# My doc and my specialist say laxatives are fine:



## amg (Mar 29, 2009)

I was diagnosed with IBS-C a little over a year ago, after months and months of having problems. You all know the story. I had never had problems before, had never used a single laxative in my life, and one day my whole system just shut down. I just could not go. I had horrilbe pain. I already eat plenty of fiber and get lots of exercise, but even increasing those factors did nothing. After normal ultrasounds and blood tests and x-rays and the horror that is a barium enema, I got the diagnosis of IBS, and was told to use over the counter laxatives as needed to manage the condition so that I am comfortable and happy. My Internist says in my case, using senna and bisacodyl laxatives are not going to hurt me. When I started to argue with him (after all, everything on the internet talks about how horrible these things are), he pointed two things out:a) my colon is already not working. I does not move things on its own, period. I can't really damage it further by using laxatives. and the goal is to manage the problem in a way that minimizes interference with my life. In my case, he feels that the benefits of being pain free and not severely bloated out weight any risks. He also said I sure wouldn't be the only person using these regularly.The GI I saw said exactly the same thing. Is there anyone else who has had this experience? Anyone using senna long term?Please, no arguments needed. I have already read all the posts about laxatives damaging you. I am looking for the other side of this story.


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## annie7 (Aug 16, 2002)

Hi amg oh yes, i'm in the same boat as you on this one. i've had ibs-c for over forty years and right, for the first thirty seven years tried everything except laxatives, nothing worked, was miserable most of the time and then i started reading articles from reputable sources like the one link posted below--and this one is on medscape and used for gastro cme training--saying basically that ideas about laxatives have changed and they now are not considered to be as evil as previously believed. i've also read several other posts on this board from people who say just what you've said--that their drs prescribed regular laxative use--either senna or bisacodyl--on a daily basis since nothing else was working. in fact one of these docs was from the mayo clinic.so based on my reading and my misery and the fact that absolutely nothing else worked i started taking laxatives regularly three years ago. my body seems to build up a tolerance to meds rather quicky so i alternate them. i also take tegibs--generic zelnorm--in the rotation. i take tegibs on mon wed and fri and on the other days i rotate senna, bisacodyl and cascara sagrada. i've been doing this for a little over three years now. i still have some bad days--usually when there's a lot of stress also going on--but for the most part this is what works for me and it's a huge improvement over how i was feeling before i started this program.and yes i sure do know what you mean about all the arguments etc that say this is harmful but for me it's exactly like your dr said--my colon isn 't working anyway...and i am definitely much more comfortable with this regimen. and after suffering for so many years i finally decided this was the only way to go. it sounds like you have good doctors. so many docs are still clinging to outdated info re laxative use. your docs sound like they are really current on their info and believe in agressive treatment for ibs--and that's what it takes for some of us stubborn cases. good luck to you with this regimen! http://www.medscape.com/viewarticle/496828_print


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## amg (Mar 29, 2009)

Thank you so much for letting me know I wasn't crazy!


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## annie7 (Aug 16, 2002)

oh you're quite welcome and oh no you're not crazy--you're quite lucky to have such good doctors who are up to date on their info and who believe in treating ibs-c aggressively. so many drs are still stuck in fiber-water-exercise mode with maybe a little amitiza and miralax thrown in but that's it. and if you don't have success with these then they just shrug and tell you to live with it. boy have i been there...and by the way, welcome to the group!


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## Kathleen M. (Nov 16, 1999)

Most of the recent data shows that any fear over laxatives permanently damaging the colon and making it stop working on it's own is way overblown.Even in the extreme cases like with bulimics that purge with extreme doses it is hard to pull out an effect. It seems severe eating disorders even without laxative abuse tend to cause some long term constipation issues.Now some people's constipation would get worse on its own, and so that also makes it sometimes seem that modern stimulatory laxatives might cause some harm (as those that take it the most are those with the worst problems even before they started regular use), but it appears that these people would have likely had ever worsening constipation even if they had stuck with fiber and miralax. It is hard to know if the older ones that are now off the market really caused all the damage people feared they did. I would still say to try fiber and osmotic laxatives and milder things first because if they work that is great. But when they don't work there doesn't seem to be much reason for the fear that once the constipation has gotten severe that you are doing yourself any more damage.


