Constipation and Bloating

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friendlygal
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   Posted 2/7/2007 8:39 PM (GMT -7)   
 
Hi there, I normally post in the GERD forum.  But I have had bloating and constipation almost every day!  So I am thinking now that I probably have IBS and that this is a big reason why I have the reflux in the first place!
 
I was wondering, does anyone know what the best foods there are to treat constipation (ones that won't cause me to bloat, and ones that are not acidic since I also reflux)?
 
Also, do I need a colonoscopy and/or a lower GI test?  Up until now I have only had my esophagus tested.  I'm thinking now that the reason why my reflux never got better is because I never had the lower part checked out to really get to the heart of what is causing my slow digestion/elimination problem.
 
All answers are appreciated.  Thanks!

Keriamon
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   Posted 2/8/2007 9:18 AM (GMT -7)   
Some people will say yes, go ahead and get the colonoscopy. But unless you suspect that you have inflammation or ulceration of the intestinal tract (IBD), I, personally, don't think it's worth your while. It doesn't show how anything works, so it can't diganose you with a motility problem. Now there are some tests which can discover motility problems--I think a camera pill is one of them--but you're probably better off starting off with trying to control your constipation and gas on your own before moving to expensive tests. As far as I know, even if they discover that yes, your guts are definitely working too slowly, all they can give you to hope to make things work better is Zelnorm, and a lot of doctors will try you out on that without the tests.

Unless you are having very serious issues with constipation (never having a bowel movement, only having a bowel movement after using a lot of laxative aid, having to go to the ER due to impactions and/or intolerable gas pains), you can probably work something out for yourself. After all, that's what people used to do 20 years or more ago before we got all doctor/pill happy.

First, have you tried probiotics? These are good bacteria found in yogurt, acidophillus milk, and in pill form, such as Culturelle and Digestive Advantage (there are a lot more out there, especially in health food stores, but Culturelle and DA can be found in any chain pharmacy). Activia is the new yogurt out on the market which boasts extra bacteria for gut health. But, if money's a little tight, cheaper yogurt will also work (although it may take longer). From what I have read, though, yogurt is one of those few things where you get what you pay for; the more expensive yogurts tend to have more bacteria and/or more different strains. If you don't like yogurt or can't do dairy, then there are the pills. Simple acidophillus can be found in most any store's vitamin section, or there are the other products that I mentioned which have a bunch of different strains and a lot of bacteria. In fact, the pill forms of probiotics have so much bacteria that they can cause gas and/or mild gas cramping when you first start taking them. Most people adjust after a week or two and that goes away, but some people just don't seem to manage to adjust to certain products; if that happens, rather than giving up on probiotics all together, switch to a different brand and see if you tolerate that better. Most people I recommed to start out on the yogurt though (2 cups a day), then work your way up to the pills if you find the yogurt helps some, but not enough.

Probitotics can take a little while to build up in your system, so give them at least three weeks of daily use before you give up on them. You may find that they help both your constipation and gas, they may help your reflux, or they may only help your gas. If constipation is still a problem three weeks into the probiotics, then you can try a few things. You can add prune juice to your diet daily (shouldn't be that acidic), or you can add prunes. You can always find some Sun-Maid prunes in with the other dried fruits (find raisins and you'll find prunes). You can try taking an aloe vera capsule a day (also in the vitamin section) and adjust up or down as necessary. And finally you can tinker with that old standby, the fiber supplement. Some people eat the Kashi cereal, but most do a drink or a pill. Like probiotics, there can be some initial gas problems, but you should get use to it. Some people have intolerable gas pains, or even develop diarrhea with certain products; if that happens, stop taking the fiber immediately and give your system a couple of days to return to normal (rather, its version of normal). Then, switch to another product. Fiber itself is not the problem; its just the combination of fiber types (soluable and insoluable), delivery method, or fillers that caused you to have an extreme reaction. You just have to experiment to see which fiber supplement is the one that helps keep you regular without any side effects. (I suggest the prunes and aloe vera first because they're not so hard to figure out as which fiber supplement is right for you; if one of them will do the trick, then don't worry about the fiber unless you start getting constipated again; some people do need a combination of things in order to stay regular, though).

friendlygal
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   Posted 2/8/2007 10:32 AM (GMT -7)   

keriamon, thanks for your detailed response!

