# Kicking my senna dependency.



## Maegwin

Hi, I'm new here. I've had IBS-C since I was 10 years old, except I didn't know it was IBS until my early twenties. Either there was little to no treatment available 15-20 years ago or my parents just never knew what to do with me. From the age of 10 to 16 I suffered from chronic constipation. I was lucky if I had a bowl movement four times a month. They were excruciatingly painful and I was in the bathroom for two to three hours. I would hold it at school or I would get in trouble for missing class. Needless to say I was not a popular kid, I wore baggy, loose clothes, lacked energy in sports, and prefered reading or drawing to public interaction. I went through a year of anorexia just to get some relief, then I discovered a senna herbal tea.

At first I took it every three days when the bloating and constipation would get bad. Then I started taking senna tea every day. It wasn't perfect but I was at least having bowel movements two to three times a week. A huge improvement. I carried on like that for the next 14 years. Because the senna wasn't completely reliable I would starve myself before any major event for which I wanted to dress up nicely or be energetic for. I know, sounds wierd right? I didn't eat so I would have energy, but that's how I worked. Usually three to four days without eating got my bowel flushed out. Eventually I got off the tea and switched to exlax pills, three per day, more if my symptoms were really bad.

In the past three years I've learned more about IBS than in my entire life. I've learned which foods are bad for me, how much water to drink, probiotics, magnesium, and have increased the amount of exercise I do. However, only in the past five years have doctors warned me that senna is addictive, but I figured, what the hell, my bowels didn't work before I started taking senna, at least they're working now. So I kept taking it. When I reached 30 a doctor warned me that having a senna dependency could really cause problems when I'm older.

So here I am today. I've cut wheat, dairy, starches, fatty meats, eggs, beans, and processed foods from my diet. Mostly I eat salads, some fruit, soy products, chicken, and vegan protein shakes. Yet I still had to starve myself for events (one to two days instead of three to four) and I would still get terribly constipated sometimes, no more than three to four days but still painfully bloated and incapacitated. So just this week after another bought of days in which the senna wasn't working at all, I decided to quit taking exlax altogether and kick my senna dependency. It just didn't seem to be working anymore.

So if you're still reading this here's my question: How do you get an incredibly sluggish bowel to work naturally again? I'm seven days in, I've barley eaten because I'm horribly constipated, and I feel like I'm going right back to square one when I was 10 years old. Granted, I'm eating better, I drink lots of water, and I exercise a lot more, but none of that seems to be helping. I am taking: a stool softener, probiotics, magnesium powder, and eating/drinking prunes. I occassionaly take tylenol for the constipation headaches I get. I'm staying off coffee as well because it's dehydrating and I realy want my bowels to learn to work without stimulus.

I appreciate any tips you can give me. Thank you.


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## annie7

do you have a gastro doc? have you had any recent tests? it may be that you have slow transit constipation rather than ibs-c and the treatment protocol is different for that.

i've have chronic constipation since childhood. in the early 70's (yes i'm old--lol) i went to a doc who told me i had ibs-c--they called it spastic colon back then-- without any tests except a flex sig.

things got worse and worse and finally i started seeing a gastro. i had a sitz marker test--it measures colonic transit--which revealed i have slow transit constipation--not ibs-c as previously dx'd years ago. the gastro also had me take a defogram which showed a rectocele and a vaginal prolapse--more complications.

a defogram is a good test to have---both of them are, actually. the defogram shows if you have pelvic floor problems (muscles not relaxing properly to allow a complete bm) and as well as other problems such as a rectocele, rectal prolapse, enterocele etc. if the defogram indicates pfd, an anal manometry is used to confirm this dx.

i really recommend you get some testing to help get to the bottom of this. and then your doc can work with you to develop a treatment protocol.

good luck. wishing you all the best.


