# Can I take Dulcolax and Magnesium together



## mossflower (Jan 21, 2017)

Hi: This is specifically for Annie cause i know she knows about this.

I am having a horrible time over the past few weeks (and even after my colonoscopy where they removed a large polyp), with bowel movements. I take a lot of magnesium and until the past few months, i would take it at night and would go easily during the night: i would have the urge and it would come out easily-- now, it is getting stuck down low into the rectum and will not come out no matter how bad i need to go until 4 am. and then at that point it still isn't easy to pass (and it is watery diarrhea and has been for 20 years): it works its way down and i have to wait for the exact right moment when it finally comes out.

I am going to see a gastroenterologist about this and other issues- What i would like to know is if i could try taking a couple

Dulcolax with the magnesium, thinking maybe the stimulant laxtive (Dulcolax) might help propel the poop out better than just taking the magnesium. Can i take them together?

Annie: i thought i recalled that at one time you took these together.


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## annie7 (Aug 16, 2002)

hi Mossflower

so sorry you are having problems.

i took three dulcolax pills with a capful of milk of magnesia, not magnesium tablets. unfortunately magnesium tablets never worked for me although i'm glad they work for you. the instructions on the dulcolax box say not to take dulcolax within an hour of taking antacids or dairy because that can cause cramping so i always took those two at least an hour apart.

but yes, sounds like it's worth a try to take dulcolax in addition to your mag tablets. the stimulant should provide the extra push needed to get the poop put of the rectum.

and yes, do discuss this problem of the poop getting stuck in the rectum with your gastro doc. it could be that you have developed pelvic floor dysfunction. with pfd, the pelvic floor muscles do not coordinate and/or relax properly to allow easy passage of stool. ineffective pelvic floor muscle coordination results in inadequate relaxation of the pelvic floor while attempting to have a BM. the puborectalis muscle tightens and contracts when it is supposed to relax to allow passage of stool. biofeedback and physical therapy can be effective in correcting pfd.

good luck with everything. take care.


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## mossflower (Jan 21, 2017)

Thanks for your input Annie: i think i will take one Dulcolax pill to start with and i will take it an hour before i take the mag citrate pills.

I read that the GoLytely can be used for intractable constipation. Of course one has to know how much of the GoLytely to use and it is a prescription medication-- there is a really good article on line about this. Go Lytely (the bowel prep) is not specifically prescribed for constipation but it can be used for that purpose. I may even try Linzess--- i think i need to think about other meds besides Magnesium.


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## annie7 (Aug 16, 2002)

i've seen this article on how to use GoLytely for intractable constipation. they recommend mixing a tablespoon of GoLytely in an 8 oz glass of water.

http://www.heritagevalley.org/media/W1siZiIsIjIwMTgvMDEvMzEvMTN5YWxjY2FhX0hWTUdfUm9zZW1hbl9Hb0xZVEVMWV9DaHJvbmluX0NvbnN0aXBhdGlvbi5wZGYiXV0/HVMG_Roseman_GoLYTELY%20Chronin%20Constipation.pdf

when things got really bad for me, my gastro doc told me to do half a colonoscopy prep once a week--in addition to all the other laxatives i was taking daily.

yes, you might want to try linzess. we have posts here on the board about linzess and how to tweak it if neceassary. or you can try one of the other C meds like amitiza or trulance. and prucalopride (Motegrity) was recently approved by the FDA and hopefully will be available next month.

good luck with the ducolax and mag citrate pills!


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## mossflower (Jan 21, 2017)

Hi Annie: we are leaving for Florida this weekend so i am not going to experiment with stuff until i get there. I am thinking of using the Dulcolax and maybe switching to Milk of Magnesia instead of the mag citrate pills. i have an appt with a gastro doc in Florida near the end of January and hopefully he can help me find the right combination of drugs to ease this situation. The Golytely seems like a real good idea - so we shall see.

I wish you a happy and healthy new year


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## annie7 (Aug 16, 2002)

oh that's wonderful that you are going to florida and can get away from this cold winter weather for a while! enjoy!

good luck with dulcolax and milk of mag. it worked for me!

and good luck with your gastro doc appointment in january. hopefully he/she can come up with a treatment plan that will help you.

thanks--wishing you a healthy and happy new year as well.


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## mossflower (Jan 21, 2017)

Hi Annie: i saw a gastro today: he thinks the magnesium is no longer doing the job (though i took it with one tab of Dulcolax last night and i worked better)- he thinks i have incomplete evacuation and prescribed Linzess which doctors have tried to get me to take for years and I have not done it. Have you ever taken Linzess? he prescribed the smallest dose 72, mg to be taken 1/4 hour before a rather large breakfast. i am always afraid of new drugs- side effects and things like that.

We discussed he possibility i would need further imaging tests such as a defacography ( i hate the thought of that)---

he wants to try a simple thing first: Linzess; if that does not take care of the problem he will consider other problems like rectocele which i do not believe i have, though i have a cystocele--

Annie: your thoughts are always appreciated.