I go to a chiropractor and he said that there are top of the line vitamin stores, middle ones, and mediocre ones (these give drugs that are just a bunch of chemicals that are passed through the urine).  so if i buy something in capsule form, I'll be sure to buy from a good place.  he said that organic is best.

I have been constipated for days and days!!  Do you think that, in this condition, it will ever be possible for me to have regular bowel movements without all the help of pills and or prune juice/probiotics, etc.?  I'd hate to have to rely on these forever!


Keriamon
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   Posted 2/8/2007 11:04 AM (GMT -7)   
Bowel movements change throughout our lives, so there's no telling what your bowels may end up doing in a few years, or even next week. Some people are constipated for years and years, only to suddenly have diarrhea for years and years. People who are perfectly normal all their lives frequently develop constipation in old age (thus all the jokes about old people and prune juice). So no, you may not need to use fiber, probiotics, or prune juice forever, but you may need to use them for a long time.

The probiotics are a good place to start, because sometimes they can cure problems and you don't need to stay on them permanently (although regular "booster" doses of them never hurts). When I had my last round of antibiotics, I had to eat the Activia yogurt once a day for three weeks before I got straightened out. I saw an almost immediate improvement in my symptoms when I ate it, but if I missed a day, I went back to having problems. After three weeks, though, I stayed regular, and could stop eating it daily. I still get acidophillus in my milk breakfast 5 days a week, though, as my booster. Oddly enough, despite the stomach flu and a cold going around the office at the same time, I have so-far (knock on wood) managed to get neither. Which is really odd; before I always seemed to catch every little thing. I'm beginning to wonder if the probiotics in the yogurt, plus the continued small dose in milk regularly hasn't given me some immunity. After all, your intestines are the biggest part of your immune system. So, even if 3-4 weeks of probiotics cures you completely, you shouldn't be too quick to throw them off and never do them again; they may give you other benefits besides just fixing your guts. They're no more onerous to take than vitamins, and most people are happy to take those long-term if they think they will make them feel better, make some disease better, or prevent some disease.

friendlygal
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   Posted 2/8/2007 2:15 PM (GMT -7)   
I am very young so the thought of using them for years scares me.  I want to go back to living again!

caregirl
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Date Joined Nov 2006
Total Posts : 24
   Posted 2/8/2007 4:39 PM (GMT -7)   
friendlygal, poor thing I fell for you. when I was a teenager I had desintery all the time . when I turned 18 I went the other way and its no fun eighther
all what keriamon said was so right. allso force yourself to drink lots of water bottled kind is best unless your water is good where you live.
I know fiber & citrucil made me worse I dont know about you thou. we are all so differant. I wish I could tel you all the right stuff but its all just trial and era.
we are all going to pull through this together.

Keriamon
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Date Joined Jun 2005
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   Posted 2/9/2007 11:07 AM (GMT -7)   
Prune juice for breakfast interferes with your life? Just wait until you get older! I'm 27 and I take a Welchol and a calcium pill everyday to control my diarrhea (and carry some in my purse for emergencies), plus a birth control shot every three months. My husband, on the other hand, who is about to turn 45, is up to 3 different diabetes medicines, 2 different cholesterol medicines, testosterone, thyroid medicine, and blood pressure medicine (8 pills in total), not to mention the two or three different vitamins he takes.

Face it, kiddo, your life is destined to be goverened by your medicine chest. This is true for all Americans, not just people with bowel problems like us. You can resist the pull of probiotic pills and fiber supplements for as long as you can, but you'll eventually be hit with having to take a pill daily for something else. So you can live your life between now and then miserably constipated (but medicine free!), or you can start taking something now and start feeling better and living life. Because you can't live life constipated, but you can live it quite well with a glass of prune juice for breakfast every morning. Taking medicine is like paying a bill: we don't like to do it, but we have to be responsible and be regular with it. Bills and medicine are just facts of life as you get older.

If it makes you feel any better, think of this as a step towards adulthood; you're growing up! Now you have something to complain about with all the other adults at functions; medical problems are especially popular among older people. Once you have one, you'll be included as an adult in the conversation.

friendlygal
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   Posted 2/9/2007 3:06 PM (GMT -7)   

Keriamon, I know what you mean about people needing to take medicine when they get older.  However, I finally had a bowel movement today and I was not taking my GERD meds today.  Therefore, for me I believe that it could be that the medication I am supposed to take for GERD is part of the cause of the constipation!  Sometimes medications are not good to take.