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## Maegwin

Thank you Annie. You've given me a battery of questions to ask my doctor next time. I'm in the process of getting a recommendation to a gastro doc. In Canada we have to go through a bunch of tests and at-home treatments before we can get on the waiting list for a gastro doc. I've just had my bloodtests to rule out crohn's disease, hypothyroid, hyperthyroid, etc... I've had these tests before and I know I don't have any of these things but since I've just switched Doctors I have to go through them all again. In the mean time I'm also doing some at-home treatments with glycerine suppositories, stool softener, and metamucil. I've also tried taking metamucil before but have found it just makes my symptoms worse. This time I tried it in pill form but it still caused painful bloating and ceased all BM even though I drink 10-12 cups of water a day. The glycerine suppositories didn't work at all. They just caused some mild burning and nothing came out except the suppository. The stool softener seemed to help a bit but I'm now three days constipated from the metamucil (which I've stopped taking) so it's not that effective at the moment. Once I pass those damn silicum husks I might have some improvement.

I don't think I have any kind of vaginal prolapse. I did some reading about it and I have not had children, any surgeries, or have ever been obese. On the other hand I'm curious about a rectal prolapse because I can feel where the blockage happens in my bowel and it's the same place every time. The end of the Transverse Colon right around the Splenic Flexure. Once the waste moves past that point I usually have a BM within a day.

So ya, just waiting to get on the waiting list of a gastro doc. Unfortunately it can take six months to see one. So I'm trying to find any alternative means of getting my sluggish bowels working without using stimulant laxatives. I really want to kick my senna addiction. With your slow transit constipation do you have any over-the-counter recommendations that could help get me moving again? I will try anything! I'm getting desperate.


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## annie7

sorry you have to wait so long to see a gastro.

i was very surprised to find out that i have a vaginal prolapse. i'm not obese either--quite thin actually except for the big belly bloat(full of backed up stool) and i was never able to have kids so childbirth wasn't a cause.

oh yes that's exactly where i have my problems--the transverse colon and the splenic flexure. i've tried to explain this to my gastro and also his PA but neither of them had any new ideas for me. and yes--once i can get stool past that area i can get it out.

and yes, fiber makes me worse too. my bowels are sluggish and fiber just bungs them up more--not recommended for people with slow transit constipation.

over the years i've tried so many many otc things, herbal things, probiotics, enemas, diets, lots of exercise, yoga etc etc---scripts like zelnorm, miralax and amitiza..well the list goes on and on. because nothing else works, the gastro now has me on both an osmotic--milk of magnesia (miralax doesn nothing for me) and dulcolax--a stimulant--and even all that doesn't always work any more. after i failed the sitz marker test the gastro told me to "take what i need to go". i had been taking exlax but that quit on me.

have you tried restoran (prucalopride) it's a new med that has been approved in parts of europe (under the name of resolor) and also canada (restoran). you'll need a doctor's script for it. it's a prokinetic and has helped a lot of people. if you have a regular doctor, maybe he/she could prescribe it for you so you don't have to wait for the gastro.

good luck..


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## Maegwin

Thanks again Annie. Interesting about you having the vaginal prolapse but having gone through none of the usual causes of it. Has your doctor or gastro fixed that now or is it ongoing? Come to think of it, we both may never of had kids but if you've ever been as constipated as I have (and your symptoms sound very similar to mine) then you know that some of those BMs are like having kids due to the amount of pushing and straining that goes on. At least that's what I've experienced. Perhaps severe constipation is also a cause of it. I'll definitely still check it out.

It's great to finally talk to someone who's gone through what I have and who has similar sypmtoms to mine. However, I'll be honest, it's a bit depressing on one level as well that, even with your gastro and doctor actively helping you, you still suffer from the symptoms without a cure seemingly in sight. What do you do to not go crazy? I find myself panicking when I think there's six more months of this before I might get help, and even then there's no guarantee. It's depressing.

