Constipation help!!

[Loulou079]

Hi everyone this is my first post here, I’m a 29F and been diagnosed with fibromyalgia since February, had the symptoms for over 5 years before diagnosis. Currently on cocodamol 4 times a day and recently started pregabalin 75mg twice a day. Since starting pregabalin I’ve suffered terribly with constipation, it’s currently been 5 days since I ‘went’, I’m in agony.

I am now taking fybogel morning and night, lactulose 30ml morning and night, senokot 2 tabs a night and dulcoease 3 times a day and still nothing! Just wind and stomach cramps. I’m so uncomfortable I’m going to ring doctors in the morning if I still haven’t gone. I even stopped my usual medication for a couple of days thinking that was the problem, but still can’t go to the toilet and my pain was horrendous this afternoon so have taken my usual doses. I’ve only had this since starting pregabalin, I’ve been on cocodamol for years and never had this problem.


Anyone else suffer with being constipated? Any ideas of what I can try please? I’m at my wits end I just want to go to the toilet! Any tips for relieving the discomfort? Will a hot water bottle help or make it worse? Any type of tummy massages I can do to help me go?
Thank you for reading my embarrassing post

 

[JayCS]

Hi Loulou, sorry to hear of such pain of yours.
It's not usually that severe a side effect of pregabalin, but it can be, and if pregabalin needs to be withdrawn, this is the most common reason; it stops if (= as soon as?) you stop taking it; the severity is dose dependent (study from 2010). So: Wdn't it be best to stop it or at least go down to once a day? Changing to gabapentin?: Pregabalin was developed for actually less sfx, but some people still do better on gabapentin. Personally, sfx this severe are a no-go for me. (But consequence for me: no meds at all, and only some herbs & supps.)
Laxatives can increase bloating, cramps and gas.
The best help for it I've heard of is psyllium (with a lot of water), but you won't have that at home.
Second is - like you're asking - a hot water bottle. Best over the liver. (Right front abdomen.)
Drink a lot. Veg, fruits (raspberries, figs, dates, passion fruit), flaxseed and beans give roughage: For me it'd definitely be flaxseed.
Tummy massage: Yep, knead clockwise (looking down: 'anti-clockwise') )with fingers or fists. Or vibrate with two fingers on painful points 3' inches around your navel, anti-clockwise, starting top right (looking down: "left"'). Exercise, easiest: walk 40' a day.
Hope there's something here that helps...

 

[sunkacola]

I suggest you stop taking the medication that is causing the constipation. Rather than take more and more medications to counteract the bad side effects of one medication, back off on all of them and try something different. There are many pain medications and some of them have bad side effects for some people and not for others. It's clear you need a different one.

Also, try doing the things that you can do that will help you manage your pain without medication. I am not saying don't take any medication, but if while you are taking pain medication you start doing the things you can do in improve the level and frequency of pain you may find that you need less. When it comes to medications for pain, less is always better when possible.

 

[Jemima]

Hi Loulou,

Welcome here, and don't worry about embarrassment! I'm sorry to hear of what you're going through. Magnesium citrate can help relieve constipation quickly, but I'd check it isn't in anything you've already taken before trying. I heartily agree with JayCS on drinking lots of water - very important - and with both him and Sunkacola on stopping the pregabalin. Constipation can cause real problems if left too long, so enduring the pain and finding a new tactic seems like a better option. If you see your doctor, I hope they're sympathetic - and that you get relief soon! Good luck

 

[aclarkwhitman]

Oh I’m so sorry! I have the opposite problem. I finally asked for a referral to a gastroenterologist. I can’t see him until after the first of the year (I’ve got to change my insurance plan) but I’m hoping for some answers. Maybe a specialist could help you.

 

[JayCS]

I have the opposite problem.

Yup, that'd be me... neither colonoscopy and gastroscopy found anything, so we concluded my elimination diet is doing its work. The gastroenterologist's nutritionist recommended psyllium to me, it also works a treat for diarrhea, however then with only a little water. Before I'd used S. boulardii, also not bad. Now I've got all food triggers sorted out since last year, I don't need either any more.

 

[Badger]

This side affect along with brain fog has been a problem for me. Prune juice helps but some days it takes a few cups. I have movicol sachets on prescription for constipation but it tastes awful and can cause nausea. Two sachets a day seems to help but it's a worry. Early during the first lockdown I ended up without Pregab for the best part of two days. Among withdraws of pain and insomnia there I had a very loose bowl. It made me realize just how constipated I must be.

The withdrawals eased with Pregab but the brain fog was worse with forgetting words and constipated once more. I'm tempted to ask if I can try a lower dose to see if the side affects improve while still giving pain relief for the burning forearm pain. @Jemima I've got myself some Magnesium citrate in case it helps.

 

[Jemima]

I hope it does, @Badger . I'm sorry you're having to navigate such a balancing act.

