# Want some opinions...



## Ashers86 (Dec 31, 2007)

Hey everyone!So I finally saw my 3rd GI for the first time this past Thursday.... After having spent the Monday before that stuck on the toilet, ready to dial 911; instead I called TeleHealth (24/7 phone service run by nurses) who told me to go to the hospital, except I couldn't move nor drive myself there. I wanted to die!Note that for the last 2-3 months, I have been taking Soflax (stool softener) on a daily basis after my family doctor (finally!) noticed my fissures. I had also been incorporating Benefiber in my water, which I've been slowly drinking more and more of each day. That Monday night when I was in complete agony, I took two Senokots before bed. When I got up in the morning, I took two Soflax. It didn't do anything - the cramps just started again as I started off with my day.Anyways, the new GI has agreed (for whatever reason, which I'm still wondering about since he commented that he agrees it may not be more than IBS, and also said he'd run any test I asked for if it helped to reassure me) to do an EGD/colonoscopy; first scope for me. So hopefully something can be done about these fissures, but in the mean time, he's altered my daily regiment of pills/meds.I currently am taking:150mg Effexor XR150mg Wellbutrin1 Soflax - 1mg? Not sure...(Womens multi-vitamin)And he's added:1 Senokot1 Metamucil capsuleAlso to increase the Soflax, Senokot and Metamucil doses as time goes on.Thing is, I really don't feel okay with taking a daily laxative indefinitely! My initial follow up with him is booked for March, so it was agreed that I keep this up until then!I have felt so gross and crampy the whole time since I started it! I skipped the laxative this morning; I feel like I need to explode with D, but don't need to go... And I haven't felt as bad on a whole today as a result. I also experienced heavy/tight chest & lower esophagus pains with the Metamucil capsules, so I personally opted to drink a bottle of water mixed with a teaspoon of Benefiber. The chest pains are gone... however I feel physically exhausted and have a constant headache still (I felt like spending the weekend in bed as a result of things, and did for 80% of the time).I have also been prescribed Prevacid for my GERD, which is to be taken twice daily. I don't seem to have a problem with it, but I can't say that I've tested it to see if it works. I was having GERD-like pains (pretty much) with the Metamucil capsules, but it didn't touch that.My question is, has anyone been advised to take laxatives on a daily basis (for more than a week or so)?I just find it isn't "logical"... I'm worried about what's going on inside with cramming laxatives into my obviously backed up system.I was thinking about altering it myself and just taking it every other day... If I have to be on it consistently, I'll do that much. Then again, I'm asking because I've never heard of this 'form of treatment' before.BTW, I was also not given anything for pain (no anti-spasmodics even).I just don't know what to do... it all makes me feel so miserable! I also do take birth control pills on top of that, and have a prescription for Imovane (sleeping pills) which I take as needed. I know that things will take getting used to, for example feeling bloating and achy from fiber supplements in the beginning and if taking too much, but I find I'm feeling worse than I normally would on a rather decent day. It's as if it's causing more problems!I don't know what it is, but over the last couple of days I have noticed a VERY foul smell when passing gas - but I'm also passing A LOT of gas suddenly, and it is painful; feels like my stomach turns and I need to bolt to the bathroom.Anywho, it just all seems weird to me. Would appreciate some opinions!


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## SpAsMaN* (May 11, 2002)

Fibers suppl. are not recommended for chronic super constipation.To evaluate if you have colonic inertia which means it takes more than 5 days to move stools,you have to have Sitz markers test:www.konsyl.comHaving said that,this test is for the doctors to admit the colonic inertia disease.You can personally evaluate that for yourself meaning you know you only go once a week.Dulcolax is one of the best laxative for IBS-C.IBS-C is constipation+discomfort/pain.Expect cramps in the beginning.The senna you take is also a stimulant laxative.I find it much more irritating.If you think that the pelvic floor dysfunction is not the cause of the constipation ordeal well you may be correct.Have you try enema?Some constipated swear by it but IBSers often find them aggravating.In my case,enema spasm my left side....


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## Ashers86 (Dec 31, 2007)

Hi Spas,I know - and I told the GI that I have been making myself stick to a form of fiber supplement with NO results! But, he insists the Metamucil.... but don't they all?!