I'm glad to hear that I'm not the only one who thinks fibre is bad for this brand of constipation. So many doctors and dietitians recommend eating more fibre for constipation but anything that absorbs water in my bowel is catastrophic for me.

I'm taking a magnesium powder in water, how do you find the milk of magnesia? Is it more potent? Have you tried oil of magnesium? I have actually tried the resotran (prucalopride). It gave me severe diarrhea and completey vacated the water from my bowels without removing the solids. This was when I was only mildly constipated. I tried it again when I was more severely constipated and it didn't work at all.

A few doctors have told me the cause of my symptoms is all in my head and I need to reduce the stress in my life. I am living a very stress free life at the moment aside from the stress I get from my bowels not working. If you don't mind my asking, have you ever seen a psychiatrist or psycologist in regards to dealing or coping with your symptoms? If so, did it help at all? I feel lately that I can barely cope with the daily pain and discomfort, the frequent starving and limited diet, and the lack of a social life because I'm just too tired and headachey to go out. What do you do?

Please forgive my continuous replies. I've never talked to anyone about this syuff before who knows what it feels like to go through it. You're like a breath of fresh air. Thank you for all of your feedback.


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## annie7

Hi Maegwin--oh thanks you for your kind words and also for the replies. yes it is good to be able to talk to people about this. before i found this board (about 12 years ago) i thought i was the only person who had this problem--and also that my constipation was all my fault--which is what my regular doc and family said--they said it was all in my head, that i wasn't eating enough fiber (what a joke) etc etc.. i actually cried when i read other people's posts and realized i wasn't alone.

i'm really sorry you have to wait so long to see the gastro!! that makes coping with it all so much harder. it's good to be able to get moving with tests and things. i wait two months to see my gastro but at least now since i'm an established patient i can call the office in the meantime and even get an appointment wiht his physician's assistant if i have to.

about the prolapse. the university doc who read my defogram did not think that either the vaginal prolapse nor the rectocele needed surgery which is good because i really don't want anything to do with those type of surgeries that use that very troublesome mesh.

and yes you're right--maybe the prolaspe is due to straining although i don't strain anymore. i learned years ago that straining just locks the pelvic muscles up and is counter productive--for me, at least. i do find using a footstool helps a lot. i put my feet up on it while using the toilet. elevating the feet like this helps straighten out the anorectal angle and allows for a more complete evacuation. it doesn't sound like you have problems with getting stool out once it's in the rectum but if you do, this website is helpful. also biofeedback and pelvic floor training as taught by a qualified physical therapist can help with pfd problems.

http://www.constipationadvice.co.uk/achieving_inner_health/practical_tips.php

please please don't starve yourself or limit your diet too severely. i know it's so very hard to eat when you feel bloated and backed up. i basically just force myself to eat. i've done it for years--lost my appetite permanently when i was a child and all this got so bad. it is very important to stay nourished--i can't stress this enough. without proper nutrition, you can't keep your energy levels up to help you cope with all this. i eat well cooked vegetables, soups, easy to digest meats, some fruit, yogurt, milk. i also find eating some fat-the healthy fats- helps a lot. many people say taking a tbl of olive oil is good. i used to do that til my reflux got bad. fat does help stimulate the gastrocolic reflex and encourages a bm. fat is especially effective in the morning with breakfast if that is the best time for you to go. it might be helpful to supplement your diet with a nutritional drink like ensure etc or instant breakfast. but please stay nourished!

as far as coping--well, i've had a lot of years (50) to help figure this out. it does get easier with time. for me, meditation helps--i started doing that in the early 70's. for me, it releases stress, relaxes me and has helped me learn to let go of disturbing thoughts. the IBS audio 100 program has helped a lot of people cope with the discomfort and pain. here the link to the forum for that. many people say cbt helps. i use a lot of those principles also.

