# Alternating laxitives, Advise?



## jfalcon (Jul 10, 2011)

Hello everyone,I suffer from pain, chronic constipation, incomplete evacuation, excessive wiping after BM's, (nasty and tired of it). I have tried many types of probiotics, they all fail. I have tried Senna/ducosate, my prescribed dosage is not powerful enough to have any results whatsoever. (Someone please give me advise on how many mg of senna is safe to take on a daily basis? Please). Magnesium Citrate, takes like 14 hours to kick in for me. This is scary, because on the label of the drink, it says it should produce a bowel movement in 30min to 3 hrs, but I feel nothing until like 12 to 14 hours later, and then the bowel movement is super nasty and all fluid. (and it takes like an hour to completely empty all the fluid that the mag citrate produces. Every morning when I wake up, I have to dedicate about an hour and half of my time to trying to evacuate my bowels. It seems that I always have little child like bowel movements and alot of excess wiping, which usually leads to alot of stomach pains throughout the day because I am so full of ####. Just like everyone else on this site, this is getting super old to me. I just recently got married and have a beautiful 8 mo old baby boy, and this stupid Chronic Constipation is depriving me from being able to enjoy the good things that I have going in my life.My Dr. just prescribed me with Amitiza. The first couple of days I started taking the meds, it was working fairly well for me. I felt like I was emptying my colon almost completely. The BM's were kinda like piles (the pudding type, not diariah and not a turd, kinda in between) Well I was satisfied with this for a couple of days, and my pain, and excessive wiping was gone. Well now, Im on like day 4 of taking my Amitiza and the pain is slowly coming back, and I am started to have trouble emptying my bowels again. Its like my body is not even responding to this presciption constipation medicine. Its becoming immune to it already, just like it is to almost every other type of laxative. This is misery. Can someone please give me some advise on Amitiza (should I stop taking it because it sucks, or should I be patient and give it more time?) Also, can someone give me advise on Psyllium Husk? I have better results from taking Psyllium Husk than I do Amitiza or laxitives. Only thing is, I dont like taking it longer than 4 days in a row, because it starts hurting my stomach and after a few days, it makes me start producing some weird slimey/mucusy bowel movements. It almost looks like I poop out a brown jelly fish or something. Does this happen to anyone else while taking Psyillium (metemucil or psyillium tablets)I appologize if my post has grossed anyone out. I just dont see any point in beating around the bush. We all know that IBS is very nasty, and we all have poop problems which result in anxiety infested LIVES! Advice Please


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## annie7 (Aug 16, 2002)

hi jfalconoh yes ibs-c, chronic c is nasty and miserable. i've had it for over forty years.just in answer to the senna. the senokot--a combo of low dose senna and stool softner--never worked for me either. i saw a great gastro doc about five years ago(unfortunately for me, he's retired now) and he told me that when all else has failed --milk of mag, miralax, senokot etc--he recommended his chronic c patients take exlax--a stronger dose senna--25 mg per tablet. start with the smallest dose and work up from there if necessary. and said that it was safe to take on a daily basis if that's what i needed to go. he based his recommendation on the following report on laxative use which at the time had just been released:"At recommended doses, stimulant laxatives are unlikely to be harmful to the colon. Although some patients with chronic constipation depend on laxatives for satisfactory bowel function, this is not the result of prior laxative intake. Tolerance to stimulant laxatives is uncommon; there is no evidence of "rebound constipation" after stopping laxative intake, and there is no potential for addiction even though laxatives may be misused." http://www.medscape.org/viewarticle/496828?src=mpand recently here on the board kathleen (thanks kathleen!) posted this report from the nih on senna use: http://www.ncbi.nlm.nih.gov/pubmed/20107583and in the past people with chronic c have posted that their docs--even mayo clinic docs--have recommended the same.so that's what i do --take senna--alternatie it with biscodyl (ducolax) so my body doesn't get too usd to the senna and i also take milk of magnesia with these because i find that added an osmotic lax like mom (or miralax) makes the stimulant lax work better.but even with all this, it still takes me a couple hours and two or three trips to the bathroom to get it all out --or most of it out--i still get that incomplete feeling too. frustrating. but at least with this current regimen i'm doing much better than i was before.good luck to you! and congrats on your marriage and beautiful baby boy!


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## mey2614 (Feb 25, 2011)

Hi Jfalcon..I would keep taking the amitiza for a little while longer. I found that when I take Amitiza I have to drink like 4 to 6 glasses of water in a row to produce any kind of movement.. usually not substantial but it's something. That much water isn't fun, but on really bad days it's worth it to find some relief. Good luck!