Take care


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## annie7 (Aug 16, 2002)

thanks for the update.

glad you saw your gastro doc today.

yes, i tried linzess--the 290 dose.

one thing about linzess: one of my gastro docs has done research and has run clinical trials on linzess. he told me that linzess works on the same receptors that food does. so generally, the closer you take it to eating a meal, the more diarrhea you get. and conversely, the more time that elapses between taking linzess and eating, the less D you get. it's all in experimenting and finding out what works best for you.

that's good your doc has you taking it 15 minutes before eating. if it doesn't work for you, try taking it even sooner before eating, like 10 or 5 minutes before or even with your meal. or you could try taking a larger dose--the 290 or the 145.

if you get too much D with it, then try taking it 30 or 40 minutes --or even longer--before eating. like i said, sometimes you have to experiment with it.

hope linzess works for you. if it doesn't, you could try trulance. and motegrity, once it becomes avaliable.

if you have incomplete evacuation (i had that), then a defecography would be a good test to have. i had one done--failed it . and i know it sounds like an embarrassing test to have (like you, i hated the thought of having to take it) but really, it wasn't. the techs were very sensitive to my needs and it was all handled very professionally. also-- a defecography will show if you have a rectocele or any other 'celes. it's a good diagnostic test.

good luck with everything. keep us posted.


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## mossflower (Jan 21, 2017)

he ordered the smallest dose for me, 75 mg--- i have to tell you Annie i am not the most compliant patient; that is why it took me 4 years go have a colonoscopy and came very close to having a cancerous polyp (but it isn't- it is high grade dysplasia, but still scary)

so now i find myself afraid to take The Linzess; not sure what to expect: do you have diarrhea all day or is it over in just a little while and what if it doesn't work very well??

I also asked him about using Golytely as treatment for constipation but he poo-pooed that idea out of hand.


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## wgbutler (Mar 15, 2018)

mossflower said:


> he ordered the smallest dose for me, 75 mg--- i have to tell you Annie i am not the most compliant patient; that is why it took me 4 years go have a colonoscopy and came very close to having a cancerous polyp (but it isn't- it is high grade dysplasia, but still scary)
> 
> so now i find myself afraid to take The Linzess; not sure what to expect: do you have diarrhea all day or is it over in just a little while and what if it doesn't work very well??
> 
> I also asked him about using Golytely as treatment for constipation but he poo-pooed that idea out of hand.


When I take Linzess what I usually do is set my alarm for about 4:30AM or 5:00AM. I take a Linzess (145mg) with a glass of water and go back to sleep. When I wake up 2 or 3 hours later I will have to go to the bathroom about 3-5 times over the next two hours and then its over with. It will be diarrhea but it should get you some relief.


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## mossflower (Jan 21, 2017)

so you don't eat breakfast after you wake up??


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## wgbutler (Mar 15, 2018)

mossflower said:


> so you don't eat breakfast after you wake up??


I may or may not eat after I wake up. It doesn't affect the way the Linzess works.

Because typically what happen is after I go back to sleep I have to wake up in a couple of hours and the first thing I do is go to the bathroom because it's kicked in. So whether i eat or don't eat doesn't matter. It's not going to become more or less efficacious from food at that point.


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## annie7 (Aug 16, 2002)

mossflower said:


> he ordered the smallest dose for me, 75 mg--- i have to tell you Annie i am not the most compliant patient; that is why it took me 4 years go have a colonoscopy and came very close to having a cancerous polyp (but it isn't- it is high grade dysplasia, but still scary)
> 
> so now i find myself afraid to take The Linzess; not sure what to expect: do you have diarrhea all day or is it over in just a little while and what if it doesn't work very well??
> 
> I also asked him about using Golytely as treatment for constipation but he poo-pooed that idea out of hand.


from what i've read about other peoples' experiences, linzess is very much a YMMV kind of med. some people say they take it and have no D at all, other people do have some D, some people have lots of D. it all depends on the person, the dose strength and and the food factor that i mentioned earlier.. your doc has you started on a very low dose so you might not have D. good luck if you decide to try it.

if you are afraid to try it, you can always just go back to taking dulcolax and mag pills or milk of mag. or you could give the GoLytely thing a try. good luck with everything. take care.


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## mossflower (Jan 21, 2017)

i was kind of disappointed that the gastro doc woild noteven consider Golytely-- that is why I like University of Michigan--- they do tbings other doctors 
never even think of


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## annie7 (Aug 16, 2002)

oh, that's great that you have a gastro doc at the university of michigan! i had one there, too--Dr Chey. he is simply terrific--best doctor ever. and yes, the docs at the U of M really know how to think out of the box.

the U of M is where i had some of my tests done, too--the defecography and the anorectal manometry with balloon explusion (i had two of those) . like i said earlier, the techs were terrific---they were very sensitive to my needs and very professional.

yes, that is a shame that your florida doc wouldn't even consider GoLytely. did he say why? when my C got really bad, Dr Chey told me to take half a colonoscopy prep (prepopik--it's low dose) once a week in addition to all the laxatives i was taking nightly. that helped keep things moving better although it sure wasn't fun.