 

[JayCS]

Magnesium citrate

Magnesium citrate can help relieve constipation quickly

Ah, the several - for me 'bad' - laxative magnesium types are what got lost floating around in my head, good on ya! My notes:

• Mg citrate for constipation; perhaps calming: depression & anxiety.
• Mg oxide (in milk of magnesia): heartburn, indigestion, and constipation, migraines.
• Mg chloride: heartburn, constipation, replenishing. Topically for muscle soreness.

 

[sunkacola]

Oh I’m so sorry! I have the opposite problem. I finally asked for a referral to a gastroenterologist. I can’t see him until after the first of the year (I’ve got to change my insurance plan) but I’m hoping for some answers. Maybe a specialist could help you.

I had chronic GI problems most of my life, all of which were improved about 85% when I went gluten-free. Not saying that will work for everyone, or for you, of course. But examining your diet is the first step. Cut out all of one thing like gluten or dairy. Read all labels to be sure you don't ingest anything at all with that ingredient in it, do this for a month and see if things improve. If not, try cutting out something else. this you can do on your own, while waiting for the doctor appointment, and it can't hurt you.

 

[Badger]

Hi everyone this is my first post here, I’m a 29F and been diagnosed with fibromyalgia since February, had the symptoms for over 5 years before diagnosis. Currently on cocodamol 4 times a day and recently started pregabalin 75mg twice a day. Since starting pregabalin I’ve suffered terribly with constipation, it’s currently been 5 days since I ‘went’, I’m in agony.

I am now taking fybogel morning and night, lactulose 30ml morning and night, senokot 2 tabs a night and dulcoease 3 times a day and still nothing! Just wind and stomach cramps. I’m so uncomfortable I’m going to ring doctors in the morning if I still haven’t gone. I even stopped my usual medication for a couple of days thinking that was the problem, but still can’t go to the toilet and my pain was horrendous this afternoon so have taken my usual doses. I’ve only had this since starting pregabalin, I’ve been on cocodamol for years and never had this problem.


Anyone else suffer with being constipated? Any ideas of what I can try please? I’m at my wits end I just want to go to the toilet! Any tips for relieving the discomfort? Will a hot water bottle help or make it worse? Any type of tummy massages I can do to help me go?
Thank you for reading my embarrassing post

I hope that you can get some relief soon, it's awful not being able to go, it would be great if something helps in the early days of taking Pregabalin and hopefully the Pregab will help your Fibro too.

 

[JayCS]

Skimming another set of notes, it might help to add important Mg dosage-information for you @Badger and praps @Loulou079:
You may need/want to try a more than recommended to get the laxative effect, spread over the day, best apart from meals.
It'd work inside of 1-4h and if it doesn't, I'd try more, but not for too long (praps a few days), then at the latest ask a doc.
The amount of "magnesium" stated may be gross or net (the magnesium itself is only 10-30%). If it's pills, you'd need >400mg/d of magnesium - that might mean 3000mg if the amounts stated are gross. Regarding citrate: If you have heart or kidney problems you have to drink a lot (good anyway...), and might not be good to try it if you have problems with histamine. I can't find the ratio for citrate anywhere, I'd be interested the amount details on your stuff (whether mg or mL).
On the sidelines: there's a di-basic and a tri-basic form of citrate (=TriMag, less laxative), the bioavailability of both varies tho (i.e. different sorts can be differently effective).
Further forms good as a laxative: ascorbate (= buffered vitamin C at the same time), hydroxide, sulfate (Epsom salts).
And as regards citrate as well as oxide & carbonate: They bind stomach acid - sposed to anyway. Wdntve thought. But I've got the carbonate in with my rhodiola, so that's OK/good.

 

[Badger]

That's very interesting, mine are Magnesium Citrate 30% 250mg capsules. It says they use "Magnesium Citrate buffered 30% which provides 30% Elemental Magnesium. Each 250mg capsule provides 75mg of elemental magnesium (20% NRV). Suggested dosage is from 2 to 4 capsules daily."

 

[JayCS]

"Magnesium Citrate buffered 30% which provides 30% Elemental Magnesium. Each 250mg capsule provides 75mg of elemental magnesium (20% NRV). Suggested dosage is from 2 to 4 capsules daily."

Ah, thx for satisfying my curiosity: 75 of 250 is exactly that 30%, so a bigger portion of Mg than in the malate and glycine forms I/we've been using, which might be one of the reasons for it being more laxative.
4 cps = 300mg, much more than in my 4 cps, but if it's not helping, I then wouldn't worry about increasing from there to 10-11 capsules, i.e. the 800mg suggested above for a certain time: Looking at the scientific evidence, 350mg/d is the amount set for men (300 for women), which does include food, however "There are few reports to assist in setting ULs [upper limits] for magnesium, as it has not been shown to produce toxic effects when ingested as naturally occurring magnesium in food. Diarrhoea was selected as the critical endpoint as it is the first sign of excess intake".
If you are worrying, I would as I suggested take psyllium additionally or instead.

 

[Badger]

I really appreciate the detailed posts, it's excellent for future reference, keeping up with things and retaining info can be difficult for me. I will be reading up on psyllium