http://www.ibsgroup.org/forums/forum/9-cognitive-behavioral-therapy-and-hypnotherapy/

also--i just take everything day by day and try not to worry about the future. just one step at a time. i try to stay in the moment. i work hard at staying positive--not easy i know but it does get easier with time. and i try to stay busy--doing things helps keep my mind off the pain and the misery and gives me the all important feeling that this disease isn't sucking my life away and that i can still accomplish things. and that keeps me from getting depressed about it.

i know some antidepressants can help with constipation because they have diarrhea as a side effect--citralopram (not sure i spelled that right) is one of them. i did try that but it didn't help and made my insomnia worse. but we are all so different in how we react to meds so don't let my experience discourage you if you should decide you want to try meds like that.

so sorry prucalopride didn't help--how frustrating!

milk of magnesia works better for me than the powdered stuff but like i said--we're all so different in how we react to things. some people say their docs have told them it's safe to drink a half bottle of mag citrate a day. mag cit alone doesn't help me though--i need a stimulant to help kick it all out. otherwise it just sits in my transverse colon and sloshes around--like all osmotics. some people say oxy powder helps. others use varying does of miralax. my doc told me i could take up to three doses in the am and three in the pm of either miralax or milk of mag but all that did was just sit there in my colon and make me miserable. but again--your mileage may vary..
one thing--if you do take a lot of milk of mag or high amounts of other magnesium products, it's a good idea to get your magnesium levels checked regularly.

i've got to stop now for the time being..sorry this has gotten so long.

please do take care of yourself. and feel free to pm me if you like..annie


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## annie7

oh--just remembered--you asked about magnesium oil. i did try that a while ago when someone here on the board first suggested it. it didn't help promote a bm--but that's me--it's worth a try--you might have better luck with it.

one thing that does help relax colon spasms and release gas for me is a heating pad--which is used along with the magnesium oil but i just use the heating pad by itself--i have for years. i lie on my back, knees up, with a microwaveable heating pad on my belly, breathe slowly and deeply, try to relax my mind and let go of all thoughts of pain and discomfort and massage my belly through the heating pad. i focus on the part of my colon that hurts the most--where i feel the spasm is and where the gas is trapped--for me this is usually the upper left side of the colon, the splenic flexure area. often i can actually feel something release in there and then the gas comes out. i love my heating pad. even when it doesn't help with the bloat it is still relaxing.

or you can do a colon massage with your fingers by massaging the colon starting on the lower right hand side and slowly moving, massaging your finger tips (in a circular fashion) up the colon, over, across and down the left side.some say this type of massage helps promote a bm.


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## oceannir

I find Annie has covered the issue very well here and I don't really have much to add when it comes to actual medical advice. But I can relate very well to both of you in the fact that there is a culture of patient blame from doctors surrounding this issue. It seems they try one thing, if it doesn't work than they blame the patient.

Its really disgraceful that doctors put next to no thought into helping us. I find the biggest reason I avoid doctors now is simply because they don't believe how bad it is. Family is kind of the same, they tend to just listen to what the doctors say and parrot it "Oh its a bit of stress, its in your head" etc etc.

Im not sure if there have always been people with these issues or if its a modern diet problem but regardless hopefully in coming years there will be treatments that actually work.


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## Maegwin

Thanks Annie. My heating pad is my best friend. I usually give myself a few hours every morning to just sit with it, drink a warm beverage, and relax as I read or surf the internet. I too discovered that straining doesn't help. I find the more relaxed I can be the better my body works. However I sometimes have days in which I cannot get those muscles to relax. Not even when I'm sleeping. Do you ever get that? Your muscles just tense up so badly that your hips, back, and head hurt? Sometimes I get light headed because my diaphram gets so tense I can't take full breaths. I've had my muscles stay like that for days until I finally get so exhausted they relax on their own. It's like driving with the emergency break on.









I've tried explaining these muscle "seizures" to doctors but they quickly correct me on calling them siezures and only suggest tylenol for the headaches, hot baths, and a massage therapist. Sometimes I wish I could just soak in a vat of hospital grade muscle relaxant.









