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Posted: Wed May 02, 2018 2:41 am
by shinyredsparkles
Hi everyone! I was diagnosed with relapsing remitting MS just under 10 years ago. I'm currently taking gilenya daily which has been great for me - but for about a year now I've been suffering terrible constipation... I'm only going 1-2 times a week :/ I've tried the usual fibre supplements, I drink water and exercise as much as I can but it's just not getting any better. Has anyone else experienced this and have any good tips to share? My tummy and I would greatly appreciate it! :)

Re: Constipation

Posted: Wed May 02, 2018 3:13 am
by NHE
Have you tried anything like prune juice or Miralax?

Re: Constipation

Posted: Wed May 02, 2018 3:16 am
by jimmylegs
hi :) if you have not already done so, consider trying magnesium oxide. see if one a day helps and if not you can test gradual dose increases. don't overdo it! at higher doses mag oxide becomes *very effective*, if you get my meaning ;)

Re: Constipation

Posted: Wed May 02, 2018 3:30 am
by Scott1

Having been in this position myself, you have my sympathy. It's always difficult to unravel and you probably need to look more broadly than the things you've mentioned.
From my own experience the thing to work out is why you have lost motility (the action that moves things along) rather than what you can take to restart a regular pattern. Apart from Gilenya, are there any other medications you take?

You said you've tried fibre supplements. Did they seem to help and then not help? It is possible to get a backlash from supplements if you body becomes reliant on them. Then you're in a loop. Did you try a mainly fruit diet (bananas, avocado, figs, pears, apples, dates etc) without supplements but with a lot of water?
There is a very effective suppository in a small gel tube called microlax. You insert it, count to 20 then remain seated throughout the entire performance. That plus a very mild laxative can help relieve things but ultimately you want to just rely on things like fruit.(pears and dates are good).

All things that are supplements are aiming to rapidly draw water into your gut and bowel to soften any impacted material so really its pretty violent. You need a lot of water to compensate.

As silly as it sounds, I find trying to go around about the same time each morning after a coffee works. I think my body just expects it.

Constipation isn't fun. Sometimes a doctor can suggest simple remedies and often a pharmacist can make the same recommendation and a prescription isn't needed.

The way I got out of it was not with supplements but with fruit, water and a gluten free simple diet. Initially I needed a suppository to get me started, then I drank gallons of water for most of the day, then had nothing but fruit for a day but kept trying to go whenever I felt I should. Ultimately I got back to regular rhythm.

I agree about magnesium. A magnesium tablet morning and night can possibly help as well but pay attention to the recommended dose or you might overdo it.


Re: Constipation

Posted: Wed May 02, 2018 4:20 am
by ElliotB
Have you tried Psyllium Husk powder in a smoothie? All natural, simple to take, very inexpensive and pretty much guaranteed to work.

Just curious, what kind of diet are you following?

Re: Constipation

Posted: Wed May 02, 2018 4:37 am
by shinyredsparkles
You guys are awesome - thanks for all the tips! Is it wrong that all this poop talk makes me giggle? I'll grow up one day I swear.

To your questions - Ive tried prune juice, dried apricots, psyllium husk to no avail. Im not on any other medications, I try and only use laxatives when I'm absolutely DESPERATE as I'm scared of ruining my insides for good! I've never tried magnesium though - that sounds like a winner.
Scott thanks so much for such a detailed response too - really appreciate it. So you ate fruit only for a day and that helped (in conjunction with the suppository and water)?

Re: Constipation

Posted: Wed May 02, 2018 6:01 am
by jimmylegs
get laughs any way you can!

interesting (old) info re magnesium and colonic motility:

Effects of oral magnesium sulphate on colonic motility in patients with the irritable bowel syndrome
"A rapid increase in colonic segmental motor activity (onset within two to six minutes in most cases)"

can't say i'd enjoy the epsom salts in water personally - a nice magnesium oxide powder capsule sounds just right :) look for lower dosage options. maybe 150 - 200mg elemental mag, or a product that requires 2 capsules to get the stated dosage on the front. it's easier to tailor to your day to day requirements that way. if you start say with a 500mg product and then try to go to two in one day, watch out! :D

Re: Constipation

Posted: Wed May 02, 2018 6:29 am
by hargarah

Number one for this problem!

