Posted 3/1/2019 12:07 PM (GMT -6)
Juliette and Jake:
A turning point for me in living my best life with chronic illness was coming to realize that I could not count on standard medical care nor physicians to hold the answers or fix to my plights. I came to realize that my life was fundamentally altered. I came to to look to myself to find different ways and means to manage symptoms and give me a better quality of live.
I think you will both come to find that the best answers and solutions to bettering your intestinal function and reducing pain/intermittent obstruction will, ultimately, come from within yourself.
Jake . . . Your symptoms are suggestive of multi-modal origins. An amalgamation of inputs from your health history.
1. Chron’s and effects of inflammation (strictures, scar tissue, absorbtion of nutrients, pain).
2. Post-chemotherapy collateral damage (neuropathic pain, neuropathic functional slowing of the intestinal tract with intermittent pseudo-obstruction).
3. Post-surgical effects (scar tissue/adhesions, vagus nerve trauma)
4. Effects of opiates on intestinal slowing
Senna is a stimulant laxative. It acts to stimulate a bowel movement by irritating nerves of the large intestine. Senna is like teasing a resting cobra snake. The snake awakes, mad, and lashes out. Senna irritates the intestine and causes the smooth muscle to react in a forceful all-in-one contraction.
But I can understand why you feel compelled to use Senna. An intestine that is functionally underpowered or acting in a hapazard mode of contracting and resting can bring distressing symptoms of constipation, bloating, and a large volume of retained decal material. It extracts an emotional toll. You lose faith in your intestine and question each day if the day will be a day of diarrhea or constipation. Your intestines begin to rule your life.
With possible neuropathy from chemotherapy affecting your intestinal motility, I can see how you may need a “big gun” effect of Senna to get things moving along.
Miralax and MofM are a more gentle approach for long-term bowel management. Miralax is used as a full fledged bowel prep, so you can be assured that it will work to keep foodstuff moving along. Key is to use Miralax or MofM on a daily basis. Every day. You may need to use 2 packets of Miralax a day or 3-4 tablespoons of MofM.
I have an ileostomy and yet still use 1/2 packet of Miralax a day to keep my intestines functional. I am on a fairly high dose of opiates for pain associated with avascular necrosis of my hips. I aim for a consistency of chocolate syrup for my ostomy output. If I see things slowing or my output thickening, I add in more Miralax for a few days.
I will admit that I have had to make more substantial changes to what and how I eat then most people would accept. I was not a big “foodie” to begin with so that made some of the diet changes easier for me then will be the case for most people.
Basically, I subsist on a predominantly liquid diet. Smoothies, chocolate milk (my favorite), creamed soups, hummus with a soft pita bread, custard. What solid foods I do eat are soft (banana bread, pasta with sauce) and of a small portion size (1/3-1/2 cup).
Yoga and stretching is a daily routine. It serves as a form of intestinal massage.
Grape juice (100% juice, not a juice blend) is also helpful. Grape juice has flavonoids that thin fecal consistency and also promote intestinal smooth muscle. 100% grape juice is a staple item in my kitchen cupboards.
Living with intermittent intestinal obstruction/paeudoobstruction is not easy but it is doable. Look at your symptoms as they appear, look for trends and patterns that may have precipitated the distress. Keep a barometer in monitoring your bowel movements and consistency. Act proactively to quell an increase in distress. That is, add in more Miralax or MofM, ease off of eating solid foods and focus on hydrating with clear fluids, stretch and move, take a warm shower or bath.
I think, with time, each of you will find a pathway out of the woods - personal insights and collaborating with your physicians will give you tools and ideas to easing the distesss you have today.
Best wishes for a better tomorrow,