Questions and Advice
My situation may be unusual, but I’m just looking for opinions and suggestions.
Approximately 18 months ago, I noticed my blood pressure rising to very high levels despite several medications for control.
I went in to see my PCP and he decided to try some different meds to help me out. About the same time I began losing weight and becoming extremely constipated.
He suggested fiber and the standard remedies that help for some people.
He suggested I consider a colonoscopy to rule out the “bad” stuff meaning colon cancer or other cancers.
I had a colonoscopy done in 2022 by the same GI I had been seeing for regular following for the previous 10 years.
The results were normal except for diverticulosis which isn’t unusual in a 69 year old male.
His suggestion was to continue on Mirilax and continue moving forward.
I have had occasional issues over the years but only for short times.
PCP kept pushing water, fiber, diet, and all the standard things people are told to try.
My diet actually had improved greatly and is now the best it’s ever been in my entire life. My wife and I made a commitment to do the best we could
in that area.
For the next 7 months I tried everything I could to improve the situation including pelvic floor physical therapy, exercise, and many trips into the PCP for regular lab work and more ideas.
Finally I found a highly regarded colo-rectal surgeon who viewed CT scans and felt I had a “stricture”.
More bowel tests including a gastro graffin enema, simoidmoidoscopy , and finally she felt she needed to view the exterior of the bowel using laparoscopy. While most of the tests were “normal” she felt my symptoms were to major for slight abnormalities.
During the laparoscopic surgery she removed the sigmoid colon and hoped that would improve my situation.
I healed and seemed to be a bit better but now after another 9 months and a variety of laxatives, I’m no better and actually very very discouraged.
I will see her in a month, but short of colostomy or ileostomy, I’m not really sure there is more she can do.
I often need enemas to keep things moving and of course there are big problems with overuse of them as well as the osmotic laxatives like MOM and Mirilax.
Frankly, it should not be this hard to achieve regularity again.
So bring on your ideas and opinions.
Interested in more discussions like this? Go to the Digestive Health Support Group.
I am definitely not a physician, but wonder if you have had your thyroid checked? Slow metabolism is happening; could that be a partial answer they could address with synthroid-type medication??
I am waiting for results due to some similar concerns but not tied to the bowel.
Thyroid was the first thing checked. Perfectly normal.
Welcome to Mayo Clinic Connect!
How is your BP now with the new medication?
Any reason for your weight loss?
Are you still losing?
We have many members that struggle with constipation. I don’t know if you found those discussions here.
I’m surprised your surgeon removed the sigmoid colon. Is this where you had strictures?
Several members have had relief using Prunelax.
Have you gone through a test measuring food transit time in your intestines?
There are a couple of prescription medications that can help with chronic constipation- Amitiza and Linzess. If your constipation is due to slow motility there is a fairly new medication called Motegrity.
Are you seeing both the GI and colorectal surgeon?
Please post again after your follow up visit?
I'm a 68 y/o male and have been dealing with severe constipation for the last two years. I'm active (in the gym 6 days a week, including 2 days with a trainer), drink a lot of water, sleep well, eat well and a lot of fiber. tried Linzess, nada. Now I'm on Motegrity. Nada.
Now I take Miralax once a day, at night. Every few days, I need to take Dulcolax (bisacodyl) to get all this moving. The Miralax keeps everything soft and the BMs after the Miralax/Bisacodyl combination are regular and soft – for one day.
I know I shouldn't be taking as much bisacodyl – but nothing else works. Also, to my knowledge, there are no studies that prove taking too much bisacodyl will cause "lazy colon".
I don't recommend this for anyone. If anyone has an idea on how to improve regularity, please respond, and thanks.
Thank you for reaching out @heyjoe415. When do you take the biscodyl, what dose, and how often? How about the Mirilax dose?
How is your diet and how much fiber?
Finally, any history of constipation and what does your physician say?
Again I take Miralax once every day, once capful as directed. About every other day, I take 6 bisacodyl at about 1AM so it works overnight.
I probably consume about 25 g of fiber/day. I eat cereal in the AM, usually cheerios topped off with All Bran. And I eat prunes every other day.
Dinner always includes a lot of raw vegetables – sweet peas in the pod (raw), baby carrots (raw), and cherry tomatoes.
Thank you. So 6 tablets would be 30mg. I go to bed much earlier.
Diets is very similar to ours.
Except for prunes.
The docs are at a loss.
Thanks for replying. I go to bed at 9am, but get up at 1am to take the bisacodyl.
And yeah, this is not a Dr. recommended program and I don't suggest anyone else try it without talking to their Dr. But as you note, the Docs are at a loss here.
Funny what you say about prunes. My wife hates em, I like em actually.
I had success with Linzess 290 and a colace 100 mg daily Good luck
I’ll answer your questions:
BP improved from large weight loss. Stable now.
Stricture was seen in the sigmoid colon and the surgeon “labored” over whether to remove it.
Linzess trial was not helpful.
I have not had sitz testing or anal manometry but surgeon felt that would not be helpful. Rectal exam and “squeeze” felt normal to her.
I’ve had luck with MOM and lactulose but as you know they are harsh and hard on the kidneys.
I’m currently using lactulose at 30 ml per day but it’s losing its effectiveness. I used Mirilax for many months before switching to lactulose. Never tried stimulants like biscodyl or senna.
Yes, I have heard of Motegrity.
The GI basically told me that there was nothing he could do for me after I informed him the Linzess was not helpful.
This problem has really had a hard affect on my life and my family. They don’t understand what has happened and why.
The CR surgeon basically told me that “it would be easier to treat me if I had colon cancer as I know what to do with that”
It’s a nightmare to say the least.
Perhaps wearing a bag would be a better option although that’s no easy path forward either. Nor an ileostomy.
I never thought my retirement would go this way however I have had 7 great years.
Let me know if I can help more.
I’ve read most of your posts here as well.
Scandinavians aren’t supposed to have to deal with this kind of stuff.
And you can’t do daily enemas either without major problems, but we are getting close to that.
The area of the remaining descending colon has spasms and when the gastrograffin enema was done I reviewed the scan with the radiologist and it was apparent that there were several areas where stool could meet resistance to flow.
So there it is!