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IBS, with constipation, how do you deal with it?


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First off I am a DL, I do have old man dribbles as I call them, neck back issues etc, But I have IBS according to my Dr thats whats causing my constant diarrhea I have sealed wit Acid reflux all the above for over 20 yrs, hemorrhoid surgeries, But I would like to know if there are others here that are dealing with IBS and constipation? it only has gotten worse adding pain meds over the last few yrs. My only so far solution has been daily enemas and I have really uncomfortable insides if I don't do them. I can't go #2 normal. My dr was trying to get me on a med but ins won't pay for it and as with name brands $400 a month. I have done enema once a day 3-4 yrs and the past 6 mos two a day. Makes it real inconvenient to travel around my enema schedule.

Most of the IBS meds out there are for diarrhea.

I am just mainly looking for input if anyone has had this and found a solution at this point because of my stomach, I can't eat salads etc, I tried on a lot of occasions adding fiber etc, fiber works the opposite on me. I tried last yr to increase fiber salads and as the dr put it let things come out natural I ended up in the hospital plugged up completely, and

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I have IBS-C on top of many other constipating factors including pain meds, Neurogenic bladder and bowel , my bowel and bladder care used too require 3 to 4 hours every other day , I used to use 8 laxatives and stool softeners daily plus 2 suppositories on bowel plan nights. What has saved me is using chronulac which used to be the only thing they could do, in 2014 I had a stroke and everyone realized the magnitude of my constipation , my pain doc started me on Movantik ,it is the drug Narcan in a special formulation that causes my opiate receptors in my bowel to become unblocked by my Fentanyl & Oxcycodone, so I still have good pain control and can usually have a BM once a day . So I only take chronulac , senna, docusate and Movantik for my bowel now , and have a much better quality of life ,my colon rectal doctor has said i am the only patient he has ever had that would manually disimpact myself most patients need anaethesia and somrone else to do it. Now a days if i eat to much fibre i adjust the Chronulac amount i take 3 X's a day as soon as I realize I have done it to compensate , and I stay around the house because I have very little sensation, up regulating the chronulac results in a temporary loss of control for people with sensation so for someone with little sensation you just have to accept about 12 hours of completely uncontrolable random soft movements which is damn site better than the constipation, it is far easier to change diapers than it is to start a stalled system , if the system stalls it means hourly emergency doses until it starts ,so since the outcome is the same soiling yourself , the problem with emergency doses is there is no fixed amount of time between the starting emergency doses and laxation beginning so if you plan for it when your at home with no obligations it is a limited amount of time before you regain control , with rescue doses you could be without control for 16 or more hours depending on how many hourly doses you needed , it also does not respect your sleep schedule awake or asleep your bowels move anytime they need to regardless of your desire or wish to control them , in healthy people with sensation the more you ignore the need to move your bowels the sooner the chronic takes control , with Neuro muscular problems there is very little to no sensation to start with , constipation also makes my bladder IC worse, so i know when I have to increase dose or start emergency doses I will be completely IC, these are not the times you want to go window shopping .

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Thanks for the information, I need to talk to my Dr and see about some of these meds. If I do my enemas twice daily I don't have any cramps etc. I have tried most of the over counter stool softeners and laxatives with no help at all. I have painful stomach intestines if I don't do a least one enema a day. The only thing I guess is ok about my soap water enemas I do know when I will go #2, I don't wear enough protection during the day to hold bowel, I just use pull ups for daytime. Movantik is a name brand, my ins is not good at covering the name brands, anymore.

Edited by dlforever
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If your taking morphine it is an opiate, Yes I me if years of constipation from the in IBS-C before the pain meds after pain meds it was a losing proposition , I use Fentanyl 100 microgram patches every 48 hours as a basal med and 10 mg Oxcycodone every 4-6 hours as needed for break thru. If they wont cover Movantik that surprizes me because i have Medicare and they cover it, most companies follow what Medicare does , if it preexisting and possibly jot opiate related there is 2 other recent constipation drugs Linzess and something else ? If its opiate related there is another drug just recently approved for it can't think of the name ,although if you have decent control with the soap suds enemas those are pretty low cost low tech least side effect you can find for dealing with , I know it's literally a PIA , Anyone who has never had the problem just Cant understand how miserable that can be .

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I guess I didn't think of morphine as an opid, What side effects do you have from Movantik? the med that my ins refused was Amitiza, I have samples, but since after a month of trying to get ins to pay for it, I never tried the samples. He said this was the only med he new of that will work for IBS-C. It really isn't a matter of preexisting thats not the issue, Blue cross, just makes there own decision on whether they think you need what ever the drug. Unless its a generic. We have had this ins for over 20 yrs, They just started refusing to pay for a lot of name brands when the Obama care started mandating them to do all of the other stuff, so I see it as there way to cut cost.

I can control it with my enemas, as long as I don't want to be anywhere early in the morning or stay out past 9 or 10 pm. so if there is a med that would not add to my side effects of meds I already take, I am willing to try it. I however do like the not having to go # 2 in a public restroom. And I am into pee, but not into messing in my diapers at this point.

