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I have multiple sclerosis and was diagnosed in 1999. Since June 2007 I have been experiencing severe constipation and terrible bloating (I weigh 48kgs and look 9 months pregnant) that is related to my MS ("bowel denervation" is the term my doctor uses).

I have tried the following remedies to try and control the problem (a lot have been taken in combination with each other in vast daily quantities):-
A very high fibre diet and 3L water daily
Coloxyl with senna - 8 a day plus Movicol - 8 sachets a day
Coloxyl
Senokot
Slipery Elm
Bisalax
Motilium
Aloe Vera Juice
Normacol Plus
Normafibre
Lactulose/Actilax
Epsom salts
Inner Health Plus
hi-up enemas
Picoprep
Fibrogel
Benefibre/Agarol/Metamusil
A course of drug therapy with Vancomycin, Metronidazole, Colgout
Maxolon - had to give up due to severe side affect
Rifaxim - had to give up due to severe side affects
Underwent a fortnight of Human Probiotic Infusion Therapy

The only treatment that is working is
6 colgout
3 motilium
18 senokot

However, here in Australia, the Therapeutic Goods Adminstration have reported on Colgouts high toxicity levels and I am extremely worried about taking this medication which I have been on since Sept 2009. (Started on 3 daily but now upto 6).

Is there anyone out there with severe constipation and bloating? Can you suggest any other forms of treatment?

Can you suggest any other forms of treatment before I have to consider either bowel shortening or a colostomy –I am desperate!!

Look forward to hearing from someone!
Jasper

Give Magnesium Oxide supplements a go. It is a smooth muscle relaxant, dirt cheap and readily available.

I would suggest at least 1000mg a day for starters.

Keep us posted on whether it helps.

http://www.vitaminexpress.com/product_i ... cts_id/511

What is your diet like? do you eat healthy? do you eat wheat/dairy?

Have you ever had a colonoscopy? Dr. Oz just talked about constipation and bloating as symptoms of colon cancer.

http://www.doctoroz.com/episode/4-body- ... ean-cancer

Jasper---
Extra fiber supplementing doesn't always help--it can make things worse, since bowel motility is a problem in MS, and fiber creates more bulk, more to move in the intestines.
http://www.ncbi.nlm.nih.gov/pubmed/15776133

This is what my husband uses, and he is regular now, after problems w/constipation and an MS dx.
Natural Calm (magnesium citrate) with lots of water. Low magnesium often causes constipation.
http://www.calmnatural.com/constipation-relief
Also, papaya enzyme (papain) taken with his meals, breaks down food in the stomach via enzymes, helps things move.
http://www.livestrong.com/article/27184 ... stipation/

move as much as you are able. Inactivity makes this a worse problem.
best to you,
cheer

i agree re the laxative effect of magnesium oxide (and citrate). inexpensive and effective.

ms patients need to absorb their magnesium since levels are typically lower, with a long list of associated symptoms and signs.

in some cases though, such as constipation, the less absorbable, less soluble forms (like oxide and citrate) are beneficial largely for the fact that they go right through you.

the bloating you describe in addition to the constipation makes me also consider zinc as a potential issue. zinc is also low in ms patients and is implicated in a variety of different issues experienced by ms patients.

glad you have something that works for the present at least, since it's a serious problem.

if you decide to introduce magnesium oxide as a laxative, i would hesitate to dump in 1000mg in one go. if you did do that, i'd recommend staying within 5 seconds commute of a toilet throughout that day, with easy fastenings on your pants at that.

you could consider taking 100mg elemental magnesium (from oxide - the pill will have to be a few more mgs to deliver 100mg elemental mag) with each meal for day 1 and day 2, plus an additional 100mg at bed time.

on day three if you have seen no benefit, then you could try 200mg with each meal and at bed time.

if you decide to supplement zinc, it will work best if you reduce or eliminate gluten, sugar, and alcohol intakes. ensure that you take a product that is balanced with copper, since the copper-zinc balance is critical in human health, and excessive zinc supplementation can cause a copper deficit. for example, see if you can find 50mg zinc combined with 2m copper and you should be good.

i too am curious about your diet and activity levels given a 13 year history with ms. iima, what do a typical day's meals and activities look like?

fyi problems associated with poor zinc and magnesium status are diverse - they're involved in 100+ and 300+ pathways in your body, respectively.
in general as a pwms it's wise to boost food intakes of magnesium- and zinc-rich foods, while at the same time reducing intakes of things that impair absorption and/or utilization. food and beverage combinations can have a serious impact on your ability to absorb both zinc and magnesium. i've attached a link below which is pretty bang on, although clearly not specific to patients with ms:
http://www.ehow.com/about_6306240_magne ... iency.html

PS if bloodwork for zinc and magnesium levels are feasible, and you're interested, just say the word and i can point you at healthy target levels (a specific place within the so-called 'normal' range)

hope you feel better soon!

Some of the suggestions here may be helpful to you, too, in establishing regularity:

http://www.thisisms.com/forum/daily-lif ... 18946.html

I have MS bowels and diverticulitis. Because THEY won't let me have SATIVEX, I smoke a couple of grass joints every night and drink some wine. I keep away from fruit now,but eat plenty of all things good, veg,bread and wine gums. But, my bowels are more controllable than ever as the grass keeps things relaxed. Grass cookie can provide a bit of a surprise, but if after 2-3 days the through put is a bit low two extra strength SENNACOT at night has very pleasing effects the following morning.