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## mossflower (Jan 21, 2017)

I brought a copy of a page you posted from a doctor- showing how GoLytely can be used for extreme constipation.

He looked at it, made a face and said something like no --- and that was that. Because I am in Florida I do have to see doctors for different things, but my main physicians are back in Michigan and for anything really serious that is where I get my treatment. I may see another GI doc down here in Florida.

Although I have seen a GI doctor at U of M, I don't really treat there for constipation. I do know that University Of Michigan is the best place to go for almost any ailment that other doctors have difficulty treating.


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## annie7 (Aug 16, 2002)

oh, that's good that you brought a copy of that page in to show him. at least that way he could see that the GoLytely protocol was recommended by a doctor. it's just too bad he didn't agree with it.

not saying you should do this, but if it were me, i'd probably just go ahead and try the GoLytely myself, since it is recommended by a doctor. plus i tend to be a pretty noncompliant patient myself. if i think something is going to help me, i'll try it.

if you decide to see a new GI doc in florida, you might want to try making an appointment with one who works in the gastro department of a university hospital (hopefully there's one nearby) or a motility clinic. just like at the U of M, gastro docs who work at places like these tend to be more knowledgeable, up-to-date and proactive about treating chronic constipation than regular gastros.

good luck with everything.


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## mossflower (Jan 21, 2017)

the Golytely has to be prescribed by a physician.

i am in Fort Myers and there is no university affiliated physicians
in this area

i have an appt with another gastro doc on1/25--so we shall see


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## annie7 (Aug 16, 2002)

oh sorry--i forgot that GoLytely is a script.

good luck with your appointment with the new gastro doc. keep me posted!

if that appointment doesn't work out, maybe you could see a gastro doc at the U of M once you get home....

good luck with everything.


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## mossflower (Jan 21, 2017)

Annie: let me ask you a question- I took one Dulcolax pill with my mag citrate pills and it helped a lot.

I know you took 3 Dulcolax-- how long did you take those pills with Milk of Magnesia and did you build up a tolerance to it?

I know with stimulant laxatives, one can build up a tolerance fairly quickly. For the moment it seems to help quite a bit

to empty me out better.

Thanks for your input: I really appreciate it.


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## annie7 (Aug 16, 2002)

you know, i honestly can't remember how long i took dulcolax and milk of mag--years, i would say-- at least ten years, maybe. it was a long long time.

when i started taking dulcolax, i started with 3 tablets because one or two just didn't work for me.

i took milk of mag daily but i rotated the dulcolax with senna and cascara sagrada because i was afraid i would develop a tolerance to dulcolax although according to this article and others i've read like it, building up a tolerance to stimulant laxatives is "uncommon".

https://www.ncbi.nlm.nih.gov/pubmed/15654804


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## mossflower (Jan 21, 2017)

Annie; that is an excellent summary of laxatives and constipation; so many myths; one that i thought was interesting was that water really won't help unless a person is dehydrated or that fiber can make someone worse. Every doctor i have ever gone to, including the last one here in Florida started talking about diet. I wanted to shout: i am so far past fiber, prunes and water. --- my colon is essentially non-functioning--- without strong laxatives. that is just the way it is and fiber always made it worse.

I think i will continue to take one Dulcolax with magnesium for a while and if I need two or three i will do that.

It is always nice chatting with you. You have a lot of great information and you are a caring person.


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## annie7 (Aug 16, 2002)

thanks for your kind words.









yes, you're right--that's a terrific article and it dispells a lot of those myths that the doctors keep telling us. adding more fiber always made me worse. i, too, had been given the more-fiber-and-water instructions by all the docs except my U of M doc and the one other good gastro doc i had. like you said, when the colon is nonfunctioning, dumping all that fiber in there just slows things down all the more. one doc told me to take 40 grams of fiber a day!! i did that and got terribly plugged up--thought i was going to die. i switched it down to 17 grams of fiber a day (obtained from the food i ate--no fiber supplements) . that's really all i could handle.

here a great article on fiber: "Stopping Or Reducing Dietary Fiber Reduces Constipation And It's Associated Symptoms". it's long--scroll down to the "discussion" part to get the short version.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/

yes, taking dulcolax and magnesium sounds like a good plan. good luck with everything. take care.


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## mossflower (Jan 21, 2017)

Hi Annie: well I took a 72 mcg Linzess this morning with a fatty breakfast and it worked a little so far (not enough)

But here is my problem: My doc said to eat my usual oatmeal with eggs and other food-- so I had oatmeal, 2 eggs, bacon and

an English muffin with peanut butter and jam. problem is I don't like to eat all that stuff for breakfast. I usually eat just oatmeal-

I don't like a fatty breakfast and I didn't enjoy breakfast at all. if I ate like that every day I would be a cow!!!

what do you suggest????

I imagine I will have to take 145 mcg to get the full benefit if I take it again.

.