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## Tiss (Aug 22, 2000)

That's good to know. I've order my old favorite Perdiem yellow to take every few days to take a break from zelnorm. I LOVE Zelnorm and it's always worked for me but it is so expensive. Maybe this way I can make it last longer. Don't know if the perdiem will work as well as it used to but it's worth a try. Those docs had me scared to death to use laxatives and i hardly ever used them!


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## alwayshappy (Mar 11, 2009)

yep, i'm in the same boat too!! i've been having severe constipation for 16 yrs now and have always tried to avoid laxatives. like all of you, i always knew that laxatives are no solution and can only make things worse. actually, when constipation issues start, it's very important to exhaust all options BEFORE "giving up" to laxatives, cause if it can be taken care of with suitable diet, enough fluids intake and exercise, then that sure IS better than turning to laxatives. unfortunately, non of the above helped me and things just continued to deteriorate more and more.. i got very miserable







so the drs said there are no more options for me and the only thing they can offer me is using laxatives on a daily basis, since nothing seem to have worked. drs do offer the use of laxatives, but only as a last resort. i started taking laxatives only a yr ago and they hardly worked even at the beginnig. so yes, when the going gets tough... unfortunately, even laxatives hardly work for me and i'm thinking of removing the colon all together. my drs are all for it (there was a 5 drs consultation over my case and they all agreed i should have surgery). it's scary, but i'm so miserable i just need relief.BUT!!! please don't let my story scare you, o.k, cause you see, in my case the laxatives hardly worked even at the beginning, so it's a much worse case, so you should know that this isn't the case with you guys, and as long as the laxatives help you, then good for you!!


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## Tiss (Aug 22, 2000)

alwayshappy, have you tried zelnorm?


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## alwayshappy (Mar 11, 2009)

Tis,no i haven't.. well, i live in Israel and i don't think we have it here. anyway, you know the nasty stuff drs give to drink before a colonoscopy..? that didn't help either. it only turned everything in my colon into water but NOTHING came out for over than 24 hrs. it just kenp sloshing back and forth, it was awful. did that ever happen to you? i'm asking as much ppl as i can cause i want to know if that's a proof for colonic inertia or it could also happen to others that are not diagnosed with CI. so has something like that happen to you?


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## baz22p (Dec 1, 2008)

Hi,In the early days of my IBS I had constipation pretty bad. My doctor prescribed Fybergel (bulking agent/laxative). After 5 days there was no effect, then on day 6, by back side exploded quite violently and repeatedly.....from the combined effects of all 6 days worth of the laxative. It changed me from IBS C to IBS D over that period. The effects for me was to change the symptoms of the problem - NOT to ease/rectify it.Baz


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## Sean (Feb 8, 1999)

I have come to grips with the fact that I will have to take something to make me "go" for the rest of my life. Both my primary care physician and gastroenterologist acknowledge that. The only alternative is surgical removal of most of the colon and I am not ready for that yet. Both of my doctors are of the belief that in a perfect world, people should not take laxatives regularly, especially stimulant laxatives. But when you have unrelenting colonic inertia and the chronic constipation that it causes, the laxatives are the lesser of two evils. I'm only 37, but I have been dealing with this since I was 16. I have to say that my life has been a lot better since I just accepted the fact that I have to take laxatives regularly to function. Saline laxatives do very little for me so I use a stimulant laxative twice a week to make my bowels move. I rarely if ever have any kind of spontaneous movement anymore. I find that my body does develop a tolerance for a particular laxative over time. The only one that still works almost every time is bisacodyl - the active ingredient in dulcolax. It can be a little uncomfortable at times, but it does give relief if taken in sufficient dosage. It works even better if also taken with citrate of magnesia. Sometimes, I take a laxative holiday if I think my body is building up a tolerance. Then I just substitute a one to two liter warm water enema for the laxatives for a couple of weeks. Of course, I tend to build up a tolerance to enemas, too. My quality of life is so much higher since I made the decision to be proactive in making sure that I have a bm at least twice a week.


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## bevybev (Mar 30, 2009)

Well I sure know how you feel How often do you take the senna?Perhaps I need to take them more than once a day, and that is at night.


