Crohn's: Constipation without apparent cause

[latichever]

77-year-old male.

Diagnosed with Crohn's in early 2020, following bouts of unconrollable diarrhea. Been very well controlled with Remicade. It as if I never had Crohn's, until recently. Earlier this year, I began to have GI symptoms. Some diarrhea, but it's kind of settled into the constipation end of the spectrum. Like tenesmus, which is the feeling of urgency wihout the ability to have a bowel movement. Every couple of days, I'm able to manage hard stools.

My bloodwork has been super. I have the proper antibodies, etc. and it's negative for other diagnoses.

My Gi doc thought I might have irritable bowel syndrome, so I just had a colonoscopy. He found no inflammation. So that's good

I'm scheduled for a consulation to discuss the situation.

But in the meantime, I'm wondering if anyone has any thoughts or has experienced something similar

I'm otherwise healthy, exercise regularly, and eat a high fiber diet.

thanks

 

[Scipio]

Try kiwi fruit. It's my current favorite cure of constipation, and it has recent research to back it up:

https://pubmed.ncbi.nlm.nih.gov/21147704/

 

[latichever]

Thanks for your reply. Although I'm negative for IBS and there was no observed inflammation at my recent colonoscopy, constipation is constipation, and I'm ready to try stuff. As I noted I've been going with a high fiber diet.

Do you know whether it makes a difference if the kiwi is freeze dried or even in powder? Easier to maintain a supply that way.

 

[Scipio]

I don't know about freeze-dried or powder. I never use anything except fresh kiwis.

 

[my little penguin]

Go slow with the high fiber diet
Since sometimes those with crohns can have a slow gut so pushing extra fiber too fast can make things worse
My adult child has constipation as part of his crohns (weird I know )
We tried all the natural stuff “things that start with p” pears prunes etc
High fiber (his case big mistake )
Benefiber
Colace
Finally miralax plus vsl #3 combo daily
Tends to keep things moving
Unless his crohns is flaring or …
He takes another med with a side effect like constipation.
Be warned miralax can take up to three days to work and must be taken with plenty of water
Since it’s an osmotic check with your Gi before
Using anything

Also see your pcp since other diseases can trigger constipation (hypothyroid is one )

 

[Anna's Bandit]

Go slow with the high fiber diet
Since sometimes those with crohns can have a slow gut so pushing extra fiber too fast can make things worse
My adult child has constipation as part of his crohns (weird I know )
We tried all the natural stuff “things that start with p” pears prunes etc
High fiber (his case big mistake )
Benefiber
Colace
Finally miralax plus vsl #3 combo daily
Tends to keep things moving
Unless his crohns is flaring or …
He takes another med with a side effect like constipation.
Be warned miralax can take up to three days to work and must be taken with plenty of water
Since it’s an osmotic check with your Gi before
Using anything

Also see your pcp since other diseases can trigger constipation (hypothyroid is one )

Where do you buy the vsl#3 ?

 

[my little penguin]

You can get visobiome from the phamacy
It’s otc for most and $$$
They have it in capsules or packets
There is double strength packets that your GI can prescribe but most insurance plans don’t cover it
We order Ds directly from the manufacturer and they auto ship every month
Visobiome is the original formula
Vsl#3 was bought out and changed formulas but still used the study claims from the original
This led to issues with the fda
So visobiome (original owners ) started visobiome and kept the original formula

https://www.visbiome.com/?srsltid=AfmBOor4n5oTeb1_7REl_-d2fAg5SGJ1ik-5y99FrHe-sXUAnB2E-YZG

 

[latichever]

I've been diagnosed with irritable bowel syndrom on top of my Crohn's. Lucky me.

The Crohn's itself is under control

I've started a food journal and have been following a low fodmap diet. Taking dicyclomine (Bentyl) and laxatives. All on GI doctor's orders

No much improvement, but I'll keep plugging away and providing feedback to my doc. I know that what works for one, doesn't work for others.

But thanks for your replies

 

[my little penguin]

Be aware bentyl stops the gut from spasming
But
Big but it can cause ….. constipation
My kiddo was put on it for abdominal pain
He has constipation as part of his crohns
Gi “forgot “ and gave him bentyl
Constipation got worse abd he got migraines from it
So in his case bentyl is a big no
It did stop the abdominal pain though

 

[Sea_Star]

77-year-old male.