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## annie7 (Aug 16, 2002)

thanks for the update. sorry to hear that the 72 mcg dose didn't work so well. yes, do try the 145 mcg dose. you could try taking two of the 72 mcg pills just to see how it works out.

and yes, omg--that's way to much of a fatty breakfast to have. i wouldn't like eating all of that food and fat, either--ugh. i'd be a cow, too. i think he told you to eat way too much. all that fatty food isn't even healthy.

i have read that taking linzess before eating a breakfast with some healthy fat in it can help make it work better. just try a little healthy fat and see how that works--like maybe adding a pat of butter or margarine to your oatmeal or eating a piece of buttered toast with your oatmeal or one egg or something like that and see how that works.

good luck.


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## annie7 (Aug 16, 2002)

or you could try taking the 72 mcg do\se right before breakfast (not 15 minutes before like your doc said) or even with breakfast and see if that makes it work better. it's the "food effect" like i mentioned earlier--the closer you take linzess to eating a meal, the more D you'll get. you might not even get D--it just might work better.


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## mossflower (Jan 21, 2017)

Hi Annie: well, while i am figuring out how and how much of the Linzess it will take to work for me, i decided for now to continue using the Mag citrate pills, but I am definitely adding Dulcolax to the mix: it seems that magnesium alone is losing its effectiveness and I take a lot of it (2400 mg which i believe is like 4-5 tbs of Milk of Magnesia)

So right now i am taking one Dulcolax with 12 mag citrate pills. i am considering taking 2 Dulcolax pills and cutting the mag to

11 pills for now. I have always been afraid of stimulant laxatives because it was always said that one can build up a tolerance pretty quickly. I know you took that combination for a long time -- ( 3 Dulcolax and MOM)- and it worked for you right?

The Dulcolax does cause a little cramping (one pill did so i imagine two pills will cause a little more) but that is the way

it is. I guess our bodies change over time and we have to adapt and find ways to handle the situation.

As far as Linzess, i still want to consider using it but i am just not sure how much it will take to work sufficiently. i do have a call to my gastro but they haven't gotten back with me (since yesterday)


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## annie7 (Aug 16, 2002)

oh yes--i took 3 dulcolax and one capful of milk of mag for many years and never developed a tolerance. i know of other people who have taken stimulant laxatives for many years and never developed a tolerance, either.

sorry about the cramping. i guess i was lucky--i never had cramping. it is important to take dulcolax at least an hour apart from daily products and antacids because that can cause cramping.

one thing--you want to make sure your kidney function is good when taking lots of magnesium tablets. if your renal function is poor, you could develop a build up of magnesium--it's rare but it can happen if your kidneys are working properly. .

hope your gastro doc's office calls you back soon.


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## mossflower (Jan 21, 2017)

i have my renal function and mag levels checked at least once every year


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## annie7 (Aug 16, 2002)

oh good--that's the smart thing to do.


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## mossflower (Jan 21, 2017)

Hi Annie: I think I have a problem with Dulcolax- I seem to have some element of urinary retention - I looked up side effects and unfortunately that can happen with this medication, though it is not common and I certainly did not expect it. So I think I have to

try another med: have you ever used Senna? I was thinking of trying that. I don't think I want to try cascara sagrada - read some not so great things about that.

In the meantime I still have not heard from the gastro doc and that makes me po'd- I will call back today but I think I try not to take anything tonight if possible and take two 72 mcg pills tomorrow of the Linzess. One thing I am concerned with however is how much breakfast to eat. I hope oatmeal and an English muffin with almond butter and jam are ok and i will take the drug closer to eating breakfast to try and get more diarrhea (isn't it amazing how graphic we are on this forum?)

Thanks again for your input Annie---


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## annie7 (Aug 16, 2002)

oh dear--so sorry you had urinary retention with dulcolax. i didn't have that--i didn't even know that could be a side effect. that's too bad.

oh yes--i've used senna (exlax). i had to take 4 of the maximum strength pills (25 mg each) in order to get it to work for me. and i also took it with one capful of milk of mag.

that's terrible that your gastro doc's office still has not called you back. they really should have by now. mine always called back the same day.

i never heard or read that one had to eat a huge breakfast with linzess. i just heard and read that eating a little healthy fat with your breakfast (not necessarily a big breakfast) can help. i really think that your oatmeal and english muffin with jam and almond butter should be just fine.

one important thing about linzess: linzess is very unstable and very susceptible to both humidity and temperature. like it says on the bottle, it's best stored at 77 degrees--with excursions permitted to 86. but best to keep it around 77 if at all possible.. and don't keep it in the bathroom or any other humid room either.

also--and this is very important. make sure the pharmacy gives it to you in the original bottle with the little desiccant thingies inside--there are several of them in there. it says this on the front of the bottle in an "attention pharmacist" note. don't accept it if the pharmacy has decanted it into one of their bottles. that's also because of it's instability--it's best left in the original bottle. back when i was taking it, cvs once tried to give it to me in one of their bottles but i pointed out these instructions and insisted they give it to me in the original bottle..

all of this info about storage (section 16) and more (like the food effect thing) is here in the full prescribing info on linzess from their website.

https://www.allergan.com/assets/pdf/linzess_pi


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## mossflower (Jan 21, 2017)

Hi Annie: you always have such great info: Fortunately for the moment my doc gave me a few samples of 72 mcg- the bottle does have that little thingy dessicant in it- I had no idea how important it is--- so I have a few pills left that I can take tomorrow. I hope 145 mcg Linzess works well. I really think I need to find something to replace the magnesium and now the Dulcolax---- I will let you know how things work out. Thanks for being there.