I can't walk at the moment but have learned the signs and always make the bog.I don't know if this may be of help, but it literally is another weight off my mind

Wb

NHE wrote:Have you ever had a colonoscopy? Dr. Oz just talked about constipation and bloating as symptoms of colon cancer.

http://www.doctoroz.com/episode/4-body- ... ean-cancer

I apologize if my post came across as alarmist. I did not mean for it to read that way.

Here is my experience that led me to post my initial message...

About 4 or 5 years ago, I had a friend of mine develop severe constipation in her mid to late 40's. She went to her doctor and tried various things, none of which helped. Her husband finally took her to the ER where they did a colonoscopy. They found out that she was backed up because the cancer had grown to the point where it was blocking the colon. Afterwards, they took her straight into surgery without any delay. I was told that her doctor came and visited her in the hospital during her recovery and said that, because of her experience, every patient complaining of persistent constipation gets a colonoscopy.

In addition, a family member of mine was recently diagnosed with colon cancer after getting a blood infusion for severe anemia which failed to bring up their hemoglobin levels. The colon cancer was slowly bleeding which went undetected. There's a test called a fecal occult hemoglobin assay which uses antibodies to test for hemoglobin in the feces. Fortunately, the cancer was at stage one, but was still 35 x 45 mm in size, and surgery to remove the entire ascending colon was all that was needed and they are now recovering well.

Given these experiences, you can see why I might be sensitized to the issue of colon cancer. It's not too outrageous to consider and it's easy to rule out.

By the way, later in the episode of Dr. Oz that I linked to, he mentions that saline enemas can be quite effective in breaking the dam in about 3 to 5 minutes.

I wish you the best.

NHE

Hi!


I am from UK, but my advice would be, to see your Doctor, the only other advice I could give you is to drink plenty of water. our body needs water and it will take it from where it can and can be from the bowel, hence constipation.

I know this as I had a problem some time ago, and my sister is a nurse, also dark circles around the eyes is a sign of constipation and dehydration apparently

I have also had the problem of incontinence where the back up becomes liquid and leaks.

But my paramount advice would be to see your doctor or practice nurse, then you can have be given an enema which should be effective. I now constipation can be scarey, but see your Doctor, you should not be taking so much laxative for it not to have an affect ok.

Seek professional help and assistance

Hi!

Also I forgot to mention passing a hard stool can cause hemorrhoids, these can then burst or bleed creating a lot of fresh blood to appear this again i frightening. but old blood needs investigation as can be a sign of bowel cancer, it may be nothing but it needs to be checked by your Doctor ok.

In the UK there is a current campaign to make people aware of bowel cancer and get themselves checked out early rather than later, it may be nothing ok but all the same, you need to see your Doctor to be checked.

I dont mean to frighten you in any way ok,

Drink as much WATER as you possibly can just before going to sleep. You may find, depending upon how dehydrated your body is, that you won't need to urinate during the middle of the night, and hopefully, you'll find yourself having a movement the next morning/day.

Otherwise, first you might need to clear out the hardened stool which two-three Correctol pills should accomplish overnight. Do not use Correctol on a regular basis--your goal is to use WATER at bedtime to prevent the stool from hardening so the stool can easily move.

Digested food enters the small intestines in liquid form which stays in liquid form all the way to the large intestines. From this liquid stool in the large intestines, water is taken for the body's use which helps create, in the ideal case, the ideal stool--soft enough to pass through painlessly while still holding form.

Best wishes

The best thing that works for me is to eat two bowls of raisin bran every other day. I find that if you have too much fiber you get the runs and too little plugs you up. This seems to keep things moving well in my case. Good luck.

jasperandmaxi wrote: Can you suggest any other forms of treatment before I have to consider either bowel shortening or a colostomy –I am desperate!!

Look forward to hearing from someone!
Jasper

Wow Jasper, I'm so sorry you're dealing with this. You seem to be getting some sound advice from other posters, so I wasn't going to comment, but... Is it possible that the constipation is aggravated (or even caused) by other meds or supplements that you're taking? I know people get tired of hearing me say this, but I've had problems from foods/vitamins/supplements that are worse than MS has ever given me. For years I've kept track of my daily symptoms & weirdnesses, as well as what I eat and swallow.

In my case, I had never had constipation in my entire life (I've had the opposite problem since childhood) until I started vitamin D a couple years ago and I've had at least mild constipation ever since. I was up to 4000 IU, but had to drop back down to 2000, and constipation is sometimes a problem even though I get plenty of exercise and a large part of my diet is fresh fruits & veggies, water, etc. I think I went a week without a BM when I first started taking vit D, but I've finally adjusted my D dosage & diet until it's now manageable (I still have to change things when I try a new supplement).

I always suggest when a problem comes up that people review all the meds/supplements they're already taking, check out potential side effects online and consider dropping something instead of continually adding one.

I know that vit D, omega 3's etc., have proven benefits for MS, but I've had MAJOR, MAJOR reactions to omega 3's like flaxseed oil, fish oil & walnuts, and eating shellfish sends me to the ER.

Sorry this is so long, but the point is, is there something you're already taking that might have a constipating effect on you? Best wishes for finding an answer that turns out to be that simple!

P.S. Speaking of simple solutions, I had a recent bout of severe (and embarrassing) gastrointestinal problems for about 4-6 weeks, and by accident I came across a caution to avoid sugarless gum/candy with Sorbitol in it for my hiatal hernia. I stopped using my newfound work treats Trident gum & Breathsavers all day, and the problem was gone. Instantly! Plus, I stopped choking so much at night.

it's true one must balance supplements carefully. in the case of d3, adequate balancing with the right minerals is required. i too have problems when i take vit d3 without taking sufficient minerals in the right amonts *and* using the right careful timing.