After I finally passed that blasted metamucil (almost a week later) I found that the magnesium powder works quite well. I had to cut back a bit as it was causing me diarrhea. I'm new to it so I'll have to wait and see how it does over the long term. My body has a tendancy to get used to these drugs, as it had started doing with the exlax. But I'll keep the MoM in mind as a fallback for dire times.

Thanks again for all of your feedback. Take care Annie.


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## Maegwin

I agree Oceannir. I have a huge chip on my shoulder when dealing with doctors. That's why I get my boyfriend to come in with me now. He does the talking so I don't get emotional. But yes, I too have had many years of doctors telling me it's all in my head and to just cope with it.

Even my family and friends say I'm too self concious about my stomach and am hyper sensitive to what's passing through me. They don't understand that it doesn't make you hyper sensitive to feel the equivalent of a balloon or brick passing through your bowel. They say everyone's stomach expands after they eat but where theirs might only expand a centimetre or two mine bloats out to 2 inches or more. I know, I've measured it. As a result I tend to buy pants two sizes bigger for that extra bloat room.

All that said, since I first started seeing doctors about my IBS to now, more treatments and medicines have come to light. There are even spcialized nutritionists and gastros for IBS patients. I really hope the awareness and treatments continue to grow and develope. It sure helps knowing there are others out there with my symptoms. For a long time I felt like I was the only one and that there was something wrong with because I was "letting" some constipation bother me so much.

It's good to know that it's not all in my head.


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## annie7

Hi Maegwin

when you refer to muscles not relaxing do you mean the pelvic floor muscles? or other muscles? i've read that sometimes sitting on a heating pad will help the pelvic floor muscles relax--also sitting in a warm bath.

i get a lot of pain in my neck and back muscles. sometimes i think it's due to tension--i tend to "carry" it there sometimes. i also have arthritis there and chronic back problems as well as mitochondrial disease, chronic pain so i think all those things make the muscles ache too---too much going on--lol . oh i do so with i could afford a massage therapist---or better yet--a live-in massage therapist! well, a girl can have her dreams--lol...

glad to hear the magnesium powder is working for you--that's wonderful!! and fingers crossed this will continue!

and oh yes--i have the painful mega bloat going on constantly and the pants-two-sizes-too-large (with a drawstring waist) to help cope with that. sometimes even wearing the pants is uncomfortable and then i turn to dresses. lately it's been dresses every day.

take care..


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## wigglesmom

This tea has been a lifesaver for me. I take it every other day (every day causes it to be less effective). Out of everything I've tried (I've tried so many things!), this has always proven effective. http://www.posharpstore.com/en-us/us-brand-ultra-slim-tea-extra-strength-20-teabags-p1618.aspx

It doesn't seem to be available at the link I posted above, but ook online for this exact one. Also, Asian stores typically carry it.
I have also found that 2T of ground flax daily does help me.


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## Maegwin

Well, it was almost a three week adventure of trying to kick my senna dependency. The first two weeks were alright-ish, I steadily got more and more constipated except for one, mid-way, three day period, in which I starved myself until the magnesium kicked about half of the blockage out of me. However, as soon as I started eating again the constipation returned. I was able to do my cross-training during the two weeks but the exercise didn't help anything move, it was more like a trash compactor. My belly was less distended afterward but bloated out again the moment I ate. The magnesium and PEG gradually stopped working after 14 days and before that, combined, they only moved about a quarter of what I ate the day before or sometimes nothing at all. The following four days were miserable. I was so backed up I couldn't exercise anymore, I constantly needed to lie down because my gut hurt so much, and when I ate I felt nauseous. On the last day I couldn't even drink water without getting painful acid reflux so I went to the Emergency. It had been a week since my last bowel movement by that point.