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## Gail2011 (May 3, 2011)

I would suggest you try the new probiotic from Genuine health. This new one is encased in omega 3 oil which helps the probiotics to stick and stay in your intestines. It is called liveprobiotic+omega3 and can be found in the health food store fridge in the vitamin oil.All of those laxatives are making the problem worse as they take the good out with the bad. Hope this helps! G


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## Sean (Feb 8, 1999)

I have had really bad chronic constipation since I was about 15 or 16. I have tried evverything including Amitiza. Amitiza worked well for the first couple of weeks and then nothing. I kept taking it for about a month to see if it would kick in again, but it did not. I never have a bm without some kind of stimulation from a laxative or enema. All of the remedies that I use lose their effectiveness with time. Thus, I have learned to rotate what I use. I have also learned to combine them. For example, magnesium citrate cleans most people out rather explosively. But for me, it takes well over 12 hours to work if it works at all. So when I really need to get myself empty, I take three dulcolax stimulant laxatives at bedtime, and set the alarm for 5 am the next morning when I down the bottle of mag citrate. Then I try to go back to sleep until the stomach cramps wake me up. The combination of the two laxatives empties me really well. However, I have to wait until a day that I do not go to work to do this. The one laxative that does seem to be consistent for me is Dulcolax. I just try not to use it more than twice a week. Three tablets at bedtime produces a large bm before noon the next day and usually several more during the afternoon. It gives me strong cramps and I know that it is bad for my body to use it so often, but I am sort of at the end of my rope. Senna also works for me, but I have to take a lot - like 6-8 tablets. It does lose its effectiveness over time, so I have to rotate it in and out of my routine. It also seems to give me more cramps than Dulcolax. I have also used Fleet enemas over the years, but I build up a tolerance to them, too. I can only use them occasionally. Large volume water enemas with the hot water bottle with the hose attachment are very good for complete emptying of the colon. I have used those with success, but my body builds up a tolerance to those too if I use them more than once a month or so. I am not sure that I have helped you very much. All I can say is that this appears to be a lifelong problem for me, and I have to constantly stay on top of it to keep from getting totally impacted (no fun at all).


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## princesshb (Aug 21, 2011)

I am sorry to hear about your painful IBS-C issues. I know ALL about them, I have them too!I would suggest that you keep taking the Amitiza and ask your doctor if you can take it with Miralax. There are different doses of Amitiza.I would suggest totally elimitating Soda and any bad foods (fast food, milk, excessive sugar, sugar substitutes) and whatever else bothers you.I also would suggest that you increase your water intake and eat one apple a day. Whatever amount of water you are drinking now, double it!!!Walking daily and excersie 30 minutes or more a day seems to help the mind, body and colon.If you are not doing this start.I would be VERY CAREFUL using laxatives as our bodies start to rely on them HEAVILY and then the colon does not move without the laxative which over time will make your symptoms worse. Magnesium Citrate in the bottle can be used for a good cleaning of the colon but not every day or even weekly....it will wear your colon and rest of the body out!Check with your doctor to see if you can take Amitiza with the Miralax and perhaps even taking a low dose of prozac with this will help too. This coupled with the daily excercise and the increased water will make a difference. I also recommened that you get weekly accupuncture and massage (I hope that your insurance covers it if not at least every other week). These are things that have worked for me. I can tell that if I eat "bad foods" that I suffer tripple and when I am anxious or stressed, I suffer tripple, so think about the Spirit-Mind-Body connection. Try to focus less on IBS-C and think of yourself healing, feeling better ever day. Once you keep taking the Amitiza and Miralax, you will be in the bathroom more than ever before....it takes time to find the balance so be easy on yourself.Think Good Thoughts & Follow Thru with Good ActionsPrincess


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## micropb (Jun 18, 2011)

I have been on Amitiza for about 3 months now. I had a similar experience to you, where I felt like it wasn't working after a few days (especially since I was so hopeful after having BMs the first few days). I kept with it. While I still may go a couple days sometimes without a BM, I am MUCH more normal than I had been. I think it may have taken a little bit for my body to figure out how to consistently respond to it. I have had to take Dulcolax twice in the last 3 months, but prior to that it was part of a very painful regimen (6 doses of miralax/day, fiber supplements daily, dulcolax once/week...after regularly having periods of 3 weeks without a BM and my students occasionally asking if I was pregnant since my abdomen was so distended). A previous reply is right, there are different doses of Amitiza, so your doctor may adjust the dose or how often you take it. I take it twice a day, once in the morning and once with dinner.Not sure what your eating habits are, but no one ever thought mine were off balance (I literally eat carrots, an apple, a piece of string cheese and pretzels every day for lunch and some sort of protein and vegetables for dinner-I'm very predictable). Keeping a food journal may help to determine if a particular set of foods create a worsened episode of constipation for you. Monitoring your food habits can help with any type of regimen you use to decrease the symptoms.I know you posted a while ago. So what did you decide to do?


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