 


Keriamon
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Date Joined Jun 2005
Total Posts : 2976
   Posted 2/9/2007 3:42 PM (GMT -7)   
I seem to recall that someone else on here mentioned that the PPI meds for acid reflux do indeed cause constipation. If you stay off it and go back to being normal bowel-wise, then ask your doctor if you can switch to another brand of acid reflux medicine as the current one makes you too constipated. Also ask if you can treat with OTC acid reducers on a need-to basis. More and more information is coming to light on long-term usage of the PPI meds and it's not very favorable--including increasing your chance of contracting bad bacteria in your bowels to a possible osteoporisis-link in women. They say it's one of, if not the most, overdiagnosed and overmedicated problem right now.

Canyonbabe711
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Date Joined Mar 2006
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   Posted 2/9/2007 4:11 PM (GMT -7)   
My Doctor took me off the PPI's and said that the Tagamet(generic) I was using may be better in the long run. He said jury is still out on PPI;s but it was not lookinggood for them. They are overused and overprescribed. A couple years ago when they out with all the advertising practically everyone had them prescribed to them if they mentioned stomach problems. They were never meant to be taken forever though Prilosec the first one has been around for over 10 years.

friendlygal
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Date Joined Dec 2006
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   Posted 2/9/2007 6:23 PM (GMT -7)   

Wow, that is interesting that PPI's can do such damage, yet doctors keep perscribing them!

I really am not sure what to do about that at this point.  I'm not sure if over the counter meds could work for me since I think that my GERD is a strong case.


TexasJen
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Date Joined Dec 2006
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   Posted 2/11/2007 8:46 PM (GMT -7)   
PPI's do have their place. DH takes aciphex because his GERD finally got bad enough for him to see the gastro doc. Turns out he has Barrett's Esophogus, which simply put, is a precancerous condition due to all the acids constantly burning the tissues. Ladies, you can relate that to having a "bad" pap test for instance. For DH, the PPIs have saved his life. It's either that, or a Nissen's fundoplication surgery, and the stories we've heard about post-op problems with that convinced us it wasn't worth it unless the PPIs no longer work. I do agree that they are WAY over-prescribed though - like pretty much any medication these days. Everyone wants the magic pill. OOPs! Sorry, didn't mean to hijack the original poster. :-)

Back to topic: if you start adding natural fiber to your diet to fight this long-term, it really isn't that big of deal. Even a glass of prune juice a day, or a couple of prunes will help. But you gotta do it slooooow or yes, you will experience some pretty bad gas and indigestion. How long have you had C problems?
Living in the Republic of Texas minus a gallbladder, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


Keriamon
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   Posted 2/12/2007 2:55 PM (GMT -7)   
PPIs have been shown to repair the esophagus, which is very good--as in the case of TexasJen's husband. But then they never take people off of them, and that's when they start having problems. Restricting the acid in the stomach too much leads to problems in the bowels, because the acid apparently helps kill off bad bacteria, and appears to help you absorb some things, like calcium. For people with acid reflux, they'd probably be better off letting the PPI heal the esophagus, then putting a person on a weaker medicine, like OTC acid blockers. Then if it gets bad again, switch back to the PPI for a while. In other words, rotate on and off the PPIs, so you only use them whenever absolutely neccessary. Frequent endoscopies would help monitor the situation (just as people with Crohn's get frequent colonscopies to monitor their intestines). Something to talk to your doctor about, anyways.

TexasJen
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   Posted 2/12/2007 6:15 PM (GMT -7)   
One quick note about Barrett's: the PPIs just keep it from getting worse. Once the cells mutate after a life-time of damage, they won't ever change back. His case is about as severe as it gets without having outright cancer, so he probably will be on them for the rest of his life. Whaddaya do? LOL! :-)
Living in the Republic of Texas minus a gallbladder, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


