Slow gi motility with severe constipation

I’m doing much better lately. I will say the Covid vaccine I got yesterday really made me go good!

Did you ever research the Vibrant Capsule? I’m looking into it. I have severe lack of colon mobility also. My regimen works BUT only if I do the same thing every day and take the same thing everyday at the same time. About 1200 mg Mg citrate powder with one cap miralax at 7:30 pm. I also add to this mixture a bit of pink salt and some nusalt which is Na/potassium. You have to be careful with electrolyte imbalance using mg citrate and mitalax and linzess. I always have a low sodium level and since started the salt I’m at the low end of normal. Reason is I have to drink water all day and have to take 7 cups of warm water with Linzess to work. So Linzess with the water at 5 am then breakfast at 5:30 am. Most days I will have a soft stool but if I sleep in just 30 min I won’t. I’ve missed my chance and then have extreme bloating in left mid to lower abdomen in my sigmoid colon. To bed at 9 pm. I also started taking one 2.5 gummy melatonin before bed which at low dose is supposed to to help increase peristalsis. I also take vitamins, extra D3 with K2 and extra B1 and B12. I don’t drink alcohol or smoke and am physically active and eat very healthy. Lots of fruits and veggies and small mount of meat. No white bread or white rice. For carbs,I will have a 1/2 cup of brown rice or sweet potatoes with dinner. For breakfast I eat one piece of toasted simple mills legumes sprouted bread with a thick layer of almond butter and some honey. I make my own yogurt using lactose free whole milk with a starter of L reteuri and a broad spectrum probiotic in a lactose free yogurt like Fage best self plain lactose free yogurt. I eat this daily and sometimes drink lactose free keifer. I’m not lactose intolerant BUT do to lack of movement in colon when I drink regular milk since my feces sits it brews if you know what I mean. Linzess is also expensive for someone on Medicare. Big pharma ripping me off because than can, no generic. . I have to have a Premium drug plan that cost 125 a month just the drug plan and then pay the Linzess cost on top of that but it covers the best. Better than paying 700 a month. So instead of 8,400 a year it’s 1500 and I think the most I will pay out of pocket is 2000. I am also in another tier 3 or 4 drug so I meet the 2000 fast. I’m not rich and not working, just retired, severe arthritis back and hands. That’s why is upsets me that only the rich have access to good quality health care. I have avoided an obstruction and a colostomy by the hardest because I’m extremely proactive. I have been researching the “ Vibrant Pill”. I live in the Houston area but the Dr that does this is downtown and I’m not driving there! Traffic is horrrible and dangerous for a 65 year old who has trouble seeing signs due to lens replacement 4 yrs ago. I plan to make an appointment with “my” GI Dr and discuss this with him. You take a pill 5 days and off two. There is a Pod which you place each pill into to Activate it then take it orally. It vibrates through the digestive process and stimulates peristalsis. You add this to your medicinal regime and if you see your having BMS in the normal or higher range you gradually take yourself off all the meds you take for constipation and just use the vibrant pill and take something extra if needed. Of course there is a Preauthorization your Dr has to do and some Drs well most are to frickin lazy to do it but if they do and it’s approved by insurance you will pay 69 dollars or less. If Insurance doesn’t approve but your Dr does you pay out of pocket 89 dollars per month. I pay that and more for my Linzess and all the supplements I have to take. My decreased peristalsis is caused from scar tissue on my intestines from many years of severe endometriosis and after my hysterectomy they only put me on estrogen without progesterone so it just grew and grew and caused scar tissue on my colon . Long story!!!!! Inept Drs! Sorry for the book but I feel your pain. FYI not everyone is a Candidate for the Vibrant pill. Certain conditions in your gut and other disqualify you.

How did you discover the cause of scar tissue?