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## wgbutler (Mar 15, 2018)

annie7 said:


> oh dear--so sorry you had urinary retention with dulcolax. i didn't have that--i didn't even know that could be a side effect. that's too bad.
> 
> oh yes--i've used senna (exlax). i had to take 4 of the maximum strength pills (25 mg each) in order to get it to work for me. and i also took it with one capful of milk of mag.
> 
> ...


When I take Linzess I set my alarm clock for 4:30AM and take 1 or 2 72mg pills with a glass of water. The great way about taking it this way for me is that when I wake up I immediately have to go to the bathroom and get most of it out of my system. I may have to go 2 or 3 more time as the morning goes by but by 10:00 or 11:00 AM its pretty much out of my system.

That's a lot better than taking it during the day and having to suffer through 5 hours of D.


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## annie7 (Aug 16, 2002)

mossflower said:


> Hi Annie: you always have such great info: Fortunately for the moment my doc gave me a few samples of 72 mcg- the bottle does have that little thingy dessicant in it- I had no idea how important it is--- so I have a few pills left that I can take tomorrow. I hope 145 mcg Linzess works well. I really think I need to find something to replace the magnesium and now the Dulcolax---- I will let you know how things work out. Thanks for being there.


oh good--glad your doc gave you linzess in the original bottle. that's what my doc did, too, when he gave me samples.

yes, good luck with the 145 tomorrow. hope it works well for you!


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## annie7 (Aug 16, 2002)

wgbutler said:


> When I take Linzess I set my alarm clock for 4:30AM and take 1 or 2 72mg pills with a glass of water. The great way about taking it this way for me is that when I wake up I immediately have to go to the bathroom and get most of it out of my system. I may have to go 2 or 3 more time as the morning goes by but by 10:00 or 11:00 AM its pretty much out of my system.
> 
> That's a lot better than taking it during the day and having to suffer through 5 hours of D.


that's good that linzess works well for you when you take it that way. i've read posts from a few other people who took it that way also. or even took it before going to bed and then they would go the next day after they'd eaten breakfast with no D at all..

linzess wouldn't work for me unless i took it with food.


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## wgbutler (Mar 15, 2018)

annie7 said:


> that's good that linzess works well for you when you take it that way. i've read posts from a few other people who took it that way also. or even took it before going to bed and then they would go the next day after they'd eaten breakfast with no D at all..
> 
> linzess wouldn't work for me unless i took it with food.


I've tried taking it before bed as well. Sometimes what happens is I have to wake up in the middle of the night and I have a major episode. That's not too bad actually. But other times nothing happens at all, and I mean absolutely nothing. It's a complete waste of a pill.

So I usually don't take it before bed unless I'm on vacation with the family and I'm trying to go in the middle of the night only so that my days are completely unfettered. I went on a family vacation last Summer and I was able to pull this off. It worked out pretty well for me, but as a normal routine its too unreliable.


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## annie7 (Aug 16, 2002)

that's interesting (and unfortunate) that sometimes it works for you and sometimes it doesn't.

i never could get linzess to work properly for me. i had to take the 290 mcg. at first it worked well, and then, after a few days, it quit on me. so i started experimenting with the food effect thing and tried taking it closer and closer to eating breakfast. for me, it would only work at all if i took it with (not before) a breakfast with some healthy fat in it. but unfortunately, that would give me D off and on for about four hours. not fun. so i only used it when i needed a clean out.

from what i've read about other peoples' experiences, it's very much a YMMV sort of med.


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## wgbutler (Mar 15, 2018)

annie7 said:


> that's interesting (and unfortunate) that sometimes it works for you and sometimes it doesn't.
> 
> i never could get linzess to work properly for me. i had to take the 290 mcg. at first it worked well, and then, after a few days, it quit on me. so i started experimenting with the food effect thing and tried taking it closer and closer to eating breakfast. for me, it would only work at all if i took it with (not before) a breakfast with some healthy fat in it. but unfortunately, that would give me D off and on for about four hours. not fun. so i only used it when i needed a clean out.
> 
> from what i've read about other peoples' experiences, it's very much a YMMV sort of med.


Indeed. I find that Linzess seems to work better with the 4:30AM alarm clock than Trulance does. Seems like when I try this with Trulance I still get stuck with 4 or 5 hours of D. But maybe that's not a fair comparison as I haven't tried it with Trulance that often. I usually take the Trulance at the end of the day and suffer through an evening of D when I get home from work.

