Myelopathy and constipation

@birdman518 Hi Mitch. The timing of your question comes right after I've had a diagnostic colon screening. Naturally, it makes me wonder if that is something that would benefit you in the diagnosis of the cause of the constipation. The other factors can also be how much water intake you have because water is absorbed in the colon when the body needs it. If your intake is not high enough, it causes constipation. You need enough water for filtration in the kidneys. There are dietary factors too, and my experience is that too much cheese can create constipation, while eating good fibrous foods like sweet potatoes can help it. Sure, there can be a spine stenosis component that affects it too. Stenosis can also cause both bladder and bowel incontinence. Have you tried prunes or prune juice or psyllium fiber? Those are things our doctors have recommended. Fiber helps hold water content as the food passes through the digestive tract.

I'm sorry I can't answer about the safety of taking laxatives. That is something you should ask your doctor and should be answered by a medically trained person.

What is your normal diet like?

Jennifer

Jennifer, I get regular colonoscopies (just had one) and there is nothing there that I believe would cause this. I eat almost only food that we prepare, and also try to drink lots of water. I *do* eat cheese...
My main concern is with the possibility of nerve damage causing this, and whether the laxatives are harmful. I will certainly reach out to my PCP and/or spine surgeon, but online, I have not seen any "solution" to the myelopathy-generated constipation.

@birdman518 Mitch, after I responded to you, I had another thought. Could the constipation be related to any of your medications? I know that pain pills are notorious for slowing down transit through the colon causing constipation and I had issues with that when I was on them. That is the reason I did not take any pain meds after my spine surgery, and because the medication nauseated me. It was better just to relax and accept it as healing pain. I wasn't sure if you were taking them. Other prescription medications can cause this too of course. You may be right about it being spine related, but there can be other causes. I know you've been through a lot, and I hope things improve for you.

Jennifer

I have herniated lumbar discs, thankfully resolved and causing no problems, from years ago. I do remember that I didn't feel constipated at the time but always evacuated stuff better immediately after physical therapy. I speculate that tight muscles in the lower back maybe affected peristaltic motion in the GI tract or something as the body has so many ways to compensate for anything out of whack.

Jen is right about meds for pain-relief, or muscle relaxants for that matter. Check their side effects as constipation is a common one.

January is relatively recent so things might still be finding a new equilibrium. My back took a good year of P/T, acupuncture and other stuff I tried before I realized, one happy day, that I hadn't 'noticed' lower back issues in a while.

I have herniated lumbar discs, thankfully resolved and causing no problems, from years ago. I do remember that I didn't feel constipated at the time but always evacuated stuff better immediately after physical therapy. I speculate that tight muscles in the lower back maybe affected peristaltic motion in the GI tract or something as the body has so many ways to compensate for anything out of whack.

Jen is right about meds for pain-relief, or muscle relaxants for that matter. Check their side effects as constipation is a common one.

January is relatively recent so things might still be finding a new equilibrium. My back took a good year of P/T, acupuncture and other stuff I tried before I realized, one happy day, that I hadn't 'noticed' lower back issues in a while.

@birdman518 @callalloo Physical therapy is a good suggestion. If someone sits all the time, the hip flexors get tight in front, and this can affect the colon when the body gets tight around it. When you are recovering or in pain, sometimes it's difficult to walk. My PT has worked on me for tight hip flexors. If you press your fingers right inside your hip bones, you'll feel the hip flexors. You can push on those muscles with something like a cane or elbow, or lay on a small ball. It's best to have 2 balls the same size if you are going to lay on them because it's possible to throw the pelvis out of alignment (like twisting one hip forward, etc) if you have that movement in the SI joints. Of course all of this should be discussed with a physical therapist who understands your post surgical capabilities and what exercise or stretching is safe for you to do.

Mitch, do you have a physical therapist that you work with?

I did PT for my nerve palsy immediately after my surgery, and did more or less get the use of my right arm back (it still hurts a bit). I have just done 4 sessions of PT including dry needling, aiming for pain relief, but this has not helped. I plan on continuing the recommended PT exercises, but cannot keep seeing a PT indefinitely.

@birdman518 Mitch, I made the suggestion thinking possibly that you may sit a lot instead of being up walking around, and for general information for everyone that this can be an issue that tight hip flexors can cause constipation because it tightens up the wall of the abdomen which is supporting the colon and all the organs. I have had tightness from my neck to my pelvis that has affected my ability to breathe by restricting my rib cage and it tends to pull my hip bone forward on that side. That of course affects my back and squeezes my guts. I've learned that keeping everything aligned and where it should be helps a great deal. That is completely separate from spine myelopathy. There can be more than one cause for these symptoms. Our bodies were meant to move, and can get stuck when we don't move enough. If your hip flexors are tight, it is hard to get your trailing leg to stay back when you walk, and your strides become short. That happened to me after breaking my ankle because I just couldn't walk for months. This is just simple stretching. A physical therapist is always good for information and asking questions about what are safe things for you to do. Only you and your medical providers know what is best.

I haven't tried dry needling yet, and I'm not sure I want to do that. Have we discussed myofascial release before? I talk about it a lot on Connect and it has helped me a lot. That is another way to stretch tight tissue and get the body realigned and moving again. Here is our discussion:

-Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
Jennifer