Surgery at age 42 total hysterectomy and some removal of adhesions but couldn’t remove all. The stupid thing is after the surgery they slap an estrogen patch on me. For 25 years they only put me on estrogen after for hormone replacement. When you have endometriosis you will continue to grow endometriosis inside your abdominal cavity and other organs which is fed by the estrogen. Estrogen alone is a no no for endometriosis! The endometriosis grows and dies and then scar tissue develops in the abdominal cavity and can even grow Inside outside your intestines and other organs. I had it all over my intestines. So after 25 more years on just estrogen and severe constipation I had vaginal bleeding. Thought I had cancer so Surgery again. Remember no uterus and no ovaries, 25 years post total hysterectomy . It was endometriosis again and bleeding from abdominal cavity seeping through my vaginal cuff. So because I did research I found out that you need to add progesterone to your hormone Regimen if you have this issue. Three days after starting a new hormone with a little estrogen and progesterone the bleeding stopped. The damage was done. The growth and dying of this endometriosis left me with scar tissue, adhesions. Yes you could technically do another surgery a surgical procedure called Lysis of adhesions BUT since everything is stuck together you risk cutting into part of the intestines or bladder or ureters etc and cause major damage and death and I don’t want a colonoscopy. I blame ignorant gynecologist. Nit their fault I have this but they surely did t treat me right! Now I’m 65 so I’m assuming they would have known this back then but traditional Drs sometimes only treat the majority,not the exceptions like me. . I had endometriosis since the start of my menses and it just progressed. Painful heavy periods with large clots(TMI!) My intestines shut down gradually meaning more scar tissue less movement. So more research and found the Vibrant pill about 1.5 yrs ago which very few GI docs will consider. I guess they see it as snake oil. It’s not a medicine but a medical device. I live in the Houston area and I found only one Dr and it ain’t my Dr and it’s in the downtown where I don’t drive . Oh of course insurance doesn’t pay and unless your rich you can’t afford the monthly cost. But consider I have to pay for a premium prescription plan through Medicare to somewhat cover Linzess for my gut and it’s a lot even after insurance and I have a 2000 deductible and still have to pay for the Linzess and just my prescription plan is 124 a month. Talk about big Pharma rip off! Linzess isn’t even that effective. I take miralax and magnesium every night. Also if I don’t go for a couple of days I do a couple Trifala capsules which is an Aruvadic herb and helps., but since it’s a kinda La stove can only take it periodically because it will become ineffective and make your constipation worse. I had CT’s and there is always a large distended amount of poop around the end of my transverse colon . The fecal matter doesn’t even get to my sigmoid. The Linzess helps force it down. I’m so done that I’m willing to try this. If it works I’d stop my expensive prescription plan. Remember 125 a month and a two thousand deductible so I have to put out 3,500 a yr and that ain’t including the med cost. If I wouldn’t be proactive I would have had my colon removed from obstruction already! All about the money. The cost of Vibrant if insurance denies it after submitting a preauthorization is 89 a month. Most will deny and you have to be dirt poor to get help with the cost. I have other tier three drugs too so I’m medicine poor, and insurance poor, LOL!!!! Just so tired of it. I’m blessed, just venting. I’m sure you feel the same, sorry to say!

@bank can you please tell me how I can get a gastro Dr to treat me for outlet disfunction, or ileus, I've been diagnosed with both I have all the symptoms, but my gastro Dr tells me to drink miralax 3 times a day??? I can do a whole bottle and move nothing but liquid, Ive told her numerous times my symptoms, and she says take Amatiza for 2 weeks!!! I don't have 2 weeks, I just went 24 days without a bowel movement, thank God I started going, I had lactic Acidosis twice, they did sepsis blood work ups, when they reported the ileus in my xrays they didn't tell me what it was they released me from the hospital and I read it in my clinical notes??? My gastro Dr says they go away!!! but I haven't gone again since the 24th, I've seen 3 gastro Drs and 2 of them refuse to treat me because I'm unresponsive to bowel stimulants???? well yeah if you have ileus or outlet disfunction you are unresponsive to bowel stimulants??? What should I do??? My PCP Dr is no help, He said he doesn't know why I'm being pushed off, and not listened to. I have a appointment with a new gastro Dr tomorrow, I'm praying for help. I went to the ER 15 times in 3 weeks I was in so much pain, My aunt is a nurse she said I'm lucky to be alive. I did take opiate medicine for years but stopped in 2017, I have severe anxiety, and that was before this health issue started 4 months ago. Can someone please give me some directions on how to get help

@cpeffer: I am so sorry with what you're dealing with, as I can sadly relate 100%. I had a full pancreatectomy, spleenectomy, 60% of my small intestines removed, wedge section, gallbladder removed, and more. Because of the no pancreas, and new "plumbing", I am not unable to have a bowel movement of any substance. Just liquid comes out if lucky. And that is with me taking every night (it's been many variations of amount, time of day, how long I use each daily wise): 2 colon cleanse, 2 stool softners (again I've tried none - 4), fleet suppositories, every other constipation liquid to oral, with plenty of water. Then injection Relistor 12mg every morning after warm lemon water min. 8oz, and/or coffee. I am so unbelievably backed up, I put 20lbs on. When this first started after the big islet cell transplant and aforementioned organs removed, the routine listed about would work, although it was never formed, but at times big substance piles. Never ever filling empty, but I did lose 15-20lbs a week if bm's were successful and frequent. Now nothing works! I have tried every possible remedy/solution you can possibly think of, read about, or anything recommended by anyone. I also am in desperate need of help, and I am left with zero GI docs (tried many) that have anything else to try. In fact, I've had perianal abccesses which ended up getting cut open and once open in the OR it had to be sliced even bigger bc of the amount of infection. Additionally, I had/have an anal fistula that has now closed, trapping in all the bacteria/infection bc I could not receive anesthesia due to the brittle diabetes, no glucagon from no pancreas which can only be controlled with dextrose via a central line, but moreover bc I can't stop getting sick, pneumonia off and on, and aspirated pneumonia bc I vomit 10-20+ times everyday. I desperately need a colonoscopy (never had one and now 42; I've been dealing with this all for almost 10 years), but can't get one because I can't empty my bowels.