I can't do the morning Linzess thing during the work week because I have to be at work by 8:00AM and it's a little bit of a risk that I will still have to run to the bathroom either on the way to work or for an hour or so after arriving at work (and maybe in the middle of a meeting). But I do the Linzess thing on the weekends when I don't have to go to work. That's a whole lot better than 5 hours of D with the Trulance at the end of the day.

Really I think they are basically the same medicine. I've even read that they are chemically very similar and operate on the same exact receptors in the small intestine.


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## annie7 (Aug 16, 2002)

wgbutler said:


> Really I think they are basically the same medicine. I've even read that they are chemically very similar and operate on the same exact receptors in the small intestine.


 that's interesting about trulance. from what i've read, you don't have to take it with or before food. i haven't had any experience with trulance because it came out after i'd had my surgery.

and i know what you mean about linzess and going to work. where i worked, i couldn't just take off and use the bathroom whenever i needed to plus, oh yes--having it work on the drive in would truly be miserable. fortunately, i was retired by the time linzess came out so i didn't have to worry about that.


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## wgbutler (Mar 15, 2018)

annie7 said:


> that's interesting about trulance. from what i've read, you don't have to take it with or before food. i haven't had any experience with trulance because it came out after i'd had my surgery.
> 
> and i know what you mean about linzess and going to work. where i worked, i couldn't just take off and use the bathroom whenever i needed to plus, oh yes--having it work on the drive in would truly be miserable. fortunately, i was retired by the time linzess came out so i didn't have to worry about that.


I've taken Trulance both with food and without food. Doesn't seem to make much difference. For that matter, taking Linzess with or without food doesn't seem to make much difference either. I think they are basically the same thing, except Trulance comes in a better package and is less likely to go bad.


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## annie7 (Aug 16, 2002)

yes, you're right. they are both guanylate cyclase-c (GC-C) agonists.


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## mossflower (Jan 21, 2017)

Right now we are in Florida and I don't have to go to work ( though I do work from home and send my work back to Michigan)

If I had to go to work I would never be able to take Linzess.

What is happening now though with Magnesium and now taking it with Dulcolax, it keeps on working and working. what I mean by that is that after it works well during the night, I keep passing gas with little pellets of poop and this keeps going on for hours and hours: This is kind of new in the past few months. when I would go work in this tiny office it was just me and one other person who sits near the bathroom it was so embarrassing. Until six months ago, It used to be i would take magnesium, it worked great until around 9:30 am and I was done. it was really great. That is no longer the case. Anyway, now I am home and don't have to worry about that.

Does Linzess keep on working for hours???


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## annie7 (Aug 16, 2002)

that's too bad about the little pellets of poop going on for hours and hours....

from what i've read, linzess is very much a YMMV kind of drug. i've read a lot of posts about linzess both here and on another board i read. some people say it works great for them, other people get some D with it and other people get lots of D from it. if you get hours of D, i'd say definitely try either taking a lower dose of it or start experimenting with the "food effect" thing that i've mentioned earlier---try taking it an hour before eating, 90 minutes before eating, two hours before eating etc etc.

did your gastro doc's office call you back today? .


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## mossflower (Jan 21, 2017)

Annie--what is YMMV??

I called the gastro doc back and talked to a medical assistant
who had given my message to him-- he agreed i should go to 145 mcg and i will
pick up some samples from his office- i am thinking with as non functional as my colon is i might wind uo needing 290


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## mossflower (Jan 21, 2017)

can you take Linzess after a big breakfast?
let's say i want to go out and have a yummy pancake breakfast
and then come home and take this drug--would it still be effective???


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## mossflower (Jan 21, 2017)

I am now beside myself with being upset: I took 145 mcg 25 min before a breakfast of oatmeal and an English muffin with peanut butter and jam and the Linzess is not working. the problem is it moved down and is just sitting there making me miserable. I am shocked. When I took 72 mcg a couple days ago it worked great within a half hour and again about an hour later. it wasn't enough but it worked. this is simply not working. I don't know why but I never expected it not to work at all. It has been an hour since I took the Linzess.


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## annie7 (Aug 16, 2002)

oh i'm so sorry the 145 didn't work! that's terrible!

you'd think it would have worked since you took the 72 mcg and that worked. how soon before eating did you take the 72 mcg?

maybe try the 290 tomorrow. or try taking the 145 closer to eating.

YMMV means Your Mileage (results) Will Vary.

i don't know about taking linzess after breakfast. everything i've read and been told is that it's to be taken before breakfast. if you take it immediately after breakfast, you'll probably have lots of D.

trulance can be taken anytime of day. food doesn't matter with trulance.

again, so sorry the 145 didn't work.....


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## mossflower (Jan 21, 2017)

update: it is still not working; it is like I did not take anything


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## mossflower (Jan 21, 2017)

I am done with this drug. I have a call to my gastro to see what else he might recommend. if doubling the dose does nothing I do not feeling like going forward with this drug since it is doing absolutely nothing. Thanks for listening Annie. I will go back to Magnesium for now.


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## annie7 (Aug 16, 2002)

so sorry it didn't work for you. that's miserable when you can't go.

hopefully your gastro doc will have something else to recommend and will get back to you quickly. keep us posted.

good luck with everything.