Canyonbabe711
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Date Joined Mar 2006
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   Posted 2/12/2007 8:05 PM (GMT -7)   
I was diagnosed with Barrett's 4 years ago so I know all about it. Mine however has not shown up since then on 3 endo's and they keep looking. The Doctor I have gone to the last 3 times says I probably had short segment and it may have gone underground. I have an endo at least every two years now. I took the PPI's for a couple years right after but now because of the possibility of them causing more osteo I will not use them and find my heartburn is about the same or better with Tagamet. I have heard of Doctors that switch their patients from one to another every 3 months. I was one of those that had no real heart burn symptoms. I had bloating but never felt the burn so it was surprising. We did the first endo to see about the bloating and found the Barrett's. Yes, I would told once the cells had changed they would not heal so maybe I didn't have it but the biopsy said probable and it is really scary. I am too old to have the fundo but there is a lot of new stuff being done cause esophageal cancer is the fastest growing cancer problem in the US. AS for everyone I know being on PPI's my PCP says it is the disease of the week so to speak. I think now they are on to something else on TV but the Purple Pill made it a very "in" thing.

friendlygal
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   Posted 2/12/2007 9:47 PM (GMT -7)   
Today my PCP told me that I might have gastroparesis, a conditon where contents from the stomach take a long time to eliminate.  It is a nerve problem and it might be the cause of my bloating, constipation, and reflux!
 
Anyone else heard of it or been diagnosed with it??
 
friendlygal

TexasJen
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   Posted 2/13/2007 10:24 AM (GMT -7)   
Friendly - Gastroparesis basically means you are a "slow-emptyer" - meaning your stomach contents don't empty as fast as most other people. That certainly could explain your symptoms! It's my understanding that you'll need to really slow down your eating, and instead of the old "3 squares a day", eat small amounts throughout the day. What did the doc tell you about treatment? Are you going to have the gastric-emptying test? It takes a few hours, but doesn't hurt. I've had that done myself, so let me know if you have any questions and I'll try to help. :-)
Living in the Republic of Texas minus a gallbladder, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


TexasJen
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   Posted 2/13/2007 10:27 AM (GMT -7)   
Canyon - Wow! Are you ever lucky with your Barretts! My DH has it really bad - pretty much involves his entire esophogus, so he really has to keep an eye on it. Oddly, the one benefit of having so much damage is that he can't feel the "burn" any longer. On the "con" side, since he can't feel the pain of reflux, he has to have it checked annually with endoscopy. Bummer, but not much else to do at this point. You're so lucky tagamet works well for you. At least it's cheaper than aciphex! :-)
Living in the Republic of Texas minus a gallbladder, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


friendlygal
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   Posted 2/13/2007 2:29 PM (GMT -7)   

TexasJen, thanks for your post. my primary doctor told me to eat a high amount of fiber and miralax due to my constipation.  We don't know yet if I do have gastroparesis.  I definitely have a slow eliminating process, but it might not be a nerve issues, as is the case with gastroparesis.  If I have gastroparesis, I read that I need to eat low fiber foods.  So I don't know if my PCP made a mistake in telling me to eat high fiber foods, or if she just meant to treat the constipation.

I will go to a GI before deciding on a treatment option.  I will ask for the stomach emptying test.  What did your results show?


Keriamon
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   Posted 2/14/2007 9:45 AM (GMT -7)   
Friendly, did your doctor recommend Reglin for your stomach? My mother was put on that years ago because I think she was having a similar problem. I know she had a test where she ate radioactive scrambled eggs and they tracked them through at least part of her system. I've taken it on occasion when I have a meal that just sets in my stomach and doesn't feel like it's going anywhere. That happens on occasion to everyone, but it was worse back when my gall bladder wasn't functioning properly. The Reglin really makes me feel better because it's supposed to make your stomach empty out. The two side effects I know about are increased appetite (because now your stomach is all empty!) and sleepiness. The sleepiness might go away if you took it regularly, though.

MSN just had an article today about high sodium in our fast and processed food lives, and some inital research found a connection between reducing salt and reducing stomach cancers. That would seem to indicate, logically, that a higher salt diet might increase your chances for stomach cancers. I wonder if a lower salt diet might help you guys with the bad esophaguses? Wouldn't hurt you any to try. They also mentioned that we now get much more of our salt from pre-prepared foods than from us just using the salt shaker.