Diagnosed with Crohn's in early 2020, following bouts of unconrollable diarrhea. Been very well controlled with Remicade. It as if I never had Crohn's, until recently. Earlier this year, I began to have GI symptoms. Some diarrhea, but it's kind of settled into the constipation end of the spectrum. Like tenesmus, which is the feeling of urgency wihout the ability to have a bowel movement. Every couple of days, I'm able to manage hard stools.

My bloodwork has been super. I have the proper antibodies, etc. and it's negative for other diagnoses.

My Gi doc thought I might have irritable bowel syndrome, so I just had a colonoscopy. He found no inflammation. So that's good

I'm scheduled for a consulation to discuss the situation.

But in the meantime, I'm wondering if anyone has any thoughts or has experienced something similar

I'm otherwise healthy, exercise regularly, and eat a high fiber diet.

thanks

I also tend to be one of the unicorns when it comes to Crohn's lol, meaning having the opposite problem where I have a BM every couple days. That's been my regular overall, but what helps moves thing along is eating fiber and drinking more water! Also, do you take an Iron supplement? That may be contributing---I have to take gentle iron, which doesn't affect the GI too much, at least not for me. I hope you find some relief soon!

 

[Anna's Bandit]

Well for years I had diarrhea. Now I'm struggling with constipation with worries of obstruction. Was in the ER in November 2023 and had an enema under sedation to remove backed up poop. [ I spent Thanksgiving afternoon in the ER. ] Fast forward to right now and I'm having a hard time having a bowel movement at all. I have been told by my doctor that I can take Miralax twice a day. I took Cholestyramine twice a day for years as a bile acid sequestrant, but I am now taking it once a day, per my doctors recommendation. So now I am sitting here thinking of different ways that I can end this cycle of chronic constipation. I'm trying to take Miralax every night before I go to bed and then two times a week I have been skipping my daily dose of Cholestyramine. Only when I skip my Cholestyramine dose and take the Miralax at night can I even have a bowel movement. I still don't feel totally emptied. Honestly in all of the years that I've been sick, and that has been 27 years now, I never thought I would be worried about an obstruction due to constipation. I see the nurse practitioner at my gastroenterologist office on a regular basis and it sounds like I will be getting a colonoscopy next year. Both the NP and the GI have mentioned surgery. Wow today I'm just super depressed about all of this.

 

[my little penguin]

How much miralax are you taking ?
Are you using the cap as a measurement or the premeasured packets ?
What are you mixing it in ?
How much water are you drinking daily ?
Are you eating high fiber foods or low fiber foods ?
Constipation is a real problem for my kiddo .

 

[Anna's Bandit]

How much miralax are you taking ?
Are you using the cap as a measurement or the premeasured packets ?
What are you mixing it in ?
How much water are you drinking daily ?
Are you eating high fiber foods or low fiber foods ?
Constipation is a real problem for my kiddo .

I'm still experimenting with my Miralax dosing. I am taking it once every 24 hours right now ( one cap mixed with water. ) I need to monitor what I eat & drink and then track my symptoms so that I have something to bring with me to my Gastroenterologist visit next year. I have been prescribed a compound medicated cream to put on my anal area because I have a fissure. I have relatives visiting my City for the next several months, so my mood is more positive due to spending time with them.

 

[Mona24]

Be aware bentyl stops the gut from spasming
But
Big but it can cause ….. constipation
My kiddo was put on it for abdominal pain
He has constipation as part of his crohns
Gi “forgot “ and gave him bentyl
Constipation got worse abd he got migraines from it
So in his case bentyl is a big no
It did stop the abdominal pain though

Seriously, Bentyl causes constipation? I, have done everything by the book since being diagnosed with Crohn's. Why is it that doctor's feel the need to not communicate these small details? Then again, I was so sick for months it's just as much my fault.

 

[MrWheat]

77-year-old male.