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## annie7 (Aug 16, 2002)

ps--have you ever read this thread? it might be helpful.

https://www.ibsgroup.org/forums/topic/152106-the-great-list-of-remedies/

also--have you ever tried Dr Schultz Intestinal Formula #1? it's a stimulant laxative. a lot of people here have had good success with it.

https://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/


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## mossflower (Jan 21, 2017)

The reason I won't use intestinal formula is that I have allergies to lots of different things, and even though this is considered

"natural", there are lots of herbs in this formula and I am concerned about an allergic reaction to something in that formula. it sounds good and I know it works for others and that is good.

Right now I am, to be blunt, full of poop from the Linzess that left me that way: I am totally shocked it didn't work not one drop.

What I need now is a dose of Golytely but I know my GI won't order it. it is too bad I am not back home where I know the docs there.

Sigh.


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## annie7 (Aug 16, 2002)

yes, that's really a shame that linzess didn't work. i hated that full-of-poop feeling.

to get rid of that full of poop feeling--can you do an enema? that should help get the poop out. or try taking a suppository. the dulcolax suppositories always worked best for me. or you could drink a bottle of magnesium citrate. i hated that stuff , though. it would clean me out but it always gave me a lot of gas and cramping til it worked. miserable.

do you have a primary care doc there in florida? maybe he/she would rx you some GoLytely. or you could always try the miralax/dulcolax prep and take a little of that..


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## mossflower (Jan 21, 2017)

well the last time I took a suppository (glycerin) I had such severe rectal bleeding I had to go to the ER

I really don't use enemas because the stuff contained in them is very high in sodium (in fact the liquid was called Phospho Soda and taken of the market), but the enema is still available. But for older folks like me (70 ish) that would probably be too much sodium.

So I will probably have to bite the bullet until tonight and take my usual magnesium citrate--

that full of poop feeling really is awful.

I am so disappointed in Linzess and shocked --- like you said though, it works for some and not others - it looked promising

I don't know much about Trulance- I googled it and read reviews, and like so many other of these types of meds, they work for

some and not for others.

As we know Annie, this chronic intractable constipation is a horrible problem- we can only try to find things that work and do the best we can do. I am glad I tried the Linzess so now I can cross it off the list and move on.


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## annie7 (Aug 16, 2002)

oh dear--that's terrible that the glycerin suppository did that to you!

whenever i used the fleet enemas, i always poured out the solution inside and replaced it with plain water. and when i used the large sized enemas (which were more effective) , i just used plain water for those, too.

yes, i've read that about trulance, too. but, really, the only way you're going to know if a med works for you or not is to try it for yourself. it has helped some people.

Motegrity (prucalopride) was approved in december and hopefully will be coming out soon. that's a totally different med--it's a prokinetic med like zelnorm was--totally different than linzess and trulance.

https://www.ibsgroup.org/forums/topic/348977-fda-accepts-new-drug-application-for-prucalopride-for-cic/page-1

and they are going to be bringing zelnorm back, too.

https://www.ibsgroup.org/forums/topic/352078-zelnorm-and-prucalopride-win-fda-panels-backing-for-constipation/

so once these meds are on the market, C people will finally have more options.

good luck with the magnesium. hope it works.


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## mossflower (Jan 21, 2017)

That is pretty smart- to dump the stuff in the enema and replace it with water--- did it work well??


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## annie7 (Aug 16, 2002)

yes, it did.

i did eventually develop a problem with the large volume enemas, though (not the fleets). my colon and pelvic floor dysfunction got so bad that i could no longer get all the water out and it would slosh around inside me all day long. not fun.

once i took a laxative, it would come out the next day.


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## mossflower (Jan 21, 2017)

Annie: you surely have been through it all-- you seem to have really taken all the tests , tried all the different meds, and finally

I guess you decided to have surgery-----I can certainly understand that- I don't think normal people realize what a horrible problem this really is. My husband is beginning to understand how terrible it is for me ( he has a hard time even saying the word poop)-

he doesn't like to talk about "those things"- but he is getting more understanding---- I was normal with normal bowel function and I fondly remember those days -it is really important to have a good gastro doc like you have at U of M. Here in Florida, good docs are harder to find, believe me.


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## annie7 (Aug 16, 2002)

yes, you're right--normal people who can poop have absolutely no idea how miserable this problem really is.

plus it really can get serious, too, if you get so backed up that you develop an impaction or. worse yet, an obstruction. i developed an obstruction during my sitz marker test. it was horrible. i was so backed up that i couldn't even pee so i finally went to the ER.

that's good that your husband has become more understanding. mine did, too, when he saw how truly miserable i was.

yes, i finally decided to have surgery when things got really bad and my U of M doc had me doing half a colonoscopy prep once a week --in addition to the daily laxatives. that was a miserable way to live and i finally got sick and tired of it.

yes, good gastro docs can be very hard to find. so sorry you're having trouble finding one in florida. i was very deeply grateful to have such a wonderful, knowledgeable, proactive gastro at the U of M and i told him so! plus i was fortunate to have another great gastro doc who was working out by Saint Joe Hospital in ypsilanti. he referred me to Dr. Chey at the U of M. they went to school together.