I monitored my weight the entire time, just out of curiosity, and over a two week period I gained five pounds, which may not seem like much, but it is when I'm doing cross training daily and only eating a salad and a protein shake each day, with the odd cracker thrown in. I was not eating bread, dairy, sugar, or any fatty foods. I was really trying to keep a clean diet so that the magnesium and PEG could do their job with ease.

I had two enemas administered to me at the Emergency but the doctors said they probably wouldn't work since my blockage was up in the transverse colon. There are tons of drugs and treatments out there to get rid of blockages in the rectum and sigmoid colon, even up to the descending colon but no help for anything past the splenic flexure. They were right, I was squeaky clean below the SP but the major blockage hadn't budged. So the emergency doctors recommended I go back on senna again.

I was desperate, no one could help me, I couldn't eat, drink, or get any work done. So that night I took senna again. The next day everything cleared out, and when I weighed myself I'd dropped five pounds in five minutes. It wasn't fat, it was everything I'd eaten in the past two and a half weeks that hadn't passed.

It's been four days and I'm still taking senna. I'm back to doing my dance and cross training again, I can wear nice, form-fitted clothes, I'm eating the food I need, and drinking lots of water. I haven't been this happy since, well, two and a half weeks ago. My conviction towards getting off of senna has greatly depleted. I know it's bad for me in the long run and when I'm a senior I'll have problems but I want to live now, not when I'm 65. When I was in line at the emergency I had an extremely edifying moment. A patient ahead of me checked in with severe constipation as well, he looked to be in his 80's. Why should I be reduced to the functionality of an 80 year old just so when I'm actually 80, my symptoms might be marginally better? I want to live now, while I'm young, not live the next 50 years with the appetite and mobility of a senior citizen.

So I think I'll stay on senna for awhile longer until either, a ) in a few months, the gastro has anything new to contribute, or b ) a wonderful new drug comes out that targets the transverse colon, is non-addictive, and doesn't give me IBS-D instead.

So ends my kicking senna adventure and may I never go through that misery again. *knocks on wood*


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## annie7

Maegwin--glad you're finally feeling better after enduring so much misery for such a long time.

i agree--sounds like it's a good idea to follow the ER doc's advice and go back on the senna.

some of us need stimulants because we have colonic inertia and our colons simply don't respond to anything else. after i failed the sitz marker my gastro told me to "take what i need to go." so for me--since nothing else works--it's a combo of stimulant laxatives (dulcolax) and milk of mag. and my gastro approves this.

i do hope you continue to feel well and also that you can get in to see your new gastro soon and get the tests you need..

and yes! fingers crossed you may never ever have to go through this misery again!!! it's truly wretched. take care.


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## annie7

Nicole--so glad your regimen of the tea and the flax seeds is working for you!


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## wigglesmom

Hi Annie-I wouldn't say it's working, it's just the best remedy I've found. I still struggle a ton. I guess "works" is a relative term for me.


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## wigglesmom

I was recently presribed a Chinese medicine formula called Go Litely. It has cascara sagrada in it, which I believe is like senna in terms of resulting in dependency. I am afraid to continue taking it.
Maegwin, I really feel for you. It seems that we experience similar symptoms and frustrations. I am 38 and am very active. I too worry what will happen when I am a senior and am unable to manage this as I do now.
Here is a link to a google docs spreadsheet I made of everything I take/do daily to help manage my symptoms. The tea i refer to is the Chinese tea I posted a link to above.
https://docs.google.com/spreadsheet/ccc?key=0AgGIOCfEadG3dGZGalpveDZkak40ODRMWHlZQ3dlVHc


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## annie7

Nicole--i hear you--even with my current regimen, i struggle too.

i just try and stay positive about it, try to look on the bright side. the way i see it, anything (or combination of things) that helps--even if it doesn't work completely--is better than nothing at all .