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  • 1 year later...

I have found that wearing a tight and form fitting diaper helps relieve my severe constipation by putting enough pressure on certain pressure points. I can often pass bowel movements quickly, fully, and with little effort and straining on my part. Confidry 24/7's seem to work the best at activating those pressure points for me. I always make sure I keep a large stock of them to help me with this problem. It beat straining and breaking a sweat on the toilet for upwards of 2 hours or having to try to dig it out with your fingers. Sorry if this is TMI.

 

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I used to use 8 different laxatives daily with 2X suppositories every other night ,it would take as long as 4 hours for the suppositories to help.my stools were the size of rabbit turds and the consistency of potter's clay, bladder and bowel care was my biggest daily activity.

I have IBS C & OIC ,after my stroke 2 years ago my doctor was like you should not be doing what your doing with so little result and exhaustive straining( hemorrhoids,anal fissures, bleeding ,impaction was the story of my life ), so they tried something different a drug that blocks the O in the bowel only and another medication that's not actually a laxative or stool softener but it works sorta like one when being broken down in the gut it draws water into the bowel thinking the stool ,creates alot of gas of course both things combined force the bowels into high speed and unlike any actualy laxatives that can be somewhat endured and ignored if neccesary, this stuff doesn't give you a vote ,when the time comes wherever you are and whatever your doing you are having a BM ,if you take it on a fixed schedule you generally know when its going to happen and I can be put on commode and wait for it to happen , yes there are times it will unexpectedly fill your diaper well asleep or I am up in my chair ,but i leave the heavy lifting to my caregiver ,they can clean & change me and start a load of diapers in the wash in like 10 minutes it would take me hours. IBS comes in 2 varieties can't stop it from coming out , or can't get it to come out.its a miserable disease.

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Cruiser 03, what meds did they put you on? I am very interested to see if my ins will cover them, because my answer is still nightly enemas I only do soapy water baby wash, and Drs say if it works ok, except for my hemorrhoid surgeon, he says anything up the but will damage it. But after I followed his instructions and tried to make my body do it, I ended up in the hospital he now agreed with me that if it works and I will just continue with the butt surgery every so many yrs. Butt I am willing to try a med to see if it would work

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  • 2 weeks later...

Sorry my friend some how i missed your question till now .
For the OIC I use Movantik, it a special form of Narcan that unbinds the Mu opioid receeptors in the bowel but doesnt act anywhere else , so it does not effect my pain control or cause withdrawl.

Because of the IBS II have ferociously hard stools ( hemorrhoids, anal fissures the whole nine yards) I use Lactulose ( chroulose ,chronulac has a ton of names ) it's a syrup that is a synthetic sugar derived from Lactose in milk ,it's not actualy considered a laxative or stool softener but it works like one ,it's pretty much the sweetener used in sugar free candy for diabetics .
When being broken down in the body it draws water into the bowel thus softening the stool ,and by virtue of bacterial breakdown it causes gas and speeds up bowel transit time , of course how much you take depends on what happens ,i take it three times a day and every night around ten my bowels move,other people take it at the same dose and require diapers ,you just need to find the right dose for your body , you start at the usual dose the doctor tells you and based on your BM your can adjust up or down as needed . The biggest thing to taking it "don't argue " since its not actually a laxative or stool softener those are more or less secodary effects ,it does something that actual laxatives dont do ,force you to go ,an actual laxative promotes using the toilet you don't "have" go , you might be awfully uncomfortable but don't have to go ,with this stuff you can resist going for a little while but it keeps going ,until you either use the toilet or your pants. I have actually had the pharmacy lose my Movantik is the mail ,at that point its either impaction and damage myself or increase how much I take and have zero control over when or where .

Before my stroke I used 8 laxatives and stool softeners by mouth everyday , and then every other day two bisacodyl suppositories ( generic dulcolax) after about 4 hours in they would start to help, and then it was struggle and strain for 2 hours to try and get as much out as could .
I have a bad heart and then with the stroke my doctors have said absolutely no straining period unless I want to kill myself .for something that isn't a laxative it sure works great , i am not a real fan of the taste it's super sweet with a slight nutty taste ,easiest way i have found to take is to put it in my coffee ,at first I tried an oral syringe but it was so awfully sweet ,it as nasty ,that's when my doctor said put in a milkshake you won't know its there or strong coffee and let it be your sweetener.

Cruiser 03, what meds did they put you on? I am very interested to see if my ins will cover them, because my answer is still nightly enemas I only do soapy water baby wash, and Drs say if it works ok, except for my hemorrhoid surgeon, he says anything up the but will damage it. But after I followed his instructions and tried to make my body do it, I ended up in the hospital he now agreed with me that if it works and I will just continue with the butt surgery every so many yrs. Butt I am willing to try a med to see if it would work


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  • 2 weeks later...

I have IBS-Diarrhea and have to wear a diaper around the clock any time I have a flare up. I have accepted it as the insurance company will not pay for meds to control the diarrhea. The insurance companies should not be allowed to deny you any meds that your doctor prescribes.

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