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## mossflower (Jan 21, 2017)

that is why I would not do the sitz marker test- If nothing moves--- well, that isn't good. I think a lot of people with constipation are afraid of getting hooked on meds so they don't take something when they should, then they get backed up and can get into trouble that way.

As far as prucalopride, I looked up some stuff about it on Google: Since I have a history of atrial fibrillation, I would not take this drug.

it can cause arrhythmias----- so far the studies seem to show it is much safer than Zelnorm was.


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## annie7 (Aug 16, 2002)

oh dear--so sorry you have a history of AFib . and yes, prucalopride is supposed to have a better safety profile than zelnorm.

i think you're right about some people with C being afraid of getting hooked on meds and then they get too backed up and develop an impaction or obstruction.

i actually told my first gastro doc (the one in ypsi) that i wanted to do the sitz marker test. i knew i would fail it and i wanted him to take me more seriously because at first he told me i shouldn't be taking stimulant laxatives. he certainly did take me more seriously once he read the ER report! after that, he told me took take whatever i needed to go.

i had to take another sitz marker test before i had my surgery because the colorectal surgeon required it. at least with this one, i made it through the test and didn't end up in the ER.


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## mossflower (Jan 21, 2017)

i just talked to the "assistant" to the GI doc: told her Linzess didn't work; she said it will probably work later. I said no, it won't, it isn't that kind of medication. if it hasn't worked by now since i took it at i:15, it ain''t gonna work. sigh.


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## annie7 (Aug 16, 2002)

oh for heaven's sake: "it will probably work later." how wrong is that! she doesn't even understand how linzess works (or doesn't work).

you're right--if it hasn't worked by now, it ain't gonna work. what a useless conversation that was.

i hope she at least tells your gastro what you said and hopefully he'll get back to you with a plan. wish he'd rx you the GoLytely. especially since linzess isn't working. after all, he's a doctor-- he's supposed to help you. how frustrating!


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## mossflower (Jan 21, 2017)

well my gastro gave me samples of Linzess 290,-so i will try that soon


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## annie7 (Aug 16, 2002)

good luck!


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## mossflower (Jan 21, 2017)

Hi Annie: well i saw another GI doc here in Florida. I like him but he also refused to prescribe Golytely because it is not prescribed to treat constipation. he told me to take Miralax, stating it was just like Golytely. I told him Miralax does no work like Golytely and that it does not have electrolytes like Golytely; he said it does but i looked it up and i am correct. Anyway, he gave me samples of Trulance. i have no idea how to take them because i have no idea how long it takes to work ( like right away or hours later). He told me that i should go to U of M when I get back to Michigan because he said there are top docs there who may be aware of more meds than he is ( i thought that was good of him to admit that). He said i should go somewhere like U of M or Mayo Clinic. Beyond Trulance, he really had no other ideas though he said that taking all that magnesium i take is not good ( i do know that but it is the only thing i can count on for relief).

I have an appt when i get back to michigan with a motility specialist who is supposed to be really good at Henry Ford Hospital so we shall see. i won't be back in Michigan until April--until then i guess i will just have to struggle along like i am. i would like to

try the Trulance and possibly i will try the 290 mcg of Linzess, though i have not tried it yet.

I hope you are doing well---I do have one question for you Annie, after all the things they tried with you at U of M, did none of them give you the relief you needed? is that why you needed surgery to remove part of your colon?

This GI doc mentioned surgery but I am "elderly" in my 70's now, and surgery is out of the question at this point in my life unless it

is life and death.

Take care


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## annie7 (Aug 16, 2002)

thanks for the update. the new doctor you saw sounds good but yes, you're right--- mirlax is not like GoLytely. like you said, it doesn't have the electrolytes in it. i really can't understand why these docs don't want to prescribe GoLytely for you. in my opinion, it's definitely worth a try.

that's great that you have an appointment with a good motility specialist at Henry Ford. too bad you're not going back to michigan sooner.

good luck with the 290 linzess and trulance.

after i had all my tests, i was dx'd with colonic inertia, pelvic floor dysfunction, rectal hyposensitivity and a long twisted colon. for the pfd, i had 2 eight week biofeedback sessions at the U of M and they did help teach me how to relax my pelvic floor muscles but i was still unable to coordinate them. and yes, i tried all the C medications that were available then including misoprostol. when things got so bad that my U of M doc had me taking half a colonoscopy prep every week to keep from getting impacted, i'd decided i'd had enough and decided to get an ostomy. i first had a colostomy but when abdominal adhesions from a previous surgery gummed up my colon, i had my entire colon removed and had an ileostomy. i was 63 when i had my surgeries.

if one doesn't have pelvic floor problems like i did, one can have a total colectomy which involves removing the entire colon and then hooking up the small intestine to the rectum.

and yes, i understand why you wouldn't want surgery because of being in your 70's.

good luck with everything. i do hope that somehow you can find some relief. take care.


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