*sigh* It's just that this stuff obviously isn't doing much for me... I used to be D-predominant, but when I changed to C, I found it to be MUCH more painful! Whenever my stomach tries to do ANYTHING I have cramps! What's weird is I feel the rushed sensation like I should be having D, but cannot go... yet I feel the need to stay in the bathroom (?)...I asked the GI to test for pelvic floor dysfunction, which he said he will do during the colonoscopy. Or I think that's what he said.. I may have to follow up on that...Thing is, I never had this problem before until a few months ago when I realized that I needed A LOT of help to push my stool during a BM, no matter how urgent it felt. I'll admit the stool softener & laxative combination has definitely softened it enough to the point where it just "drops" out, but quantity wise, I'm not going much more than I normally do with being constipated.I am considering trying the Dulcolax... have not tried an enema but wish I had one on the incident mentioned! I may just have to have a look... I'm still new to this stuff!


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## SpAsMaN* (May 11, 2002)

If you strain a lot it looks like defecation problems.These problems are often associated with tightning of colon muscles which often benefit from anti-spasmodic or muscle relaxant.Suppository can help,however i've found that "the butt in the air" position seems to expell gas as well


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## IanRamsay (Nov 23, 2008)

hi AshersHope you are feeling a bit better! i have a real strange one for you to try. this worked for me with alarming ease some time ago and i have been doing it ever since. when you go to the toilet, in stead of sitting on the loo, squat on it, as in feet on the loo seat. it sounds reeally silly but it works by closing teh IC valve securely when you are in teh squat position and that pressurises the bowel to teh proper amount. this in turn lets teh muscle at teh rectum relax and what follows is a bowel emptying. at least that is what happened to me! (Google squat toilet technique) for a diagram of the posture.Also, have you tried NOT taking any fiber? it seems that taking lots of fiber isnt doing any good, so is it worth trying taking very little fiber? im not a doctor so i dont know if it would give you any relief, but it seems logical (at least to me anyway!) that if one thing isnt working, do the opposite!CheersIan


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## Ashers86 (Dec 31, 2007)

Hi Ian,LOL - quite interesting... But I will say I'm not sure how well I can do that squat you're talking about. Something tells me it may be an accident itself!







But I do understand the logic behind it... so maybe I will...Fiber has never seemed to do anything... so I really don't know why a doctor is ordering me to do it AGAIN. Ugh, I'm physically in so much pain right now because of taking Metamucil supplements... I mean, I can put more fiber into my diet, but this is getting ridiculous... I feel like absolute cr*p!







I seriously feel like I'm 9 months pregnant all the sudden, and the bloating hurts.. plus I've got a GERD like burn/pain high up in my chest which my GERD med isn't even touching! I really don't know how long I can do this....


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## annie7 (Aug 16, 2002)

HI Ashers sorry you've been having so many problems--yes it is miserable isn't it. if the colonoscopy and other tests don't show anything you might want to ask the dr for a stiz marker test like Spasman mentioned to check your transit time and see if the problem is colonic inertia. fiber definitely does not help colonic inertia one bit--seems to make people worse.about the squatting--despite my arthritic knees i actually did try to squat on the toilet seat like Ian mention because i'd read so much about squatting and how it can help. well guess i'm not as nimble as i thought because the first time i almost fell off and almost broke the seat. LOL i finally did manage to be able to do it but i just couldn't relax in that position and if i can't relax i can't poop. so i experimented with a modified version of squatting--tried propping my feet up on a step stool about seven inches high while sitting on the toilet and that does seem to help--or you could try a small waste basket turned on it's side--anything to elevate your feet off the floor so your knees are higher than your hips. of course everyone is built differently so as they say your mileage may vary but the step stool really helps me a lot....


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## IanRamsay (Nov 23, 2008)

hi annieSnap! Thats ho wi started off with a waste bin turned upside down used as a foot rest! and that did help alot. i too had trouble with teh squat at first. in fact i fell off and took the loo seat with me as well. but i got there in the end. apparently broken loo seats are really common.......... shame they dont tell you that in the instructions.cheers Ian


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## IanRamsay (Nov 23, 2008)

Hi AshersHunny i dont know what to say! Have you tried probiotics? they may help but its not a quick fix, infact it can take a few weeks and it seems you need some relief yesterday. have you tried the crooked river accupressure point? the link below will give you direct instructions.http://wakowa.wordpress.com/2007/11/03/acu...e-intestine-11/it has helped me in the past when things have got desperate. the next link may also offer some relief with the bloating and peristalsis.http://www.ehow.com/how_6616_shiatsu-indigestion.htmlhave you got any prokinetics? if you have they will do more for the gerd than any acid blocker will. if you havent got any and live in canada you can get soemthing called motilium from most chemists. if you are in the rest of the US metoclopramide can be obtained on perscription.i wish i could give you a migic bullet.i hope the above gives you some relief, even just a little!Cheers and take careIan