If I find any remedy or solution(s), I will 100% share them with you! Please feel free to ask me anything, and if possible could you please and kindly share any help with me too? Many thanks in advance!
My Best,
Ryan L

Where is your outlet obstruction? Like where your stomach meets your small Intestines?????? Have you had a CT or MRI, an EGD and Colonoscopy and a Sitz study( tells how long it takes to pass the radiopaque pill). There are more test also. I have to take miralax mixed with magnesium citrate every night at 7:30 pm and without fail I use Linzess 290 mg daily at 5 am with six glasses of very warm water. Half hour later I eat breakfast. I usually have a BM 45 min later. I also drink lots of water and eat high fiber and chew my food well. I also take digestive enzymes. If you do alcohol or any drugs or even meds for nerve pain that will hault motility. I have severe arthritis in hands and low back and some nerve compression in back. Dr wanted me to take gabapentin( neurontin) 600 mg three times a day. Three days on that and I was major stoned and I didn’t have a BM until I was off of it for a week. Now I only take 100 mg in the morning and Celebrex . I’m sort of glad my intestines are slow because it has prevented me from using pain meds and becoming addicted. I would go ahead and take the Amitiza as instructed but maybe in addition try a bottle of Mag Citrate with some ducolax. Check with your Dr first!!!! It can cause major dehydration and electrolyte imbalance and other problems but they use this to clean people out for colonoscopies. Drink Gatorade after doing this. Only do this as instructed by your Dr. Also eat a soft diet, low residue until you get unblocked, or just liquids, but if your completely blocked you will have nausea, vomiting, pain, distention don’t eat anything and go to ER. I also use an abdominal massager before and after every meal. If you truly have an obstruction with multiple ER visits you need to have more test and possibly time for a GI surgeon. Not always the answer and if they remove the part that’s blocked, scar tissue can form and other issues can arise but sometimes it solves the problems. Drs today are a different breed than they were in the past( dumbing down), lower standards. Can’t critical think without a million test, no ability to listen to the patient and evaluate signs and symptoms. It is “ok” for you to be proactive about your issue; you know your body.

bb. yeah they have done no test but CT and X-ray, I can't get any of these GI Drs to help me I can do msg citrate doculax senna miralax, nothing but liquid comes out. I might push out a small piece but it shuts off, it feels like it stops in my colon by my bladder, but my right upper quadrine is always full of stool too. 2 colonoscopys neither one worked, had stool in me still. This motility specialist keeps telling me the same thing and it hasn't worked for 3 weeks.

@bb03 BB I drank a bottle of magnesium citrate 4 ducolaxe and 4 caps of miralax, one 3 inch piece came out now just water, I haven't had a BM since the 24th, well a little bit on the 1st. But I made an appointment for my specialist in Hershey PA on Monday. I'm on a liquid diet so I can hopefully work Monday. What test can I ask for to tell me what part of my intestines aren't working??? I can feel stool move and then a tightness in my lower stomach by my bladder and it just stops dead. How are you doing??? I feel bad even telling you about my problems, but I'm headed for an obstruction, I can't believe when I went 24 days that it didn't happen. I really don't want a colonoscopy bag but if I can stay alive I'll take it. They've done sepsis blood work on me twice and there was not growth in 120 hours. But these ERs don't want to do anything but enemas and Golytley, and if you've ever been diagnosed with ileus you are not supposed to do Golytley. I hope you are doing okay. Please tell me what to say to this gastro Dr. She's just not listening to me.

Hello again,
A gastroenterologist will want to do EGD and colonoscopy, CT scan, will assess drugs your on. I had what they called a Sitz study which was out patient and I went to the radiology dept at a hospital and had a series of x rays after taking a special radiopaque capsule and went back daily to have x rays to see how fast I digested the capsule. It never got into my sigmoid colon. My problem is scar tissue on my intestines inhibiting peristalsis( movement of your intestines). They may also order a barium enema, look it up. All the test in the world won’t help your immediate problem. If you have an ileus you could be admitted to a hospital no food or drink and IV fluids, blood test and maybe a tube inserted into your nose all the way into the esophagus to your stomach. They will do x rays/ CT. If you have a complete instruction possible surgery. You need a good Dr who will listen to you. You may need to seek out a stomach/ intestine surgeon. They have seen the inside of people and from experience they would understand where you are coming from. Before I took Linzess I pooped like a rabbit and almost blew a carotid artery from straining LOL and I was a vegetarian. I was super active, drank lots of water and extremely active so no earthly reason for it. No drugs or alcohol. I had scar tissue and still do. I had surgery lots of scar tissue from endometriosis was removed but not all. It’s a long story. Did the Dr give you the ok for the Mg citrate and ducolax? I feel your pain and your desperate. I’m sorry you are going through all this. Even a GI Dr if they never walked out walk don’t quite get it. Let me know how your doing.