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## amg (Mar 29, 2009)

I take appx.15 mgs of senna twice a day. The package says you can double that, But I've never had to. Some mornings I go on my own (painfully, but it happens) so I skip it that morning and resume at night. On really really bad days, I'll have to use a suppository laxative to get things "going." They are unpleasant, but very effective.


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## janetmtt (May 28, 2007)

My Dr, after trying a few things and having other side effects, was quite happy for me to take senna on a regular basis and said as it was all natural it was safe to take.So I take senokot regularly but like everyone else it does cease to work after a bit and then I stop it for a while and restart. For me - it's so much easier popping a pill as you know where you are and I tend not to have any reaction to senna. This last week I've tried Elifexir Flat Tummy that contains sorbitol and had side effects from that and then I tried Solgar Caricol and can honestly say last night I had a night from hell starting at 2 am - though I was dying, sweats, palpitations, pains, feeling sick and it only went when eventually I had to get up at 3 am for a BM - is it worth trying all this other stuff when it seems to give me bad reactions - never get that with senna.I just need to find something that works for me when senna stops but I always go back on it - at least I know where I am with it when I take it not like the other stuff.But again my Dr said the same that the dangers of what they thought were there with taking laxatives on a regular basis are not now.


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## sarah jane (Apr 1, 2009)

Hi Sean,[ you replied to janetmtt]I'm new to this forum, but have been making note of your messages, because I believe i also have full-on colonic inertia, vs IBS-C.I'm surprised you are able to tolerate only having a bm twice a week..if i don't have at least one a day i am physically miserable.so, like you, i am trying a rotating mix of laxatives..MOM is super helpful..a giant slug at night..besides several others that I use on other days..but i wanted to say to you that w/the inertia, i could be sloshing around with liquid stool from an oral laxative, and my colon still won't move..the only luck i've had is to then insert a suppository, which then stimulates me enough to evacuate.I either use a dulcolax suppository, or, [ my preferred] a capsule of 100%organic peppermint oil..i like to use this because it's natural and actually good for the body.the only place i trust to buy the oil is from YoungLiving.com..an essential oil company i have been dealing with for 25 years.hope this input helps.SJ


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## baz22p (Dec 1, 2008)

Hi,I have already put my views in this thread, but I though I would share with youmy latest experience on this subject. I've been in the usual pattern of things - mainly IBS C, only a few small BM's in the last 5/6 days.....output definately less than input (you know what I mean?). So I thought, seeing as this is making me miserable - as well as the constant discomfort - I'd take a laxative. So I took 2 Bisacodyl.Today I have been in the bathroom most of the time......actually had 7 BM's so far, and the consistancy has been very soft (sorry for the graphic description - nothing further I promise). What seemed a good idea at the time has made me suffer in the other extreme. I'll definately think twice before doing this again!Baz


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## Angcr27 (Apr 13, 2009)

You are definitely not crazy. My specialist told me the exact same thing. Prescribed senna and although i told him about the things I've read, and how it can be harmful for you, his answer was exactly the same you got. For me it's ten times easier to just take a pill than mixing powders (Took Miralax for a while, but it gave me nausea) in my drinks.


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## Mary5 (Apr 17, 2006)

After 5 years of tests and trying everything else, my gastro also told me to use senna and bisacodyl as needed. He said that if nothing else works, then it is OK to use laxatives and he assured me that if you have tried everything and nothing works then go ahead and use, and that the Mayo Clinic would tell me the same thing. I do try and use Miralax on some days, it depends. As you know by now for those of us who have serious IBS-C nothing works consistently over time so it is best to have several alternatives.


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## amg (Mar 29, 2009)

You know, I tried Miralax on two separate occasions and hated the way it made me feel. I know it's a miracle for some people, but not only did it not adress the constipation (which in turn made me feel horrible) but I got headaches and felt generally bad all over. One thing I have noticed that helps tremendously is adding more water. That same specialist told me I should be drinking at minimum 3 liters of water a day. I had no idea just how much water that was until I tried to drink it. It a lot, way more that I had been drinking. I feel much better when sticking to my 3 liters a day.


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