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## Ashers86 (Dec 31, 2007)

Thanks so much Annie and Ian!I suppose sitting as normal, then leaning back and holding your legs with your knees against your chest would probably be about the same? Has anyone done it that way?I know, I really don't think the fiber is doing any good at all! But I don't know what to do about that... I don't see him again until March, and he wants me to have been on this new set of pills until then... all about the "fiber will take awhile to work".But I dunno... I actually wonder if maybe I should've been told to do an enema first and THEN continue taking stool softeners, laxatives, etc. daily after that..? That makes a lot more sense to me...Thanks for the links Ian, I will have a look. I am in Canada so I'll look for Motilium when I'm at the pharmacy tomorrow.As far as probiotics go, I used to take Acidophilus daily for a few months when I was D, so I can't say much... I tried to take it again when I turned to C, but it seemed to make me feel uncomfortable like with the Metamucil. I can't even tell you if it did make a difference...


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## annie7 (Aug 16, 2002)

Ashers --yeah--your idea about the modified squatting position-- that might work-- it's certainly worth a try. that's one of the big things with ibs i think--anything is worth a try. we all have to try anything and everything to see what works for us and usually it's a combination of things, not just one thing. personally i don't think i'd be able to relax in that position--i think i'd have to tense up too much to maintain it and in doing so would be tensing up my pelvic floor muscles too so for me that would inhibit any pooping--but yes it's worth a try--everyone is diiferent and just because something doesn't work for one person doesn't mean it won't work for another. or try some folded up towels on the floor to elevate your feet if you don't have a handy footstool or waste basket.do you have to wait til march for your colonoscopy? and yes it does seem that that's an awfully long time to have to wait until march to see this doc again and having to stay on the fiber regimen until then --is that how health care works in canada--you have to wait forever for dr visits and tests? that's so hard to do when you're having such continuous ongoing pain! i hope you can get back to see him sooner than that.and well i'm no expert but i do think that your idea about cleaning yourself out with an enema or maybe something like magnesium citrate first before starting the regimen he prescribed would be a good idea--get rid of any possibly impacted material in there and start fresh so to speak. good luck. i really feel for you. it's miserable..


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## IanRamsay (Nov 23, 2008)

Hi AshI must say that i agree with anne about the enema. get something in there to get it all out first and foremost to make your self feel better, give the toxins a chance to leave the body and the bloodstram, give the liver a brak for a few days and then start on the fiber treatment. do you still feel bad or have you had some relief yet?Cheers and keep the faithIan


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## Ashers86 (Dec 31, 2007)

Thanks for your support guys! {{{HUGS}}}I did pick up a suppository this morning that my pharmacist recommended - she too didn't like the idea that I was told to pack the fiber supplements into me while I'm backed up.. it's quite obvious that that's the severe pain I'm having. So I will try that and slack on the fiber for now...My colonoscopy is booked for Jan. 5, but he wants me to take fiber supplements, stool softeners and laxatives DAILY until March, which I don't see as safe! I just can't believe that!I am beginning to belief there's something else wrong at the bottom end of things... I had mentioned testing the muscles, and he said he would look during the colonoscopy....I'm feeling okay without the Metamucil capsule, and will stop the laxative for now since I've got a few in me somewhere and it's obviously not doing anything... But I'm so physically exhausted...


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## annie7 (Aug 16, 2002)

hey Ashersthat was smart asking the pharmacist. hope the suppository helps. and yes it is exhausting and especially difficult going through all this with the holidays coming up and everything. hope you feel better soon.


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## Ashers86 (Dec 31, 2007)

Hello all again,I tried taking a Glycerin suppository last night... released some liquid with some stool in it, but not much!*sigh* Oh well... I'm going to stop with the pills until after the clean out from the colonscopy, since it seems that that's the only hope left for me... (gees, now I wonder if even that will work).I had mentioned quite a bit about these issues in the IBD board - posted there about the possibility that I don't even know if I have IBD because no scopes have been done.I know my diet will most likely need to be changed... I'm just so frustrated right now because I AM trying but nothing seems to make much difference.Someone actually asked me a good question on the weekend when I was asking for opinions on whether or not I should have been advised to clean out before going on all those pills; does my GI understand HOW constipated I am? I really don't know.... I don't doubt there's something else wrong down there, even if I do just have IBS.Oh, I'm just at my wit's end and it's hard when everyone around me doesn't know what to say or how to mentally support me. Luckily, I have an appt. this afternoon, and will inquire on the change of meds, and am thinking about asking for a minor sedative for the plane ride early Thursday morning...Thanks for listening!


