# Why would Linzess stop working after colonoscopy?



## sjw596 (Feb 19, 2014)

I've been taking Linzess 145 mcg for seven months with great results. The 145s were more than adequate to provide relief after many years of CIC. After my colonoscopy two weeks ago, they abruptly stopped working unless I added about 1/2 dose of Miralax, but still not as well as before. I went through a two-day colonoscopy prep and all went well. I added some probiotics, just in case I needed to restore some bacteria to my system. This makes no sense. Perhaps I should take two 145s and see if things come back to normal. Thanks for any suggestions!


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## annie7 (Aug 16, 2002)

no that doesn't make any sense. i've never heard of a colonoscopy affecting how linzess works.

yes you could try two 145s and see if that helps.

another thing and i've mentioned this on the board before so maybe you've already read it but-----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 the quicker it works. and conversely, the more time that elapses between taking linzess and eating, the less D you get.

so you might want to try taking linzess 15 or 20 minutes or even less before eating instead of a half hour before, as prescribed. that might make it work better for you. it made a difference for me. and make sure you eat a warm meal with some healthy fat in it--that can help make it work better. also drink lots of water with it.

good luck. hope you can get it working for you again.


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## flossy (Dec 8, 2012)

sjw596 said:


> I've been taking Linzess 145 mcg for seven months with great results. The 145s were more than adequate to provide relief after many years of CIC. After my colonoscopy two weeks ago, they abruptly stopped working unless I added about 1/2 dose of Miralax, but still not as well as before. I went through a two-day colonoscopy prep and all went well. I added some probiotics, just in case I needed to restore some bacteria to my system. This makes no sense. Perhaps I should take two 145s and see if things come back to normal. Thanks for any suggestions!


Well, it's good to hear a positive post about Linzess.

I would drop the probiotics, see if that helps. (Tried 'em a few times but probiotics always make me more constipated. Not for me.)


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## sjw596 (Feb 19, 2014)

Thank you both very much! I do agree on the probiotics, as they had the same effect before I started the Linzess. I drink 8 oz. of water with my Linzess. I usually end up waiting 40-45 minutes before having any solid food after my Linzess. I eat a low-fat, high fiber breakfast, usually healthy cereal (2% milk or yogurt) with whole wheat toast. Aside from whatever's going on here, Linzess has made me feel better that I have felt in 10 years. For the first time, I can empty my colon, don't have gas all day, and no longer feel bloated. For once, I could know that would feel good an hour or so after breakfast. I haven't had a bout with hemorrhoids in over a year. The only downside was that my stools were typically on the "loose" side with at least some liquid most days. It didn't bother me in the least. One thing that I forgot to mention, is that, after my colonoscopy, I was on a Medrol dose pack of prednisone for a week and was taking the azithromycin antibiotics for a sinus infection. That antibiotic, however, is more apt to cause diarrhea.


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## annie7 (Aug 16, 2002)

for me, drinking 16 oz of water with linzess worked better than 8 oz. others have mentioned this as well. plus i also drank lots of water throughout the day. but that was my experience--we're all different.

you could try eating within 20 or 30 minutes after taking linzess and see if that helps...

good luck with everything.


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## flossy (Dec 8, 2012)

sjw596 said:


> Thank you both very much! I do agree on the probiotics, as they had the same effect before I started the Linzess. I drink 8 oz. of water with my Linzess. I usually end up waiting 40-45 minutes before having any solid food after my Linzess. I eat a low-fat, high fiber breakfast, usually healthy cereal (2% milk or yogurt) with whole wheat toast. Aside from whatever's going on here, Linzess has made me feel better that I have felt in 10 years. For the first time, I can empty my colon, don't have gas all day, and no longer feel bloated. For once, I could know that would feel good an hour or so after breakfast. I haven't had a bout with hemorrhoids in over a year. The only downside was that my stools were typically on the "loose" side with at least some liquid most days. It didn't bother me in the least. One thing that I forgot to mention, is that, after my colonoscopy, I was on a Medrol dose pack of prednisone for a week and was taking the azithromycin antibiotics for a sinus infection. That antibiotic, however, is more apt to cause diarrhea.


You might want to experiment with less fiber and see if that helps. *I avoid fiber like the plague*. For me (and many of us on this board), more fiber = more constipation.


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## annie7 (Aug 16, 2002)

agree with Flossy on the fiber..i found i did best on a low fiber diet. although in your case, if the amount of fiber you are eating was working for you before the colonoscopy, i don't know why that would change now...

just had another thought as to maybe why linzess stopped working--

it's a very unstable medication and should not be subjected to heat and humidity. for that reason, it should be kept in the original container (tightly closed) from the pharmaceutical company and not decanted by your pharmacy into one of their pill bottles. the original bottle also has several little desiccant thingies in it to help protect it from humidity. it says all this on the label under "instructions to the pharmacist" so they are supposed to pay attention to that when dispensing it. one time, cvs didn't (new pharmacist) and gave linzess to me in one of their bottles which i gave right back to them and asked for the original packaging.

so i don't suppose that has happened to you. is it in the original bottle? and it's not been kept in a humid area like the bathroom...


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## sjw596 (Feb 19, 2014)

Thanks again for the suggestions! I had thought about the stability issue. I do know that the pills from the particular "factory" bottle worked before the colonoscopy. I'm pretty careful about handling. I close the bottle very tightly, though I've left in in the bathroom 1-2 while showering. I think it's been closed tightly enough. I get a three-month supply, which is three bottles, which I store in the pantry. Regardless, this is odd enough to make me try pills from a new bottle, and I'll report back on whether that did the trick.