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## RegularGuy

Please read my post, "I HAD IBD-C; Now I don't. This worked for me." It's close to the bottom of page 2 now. You may just have weak stomach acid that can't digest your food well enough before it goes into your intestines. That's what causes the lower abdominal pain 30 - 45 minutes after eating. The solution is to supplement your stomach acid when you eat with the right kinds of acid. If you're taking calcium and/or magnesium supplements, stop temporarily while you try this. Ca/Mg neutralize acid. After 7 years of severe, chronic constipation, this worked for me from day one.

R.G.


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## oceannir

Meagwin, im sorry to hear about the adventure of kicking the drugs not working

I think we've all seen similar effects when we try and do the same. You think its working but after a week it just gets less and less effective.

May I ask, how old are you and how long have you been using Senna? Are you noticing a reduction in effectiveness?


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## Maegwin

Hi Oceanir. Have you tried kicking these kind of drugs in the past as well?

I am 30 years old and I've had IBC-C since I was 10. I didn't start taking senna until I was 16. I started off with a herbal tea that had other ingredients as well as senna. I took that every three days or whenever my symptoms got really bad. When I was 20 I switched to a pure senna tea, which I took once a day before bed. This still wasn't always effective, and sometimes it was too stimulating, causing my muscles to cramp badly and further constipate me. When I was 26 I switched to exlax pills for convenience and a milder dossage. They took a few weeks for my body to adjust to. I took three per day for 4 years. They never did work perfectly. I would still have weeks in which I was constantly constipated but they at least moved some of the blockage each day, so it rarely built up into acid reflux.

In this last year I completely overhauled my diet and started eliminating foods that made my symptoms worse. This helped a lot. With the diet change and the exlax my bowels worked nearly everyday. I almost felt normal and started exercising and racing again. However, my doctors were always warning me against the dependency issues and health problems down the road that taking exlax can cause. In the past few months I noticed the exlax not working as well anymore. Some days it wouldn't kick at all and I had to take four or five pills at once to get results.

I decided to try to get off of senna and, as you read above, it didn't go so well. On the plus side I eliminated magnesium and PEG as alternatives, found out that Resotran gives me IBS-D instead of IBS-C, and that the symptoms I had as a child still exist despite my diet changes. So I learned what doesn't work. Also, being off of senna for two weeks allowed my body to lower it's tollerance of it, and now it's effectivene again. I've also started taking something called LBT-3. It's a herbal tonic in pill form that's supposed to naturally stimulate the bowel muscles without the side-effects of senna. It's a Lower Bowel Tonic put out by a company called Wild Rose.

My bowels have been working great for the last few days. I don't know if it's the fresh re-start of senna or the LBT-3. I'm just happy I'm working again. In the future, until a new, promising, drug alternative comes out, I'll continue taking senna and if I find it's effectiveness wearing off I'll go on a two week cleanse.


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## CarolyneJane

Hi sweetie. Your story sounded so familiar and heartwrenching I felt I had to respond. These issues are so familiar. I too have overdepended on senna, although these days it's more when I decide to eat something I know is going to trigger my constipation-type IBS. I've found that when I stick to the diet that works for me, I am symptom free- and have been for around 4 years. I wanted to comment on this part of your story, where you showed you'd done some considerable work trying to identify the culprits that trigger your IBS:

"So here I am today. I've cut wheat, dairy, starches, fatty meats, eggs, beans, and processed foods from my diet. Mostly I eat salads, some fruit, soy products, chicken, and vegan protein shakes. Yet I still had to starve myself for events (one to two days instead of three to four) and I would still get terribly constipated sometimes, no more than three to four days but still painfully bloated and incapacitated."