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## annie7 (Aug 16, 2002)

Hi Asherssorry the suppository didn't help. glycerin supps help empty the rectum so if there's stool in there they can help get it out but i don't think they help much with stool that's higher up. an enema or mag citrate would definitely help with that and usually a laxative like senna or dulcolax should also clear some of that higher-up stool out. frequently i get a crampy full feeling in my colon--left side--even when i'm not constipated--i think it's spasms and/or trapped gas. when i can i use a microwaveable heating pad for that--it often helps to lie down with it, try to relax and breathe deeply, and massage the sore area with the pad. and sometimes that helps but not always..good luck with your appt today. is it with the gi doc? hopefully he can do something that will help you--you've been in misery for such a long time. yeah maybe a change or tweak in meds will help. some of the ad's do have constipation as a side effect. seems like they affect different people in different ways. good luck!


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## Ashers86 (Dec 31, 2007)

Hi annie!Just got back... appt. with my psychiatrist.


annie7 said:


> glycerin supps help empty the rectum so if there's stool in there they can help get it out but i don't think they help much with stool that's higher up.


Just wondering... could that indicate something then? I stood and clenched for at least 15 mins - the minimum recommended amount of time... and even had to push all the water out... didn't feel any urge besides that from the suppository itself Thing is, I also took a nice relaxing bath before inserting it... so my body was exactly tensed at the time. So, it must have just not worked, huh?I know what you mean by the left side pain - that's usually where it's the worst for me too. I do have a plug in heating pad that I use, which I probably couldn't live without right now...I will be packing that in my suitcase for my trip! (YAY, Florida Thursday! My first time out of the country too







)On another note, I went to my shrink with the intention of discussing possibly switching meds and asking about something to use for the plane ride. It must've been my mood today - I let it all pour out of my mouth, and she agreed to tapering off the Effexor, and trying Prozac instead.Weirdest part was, she ended up telling me she was going to put me on valium before I even got to ask for it! Woah...But it was weird today... must have been because I told her I was nervous about the vacation (which IS stupid, right?!) because of IBS, and she drilled me with questions on what I do to leave the house, etc..... Apparently anxiety is my problem - meanwhile we were going on treating depression, but now it seems to be a lesser issue. And apparently I have social anxiety - meh, I can see it...So maybe these switch in meds will help!


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## annie7 (Aug 16, 2002)

well i was just thinking that not much came out when you used the suppository maybe because there wasn't anything in the rectum for it to push out...that all the stool was higher up...anyway, hope the switch in meds helps and good luck with the trip! i get nervous about taking trips too--any overnight stays---because of my ibs. staying overnight anywhere always makes my constipation worse unless i have my own room and own bathroom---as in a motel stay--now those are fine. but having to share bathrooms in someone's house and the lack of privacy that goes with that always stops me up...and switching time zones can also play havoc with c-- as well as sleep.


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## Ashers86 (Dec 31, 2007)

annie7 said:


> well i was just thinking that not much came out when you used the suppository maybe because there wasn't anything in the rectum for it to push out...that all the stool was higher up...


Yes... I'm not freaking, but maybe something to note to the GI? I really don't know why it didn't work as I seemed to literally be spewing quite a bit of water every time I pushed...I think the trip itself will be fine - our bedroom has it's own bathroom! I couldn't be happier! And his parents told me we're not expected to be doing anything so if we lounge in the bedroom, so be it. I think I will bring some bubble bath...







For myself though haha!It really is just the flight out that's bothering me because of showing up 3 hours beforehand... check in closing an hour before flight time... etc., plus I would have just woken up at 4am... GR - I anticipate feeling bad just because mornings cannot be rushed for me.I don't necessarily have the problem where my colon seems to be most active in the morning... but I have to get up slowly and give myself a couple hours to get into the groove, so to speak... or else I'll just be achy!


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## annie7 (Aug 16, 2002)

oh sure i'd mention it to the gi but i don't really think it's anything to worry about--i've had them not work for me before. usually they do but sometimes they don't--sometimes they don't come out all--not really sure why, just happens..that's great about your own bath...and hey--bubble bath sounds fun...no i can't be rushed either in the morning. need to give myself a couple hours or so to relax after coffee, breakfast in order to get everything out...wish it would all come out easily and efficiently at once but that doesn't happen...gotta take time.


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