way you can get things going quicker. I can totally understand the frustration of waiting and nothing being done and I think you would feel better being more proactive and hurrying the process.Pleas keep us posted.


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## ABNormal (May 24, 2006)

Well, I found an herbal tablet that has things moving again, but in the past some have stopped working.I will ask my doctor about the sitzmarker test.


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## 2btrue (Jul 22, 2003)

Whats in the herbal formula? Sometimes it could contain harmful laxatives? Have you tried Miralax or MOM, I cant remember?


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## 18480 (Jun 9, 2006)

Hi there. I'm new to the board and don't want to be an alarmist, but I just had an appointment with my GI specialist yesterday and although he is considering Amitiza for me (I'm currently on Zelnorm) ... he made sure to warn me that the drug can cause birth defects. Please talk to your doctor if you haven't been notified of this.


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## screeb (Jul 25, 2001)

Like most people, I need coffee in the morning to get me to the loo. Coffee can also cause distal colon spasms (colo-rectal distention). When I get distal colon spasms, I take Amitiza, which in my experience, stops the spasms palpable as lower, left side pain. Given that the symptoms include sigmoid spasms and inflation of the entire colon, I am going to make a physiological argument connecting the two. Stretching of the colon causes ATP-release and Ca(2+) signaling that are cell-shape dependent, i.e. they were further enhanced by stretching. The colon acts as a mechano-sensor according to Furuya et al., 2005. Subepithelial fibroblasts form a cellular network just under the epithelium of the gastrointestinal tract and have unique characteristics, such as cell-cell communication via released ATP and Ca(2+) signaling in the cellular network. Since Ca2+ contributes to the activation of contractile proteins (actin), these findings suggest a contribution from the actin cytoskeleton on ATP-release in subepithelial fibroblasts. The released ATP activates Purine (P)2Y receptors on the surrounding cells and propagates Ca (2+)-waves through the network and also activates P2X on terminals of mucosal sensory neurons. The number of DRG neurons responding to ATP and the number of those staining for the P2X3 receptor, were increased after application of ATP.Regulatory volume decrease is a protective mechanism that allows mammalian cells to restore their volume by the release of ATP that in epithelial cells is compartmentalized to the basolateral membrane. When Amitiza shrinks the cells, the above effect is reversed and there is a reduction of ATP at the sub-epithelial/mucosal layer. This results in a decrease in Ca++, (associated with ATP at this layer) and increased Ca++ is required for triggering exocytotic neurotransmitter release at nerve terminals.DRG (dorsal root ganglion) neurons project to the PBn via the spino-parabrachial(PBn) pathyway, and then to the CeA (central amygdala), which has CRF (corticotrophin releasing factor) neurons projecting to the BN (Barrington's nucleus), whose activation is causing CRD (sigmoid spasms). The BN also projects serotonin (5-HT) to the spinal cord . 5-HT produced a contraction of the spinal branch of the intercostal artery (SBICA). Since Amitiza causes decreased Ca++, resulting in decreased DRG firing and ultimately decreased BN activation, this produces decreased CRD and 5-HT at the spinal cord, which causes relaxation of the SBICA, (and increased bloodflow).The internal VVS communicates, via inter-vertebral veins with posterior intercostal (IC) veins. The IC veins (intra-muscular) are equipped with tiny valves which prevent arterial backflow. Increased venous pressure in the IC veins of the back may trigger the â€œmuscular pump,â€ in which skeletal muscles surrounding the deep veins contract and relax, â€œmilkingâ€ blood toward the internal VVS from the IC veins (â€œIC milkingâ€), causing increased upstream internal VVS pressure. Palpable â€œIC milkingâ€ is usually associated with a contraction of the scapulae towards one another, and an intra-scapular clicking noise.The radicular veins drain into the internal VVS plexus, which is situated epidurally. The radicular veins connect the intradural venous system and the epidural venous plexus. Venous reflux is prevented by means of intravenous dural folds within the transdural part of a radicular vein. Narrowing of the transdural part of these veins and the presence of large amounts of smooth muscle cells (actin) in the venous walls suggest the existence of a dynamic reflux regulating mechanism. This has the ability to increase the intravascular resistance under conditions of venous hyperpression, and will protect the spinal cord from venous pressure waves. This â€œbottle-neck,â€ created by radicular vein closure, would increase upstream venous pressure at the spinal cord capillary bedâ€™s venules. Postcapillary venules in the rat mesentery were perfused in situ, and paired measurements of hydraulic permeability ([Lp]) were obtained using the modified Landis micro-occlusion method (equivalent to "bottle-necking"). The effect of basal endogenous endothelin-1 (ET-1) was tested by measuring the effects of ETB receptor blockade on [Lp]. ETB receptor blockade prevented any decrease in [Lp] induced by ET-1. Contraction of the pericytes in response to various stimuli was evaluated by the change in surface area measured by a light microscope with a digital camera. Intracellular Ca2+ was measured using fura-2 fluorescence spectroscopy. ET-1 induced contraction of CNS pericytes. ET-1 caused a rapid response in [Ca2+]i. Ca2+ contributes to the activation of contractile proteins--actin, which is located in pericytes and ET-1 is located in the vessel wall. To characterize the in vitro response of equine cecal longitudinal smooth muscle (CLSM) to ET-1, CLSM strips were suspended in tissue baths containing graded concentrations of ET-1 (10(-9) to 10(-6)M). Results indicated that ET-1 has a contractile effect on equine CLSM.


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## ABNormal (May 24, 2006)

I thought I would bring this thread back. I've been given Amitiza by my GI and so far it has had not effect. I, as some others have said, was hopeful about the Amitiza. I'll keep taking it for a while longer, but I've seen absolutely no effect.Maybe I'll try Miralax as some of you have said it seems to help.


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## screeb (Jul 25, 2001)

I would like to offer some practical advice to IBSers trying Amitiza. I have been using a procedure that involves the sexual response for the past few years, that has me crapping like a race horse. The good news is that the pill (Amitiza) completely replaces the procedure (rendering the sexual response a moot point). However, coffee, and nicotine (or Zyban/Wellbutrin/Bupropion--anti-smoking medication), are necessary prerequisites. Give the coffee a couple of hours to work it's magic, then take the Amitiza, and go for a long automobile drive, ( the more hilly and twisty--the better). If you feel cecal contractions, (pain under right ribs), and then anally directed "off-contractions", that means the system is working! If you pass this test, then you may consider buying a cervical Traction Device, (in order to save gas money and risk to life and limb from hurtling down the roadway at high speed). If anybody is interested in specific techniques in applying the traction device to maximize bowel function, I can write a blurb. The Goodley Polyaxial Cervical Traction-Mobilizer System can be purchased from Ortho-Tech in CA, USA.


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