TexasJen
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   Posted 2/14/2007 11:35 AM (GMT -7)   
The radioactive meal is the gastric emptying test. I had a choice of eggs or oatmeal, so I opted for the oatmeal. Hmmm... which one do I want to take the chance on seeing again? LOL! Anyway, you eat the stuff, and periodic x-rays are taken to see what ends up where and in how much time. In my case, I'm a "fast emptier" from stomach to small intestines, but that's where the worst of my adhesions are. So all that food just goes BAM! right through my stomach and from there, hits several "dams" on the way out because of all the adhesions. Fast emptiers have their own set of unique problems as well. Not just the big D, but crazy swings in blood sugar that cause all kinds of weird symptoms. <sigh> Why can't we all just be "Normal"? :-)

One last note: reglan increases motility not just in the stomach, but the entire intestinal tract as well, which is why it is commonly used for nausea and can cause D in people who do not have chronic C. Most anti-nausea drugs act as a tranquilizer as well and have the usual side effects of drowsiness, whereas reglan does not.

Friendlygal - I certainly understand your reluctance to changing your diet until speaking with a specialist. If you go ahead and increase your fiber, just do it very slowly. So many people just give up on fiber because they do an overnight change in diet and there are just too many consequences. Fiber really can be a miracle for many people with both C and D - just have to go really slow with it and figure out the right dose for your own body.

Keriamon - I know reglan increases motility, and I am assuming that zelnorm does the same thing. Since I can't take zelnorm because of my adhesions, I have no experience with it. Do you know any more about it?
Living in the Republic of Texas minus a gallbladder, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


friendlygal
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   Posted 2/14/2007 12:14 PM (GMT -7)   
Keriamon, thanks for your info.  Did you/your mom take Reglan at a low mg?  Because I heard that reglan can cause neurological problems otherwise (like seizures).  But it's ok to take it at a lower dose...

Keriamon
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   Posted 2/14/2007 12:15 PM (GMT -7)   
I'm afraid I don't know much about it, other than I was told that it emptied the stomach quickly. I've never noticed that it gave me D, and I'm D prone anyways, so maybe that's a good sign for it! It definitely works to get that pizza or whatever that's been sitting in my stomach for hours to move on through. I would think, with you already having a rapid stomach transit time, you should probably avoid taking it right before or after a meal, but wait until your food has had time to get down into your intestines, and then let it move that through. I didn't know about it hurrying up the intestines too, but it does make sense that anything that turns the stomach on would turn the whole digestrive tract on. I only use it every great once in a while, but I think my mother used it more regularly. I don't know if she still takes it much anymore or not, but she's the one that put me onto it. She was the one who told me that it can make you sleepy and it makes you really hungry in a couple of hours! My stomach problems always seem to come at night--I wake up with dinner still sitting in there--so I take one and then go back to bed, so I can't personally attest that it does or does not make you sleepy, lol.

friendlygal
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   Posted 2/14/2007 9:29 PM (GMT -7)   
keriamon, i don't have a "rapid transit time."  it's the opposite, i am constantly bloated and my stomach is not emptying at all.  i do not produce bowel...

Canyonbabe711
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Date Joined Mar 2006
Total Posts : 1451
   Posted 2/14/2007 11:51 PM (GMT -7)   
I have a problem with this as well so need to keep meals small but when I do get the bloat and feel like it is not moving I take Motilium. It is not available in the US but is available over the counter in most countries and has been for years. Just no money to bring it to the states so I get it over the net. It has very few side effects, nothing like Reglan, in fact it is given in larger quantities to nursing mothers to help with milk production. My Dr. knows Itake it and said it is fine, safer than Reglan and far less expensive. Problem is that most doctors here don't know about it and can't prescribe it. It basically helps move food out of stomach better but not so there is a problem. You might check it out on internet. It is for gastroparesis.
 
TexasJen. I only hope they are not missing it but I guess since I am being checked regularly and it is coming up with no sign of it I am OK. I am going 2 years this time for endo but in past have had it every year.
 
REgarding the average person and PPI's I really think they are over prescribing them. Our stomach needs acid and when you go off the PPI's it seems you get really unpleasant problems until the stomach readjusts itself. I noticed this when I had the H. Pylori test and had to be off the PPI's for 2 weeks. It was worse than ever and then calmed down. Also somer research is showing that lack of acid is allowing other bacteria to flourish. Who the heck knows anything anymore. We are just guinea pigs when you get down to it. :-)

Post Edited (Canyonbabe711) : 2/14/2007 11:58:10 PM (GMT-7)

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