You know, I too cut many foods out of my diet over a period of 25 years. All the ones you mentioned, wheat, dairy, fatty meats, eggs, beans, etc are triggers for me too. But I have to say that for me, I also have symptoms when I eat soy. Soy causes some of my worst constipation symptoms. And vegan protein can have soy in it. Soy is a highly inflammatory food and causes auto-immune responses in many people. Perhaps if you stopped eating soy and vegan protein (which is processed and can have free glutamate which some people react to), you would notice an improvement in your symptoms. I also went completely vegan, and that helped me tremendously with my constipation. Chicken has no water and no fiber in it- all meat is constipating, I have found. I was on the 80-10-10 (raw vegan) diet for a couple years, and this helped alleviate my symptoms tremendously, but then I found that things like raw broccoli and other raw non-tender vegetables and raw cruciferous vegetables and raw zucchini cause bloating and constipation issues for me. When I eat broccoli and cabbage, etc now, I eat them steamed till it's literally falling apart soft (so I'm no longer following a completely raw diet but have a high percentage raw diet.) They don't give me IBS when steamed like this and eaten once in a while, but I still prefer to eat veggies like cucumbers and lettuce and spinach raw instead. Instead of starches, I get most of my carbohydrates from fruit, and I don't worry about protein at all. It is a huge myth that we need so much protein, one created by the marketing industry to sell animal products. In reality, the WHO says we need only around 5% of our caloric needs from protein, because our body recycles its own protein every day and the replacement rate of protein we need is low. There are no cases of protein deficiency on their own in the medical literature as people only get protein deficiency when they are starving and aren't eating enough calories overall. Since all plants have protein, amino acids, you can't get too little protein unless you aren't eating a large enough quantity of food. It was erroneously trying to get enough protein that sent me toward foods that caused me many IBS constipation flareups, as even when I gave up meat, I was advised to eat soy (which like other beans, is a legume) because of its high-protein content, and it was only when I gave that (even the fermented tempeh) up that my symptoms improved. Now my protein comes from whole plant sources, like spinach and other greens, hemp seeds, and fruit. You'd be surprised but whole plant foods have a complete nutritional profile, so you don't have to take supplements. Just remember that under-ripe fruit can also be constipating. For example, bananas should have tiny brown spots on them when they are ready to eat as that is when the starch has been fully converted to sugar. If you eat them without the spots as most people do, you can have digestive issues because then it's like eating a starchy food when they are under-ripe. I know it all sounds complicated, but trust me that after 25 years of trial and error, you pay attention to these kinds of details! When I follow them myself, I have 1-3 bowel movements per day without any need for senna at all. The problem is, even after 25 years I sometimes cheat on my own rules and have to resort to senna again. Nobody's perfect.


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## Maegwin

Hello CarolyneJane,

You are absolutely right. Soy was also a huge factor in my constipation. I have since stopped having it and I've also stopped the protein shakes. I now make my own almond milk and I purchased a juicer to make veggie juices for myself that will give me the nutrients I need without that bloating fibre.

I have changed my diet to more veggie based foods. I too, cook some of them, but most are eaten raw. I still enjoy meat proteins from time to time, but yes, I have cut back on them and I keep the portions very small when I do have them. I do stay away from most fruits, they bloat me horribly, but berries and tomatoes are okay.

I am still on the senna, and I still can't eat solids for more than four days in a row without my symptoms becoming unbearable. I try to keep my solid food days to 2 or 3, then fast for a day or two on liquids until I get enough relief to eat again.

Unfortunately, those LBT-3 pills I had been taking went out of production for two years. They are back now, but their formula has changed. They are more harsh than senna now. So I stick to exlax and sennakot.

Another thing that has been helping a lot is doing stretches that target my psoas muscle (also referred to as the muscle of the soul). I've always had a lot of muscle tension, pain, and limited flexibility in my hips. For some people with trauma or PTSD from their past, the psoas muscle can become over engaged and effect the operation of the bowel muscles. Since doing these stretches my range of motion has greatly increased, my pain has diminished, my anxiety dissappears, and my body works a lot more efficiently. If I have to become and maintain the flexibility of a gynmast, so be it, if it means no pain and eating more regularily.


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