I take 6 of them. Always works!

You need something with SENA in it, Trust me!

Re: Constipation

Posted: Wed May 02, 2018 8:09 am
by jimmylegs
re senokot (senna alexandrina) - makes sense, with caution

Study on selected trace elements and heavy metals in some popular medicinal plants from Sudan ... 012-0630-6

Table 3 Concentration of some essential trace elements in the studied medicinal plants
...............................Copper .......Iron.............Manganese....Zinc..............Chromium......Selenium.........Magnesium
Senna alexandrina Mill..4.6 ± 0.4.....261 ± 13.......13.2 ± 0.9.......21.1 ± 1.2.......0.67 ± 0.03.....0.21 ± 0.01.......2950 ± 45 (mean ± SD, mg/kg)

check price comparison with regular essential nutrient supplements, and always consider herbal medicinals just that - a short term therapeutic approach, not a way to meet essential nutrient requirements.

An Evidence-Based Systematic Review of Senna (Cassia senna) by the Natural Standard Research Collaboration ... 011.573186

the full text for the above is massive. decent summing up in the adverse reactions section here


takeaway from last link above, don't be like that case who took 40 senokot a day for 15 yrs...!

Re: Constipation

Posted: Wed May 02, 2018 8:54 am
by Music
Hi shinyredsparkles - love the name!

This is what works for me/my body:

- cranberry juice and/or
- bananas and/or
- nuts
- magnesium glycinate - every day

Find what food works for you. Cheese was the ONLY thing that worked for a friend of my mother-in-law.

Excercise and massage help too.

Take care!

Re: Constipation

Posted: Wed May 02, 2018 9:27 am
by koneall
I take one Colace with lunch. By breakfast the next morning I'm able to have a BM. If I forget to take the Colace I'm 'bound up' at least two days.

Re: Constipation

Posted: Wed May 02, 2018 9:51 am
by NHE
shinyredsparkles wrote:You guys are awesome - thanks for all the tips!
Miralax acts as an osmolyte to draw water into the gut and thereby help things move more easily.

Re: Constipation

Posted: Wed May 02, 2018 1:02 pm
by Scott1
Hi again,

Yes, that's correct. The issue is clearing the stuff but not becoming reliant on a particular method of drawing water to the gut after that. Once you're clear I agree a magnesium supplement (in moderation) plus a fruit focused diet in the morning should help keep you regular. Magnesium is good for many other reasons as well.

I eat a banana and a whole avocado every morning as part of my breakfast, A little later I take the dogs to a coffee shop and have 2 double expressos (we call them long blacks). If I was a blunderbus, then the fruit is like the powder and the coffee is the trigger. The result always goes bang!


Re: Constipation

Posted: Wed May 02, 2018 11:46 pm
by shinyredsparkles
I tried senna after a pregnant friend recommended it to me and even that didn't work! Honestly feels like I'm broken - tired of looking pregnant!
Very excited to try magnesium - will pick up some low dose tablets tomorrow and give it a whirl.... Washed down with some cranberry juice! What a way to spend the weekend ;)

Thank you everyone! You're all amazing :)

Re: Constipation

Posted: Thu May 03, 2018 5:24 am
by ElliotB
Chances are your gut bacteria are out of balance. Consider supplementing with pre-biotics, pro-biotics, and digestive enzymes which are all easy to take and available in pill/capsule/liquid form. You might also consider supplementing your diet with foods rich in probiotics such as yogurt, both water and milk kefir, Kumbacha, fermented foods such as sauerkraut and pickles (make sure these are REAL fermented foods, many of the food producers cut corners to save money and process these foods with a vinegar process rather than true fermentation - check the product labels). There are others... Homemade is best but all these products are available at specialty supermarkets - Whole Foods carries all of them.

Something else to consider - getting the dosage right to the numerous digestive products you have tried is key. I use psyllium husk powder. It took me many weeks of trial and error to figure our the correct amount I needed each meal for 'success'. It is almost impossible for most of the products not to work but the wrong dosage (not necessarily the recommended dosage) may not deliver the desired results.