Aside from dietary fiber, I do take two Fibercon pills each day. After starting Linzess, I cut out Metamucil (2x/day) entirely. The only issue that the GE found from my colonoscoy was minor diverticulosis, for which he told me to keep up the fiber.


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## flossy (Dec 8, 2012)

sjw596 said:


> Thanks again for the suggestions! I had thought about the stability issue. I do know that the pills from the particular "factory" bottle worked before the colonoscopy. I'm pretty careful about handling. I close the bottle very tightly, though I've left in in the bathroom 1-2 while showering. I think it's been closed tightly enough. I get a three-month supply, which is three bottles, which I store in the pantry. Regardless, this is odd enough to make me try pills from a new bottle, and I'll report back on whether that did the trick.
> 
> Aside from dietary fiber, I do take two Fibercon pills each day. After starting Linzess, I cut out Metamucil (2x/day) entirely. The only issue that the GE found from my colonoscoy was minor diverticulosis, for which he told me to keep up the fiber.


I would try no extra fiber for a few days, but of course it is up to you. Doctors always say just eat more fiber and it should work, but for many of us on this board? No go (pun intended).


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## annie7 (Aug 16, 2002)

oh yes--i think it's worth it to try some of the pills from an unopened linzess bottle. you never know...

my gastro doc told me the same thing about fiber when my colonoscopy showed diverticulosis but i sort ignored that, knowing what more fiber would do to me. (bad patient!!) not that i'm saying you should do that of course. your own judgement is best --you know your body and how it fits in with your doctor's advice.


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## sjw596 (Feb 19, 2014)

Well, I opened a new bottle (the second from the three-bottle set) on Wednesday, and my "results" were much more normal. Thursday's effect also was improved. I do think that a few more days are in order before concluding that I had a bad group of capsules.

If things return to normal, I suppose I can re-try capsules from the "bad" bottle to see whether I again have a bad result, though I'm not inclined to make myself suffer to prove a point. If the remaining pills in the bad group appear to be ineffective, I suppose that I can take them back to Costco to see what can be done. It's not the money, as I get a 90-day supply for $30.


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## annie7 (Aug 16, 2002)

oh so glad to hear that so far the new bottle is working. and hopefully that will continue.

you're right--see how it goes for the next few days before deciding that you had a bad batch.

i wouldn't want to make myself suffer either just to prove a point....


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## Patrick ibs c (Mar 5, 2016)

why is linzess stll not recommended for ages 13 to 17 is it too strong??


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## annie7 (Aug 16, 2002)

i think it's because it hasn't been extensively tested on kids that age. the linzess website says: " it is not known if linzess is safe and effective in children."

you could always ask your gastro doc or pharmacist this question. they might know more about it.


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## annie7 (Aug 16, 2002)

or you could call the makers of linzess and ask them.

https://www.linzess.com/


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## Patrick ibs c (Mar 5, 2016)

annie7 said:


> or you could call the makers of linzess and ask them.
> 
> https://www.linzess.com/


well its for my niece Gina


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## Moreaux (Jul 2, 2016)

Regarding the Lizness not working, I have been on it for about two months and have found that if I am severely constipated it does nothing. I have to use it in addition to other tactics like mineral oil, enemas, and magnesium citrate. This week I experienced that and got so desparate I broke down and used senna, which I only use every couple of months because I don't want to make my motility issues worse, but it's the only thing I know of that stimulates the muscles. I'm glad it's working for you again!


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## Patrick ibs c (Mar 5, 2016)

yes didnt work for me at all


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## sjw596 (Feb 19, 2014)

annie7 said:


> or you could call the makers of linzess and ask them.
> 
> https://www.linzess.com/


Thanks, Annie. If it appears that I have a dozen or do "bad" pills, I'll just go to the pharmacist at Costco. They're usually pretty good. Who knows, maybe they'll replace them. I don't even want to think about contacting Ironwood Pharma, unless I have nothing to lose after going to Costco. I have no doubt that they'd run me through the "proper storage and handling" drill and simply make sure to avoid any liability. Anyway, I agree that a few more days are in order, though today made three good days in a row. I'll post back when I have a more conclusive result.


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## annie7 (Aug 16, 2002)

sorry for the confusion--i was reply to patrick's question ....

good luck with costco


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## sjw596 (Feb 19, 2014)

Okay, this issue is resolved. The capsules from the second bottle from the 3-bottle set have worked normally for the last seven days, and I did not change my diet or other routines. I called Allergan to report the "bad" pills. After 30 minutes on the phone and speaking with the fourth rep, I was told that the customer service department would call me with a plan for reimbursement. Later today, I received that call. Allergan will contact Costco to arrange for a free bottle of pills to be dispensed. So, that's worth $10, and I had used about 15 pills from the bad bottle. They do not want the bad capsules returned, though I'd be happy to do so for testing purposes. At least they could determine whether the pills were degraded. I almost think that I had to share some blame, though I have stored the pills almost perfectly and live in a semi-arid climate with moderate temps. Maybe I would be wise to store 1/2 of every new bottle in an empty factory bottle (with the desiccant packs) and use 15 at a time.

Anyway, I'm back on track with my 145s. Even though 290s are indicated for CIC, I can't imagine doubling the dose. I hpe you have similar success with your issues. The Linzess leaves a few things to be desired, but as I said at the start, I haven't felt this good in many years. I want to thank you all again, as your suggestions were invaluable!


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## annie7 (Aug 16, 2002)

thanks for the update. that's great that Allergan reimbursed you the $10.00 although it's too bad you had to go through so much work to get it. perseverance pays off.

and glad that things are back on track for you. take care.


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