Diagnosed with Crohn's in early 2020, following bouts of unconrollable diarrhea. Been very well controlled with Remicade. It as if I never had Crohn's, until recently. Earlier this year, I began to have GI symptoms. Some diarrhea, but it's kind of settled into the constipation end of the spectrum. Like tenesmus, which is the feeling of urgency wihout the ability to have a bowel movement. Every couple of days, I'm able to manage hard stools.

My bloodwork has been super. I have the proper antibodies, etc. and it's negative for other diagnoses.

My Gi doc thought I might have irritable bowel syndrome, so I just had a colonoscopy. He found no inflammation. So that's good

I'm scheduled for a consulation to discuss the situation.

But in the meantime, I'm wondering if anyone has any thoughts or has experienced something similar

I'm otherwise healthy, exercise regularly, and eat a high fiber diet.

thanks

I'm in the same boat. Lots of gas bloating I feel like it's the gas causing the constipation but could be vice versa. Tried so much everything works for a week or two then stops. Want to solve it.

 

[MrWheat]

Go slow with the high fiber diet
Since sometimes those with crohns can have a slow gut so pushing extra fiber too fast can make things worse
My adult child has constipation as part of his crohns (weird I know )
We tried all the natural stuff “things that start with p” pears prunes etc
High fiber (his case big mistake )
Benefiber
Colace
Finally miralax plus vsl #3 combo daily
Tends to keep things moving
Unless his crohns is flaring or …
He takes another med with a side effect like constipation.
Be warned miralax can take up to three days to work and must be taken with plenty of water
Since it’s an osmotic check with your Gi before
Using anything

Also see your pcp since other diseases can trigger constipation (hypothyroid is one )

What time and how much on the Miralax?

 

[my little penguin]

14 years of miralax
They sell it in boxes in premeasured packets .
My adult kiddo mixes one packet with 8-12 oz of Gatorade plus 2 packets (visobiome probiotics)
Every evening a few hours before bed .

The Gi has had him use 3 caps full (each cap full is approximately one packet but can vary a lot ) one day then back to one packet a day .

Beware of capful measurements -use a kitchen scale to get more accurate dosing .
My kiddo found too much miralax daily and your running to the bathroom .

Drink plenty of water otherwise things don’t move .

 

[Stressedmom]

Have you been tested for a motility issue? That can be used to decide if you would benefit from biofeedback and PT.

Have you tried magnesium? Aloe Vera?

There are also PT exercises you can try from videos online. It will sound crazy, but you can find them searching things like "yoga for constipation."

 

[Anna's Bandit]

14 years of miralax
They sell it in boxes in premeasured packets .
My adult kiddo mixes one packet with 8-12 oz of Gatorade plus 2 packets (visobiome probiotics)
Every evening a few hours before bed .

The Gi has had him use 3 caps full (each cap full is approximately one packet but can vary a lot ) one day then back to one packet a day .

Beware of capful measurements -use a kitchen scale to get more accurate dosing .
My kiddo found too much miralax daily and your running to the bathroom .

Drink plenty of water otherwise things don’t move .

What is your opinion of generic type Miralax products, like from Costco. Are the ingredients the same.

 

[NightShiftWarrior]

Possible causes, most likely to lesser likely.

1) Hydration and activity level. (Timing matters, if you get dehydrated or become very stationary for periods of time, stool can harden.
2) Fiber intake. Increase soluble and insoluble fibre intake. Try something different, maybe oatmeal with added bran fiber, try adding several times a day spread out.
3) Magnesium deficiency - Don't assume bloodwork would detect lower levels, try a supplement for a few days.
4) Potassium deficiency - Less likely than magnesium, but if you are having muscle cramps regularly, it could be effecting your bowels as well.
5) Drug causes - some drugs will slow bowel transit. Opioids, Antacids, or Calcium or Iron supplements
6) Stress/Anxiety
7) Vitamin B, B12, C / D deficiency
7) Nerve damage - unlikely but maybe get blood sugar checked for diabetes, talk to doctor if you feel numbness anywhere.

If all else fails, I'd probably use a laxative, get cleaned out. Fast for a day, then re introduce foods slowly. Try like oatmeal, bananas, protein powder for a day or two. Try introducing your regular foods slowly and mix things up to see what works diet wise. Check with your doctor though before doing anything that might not be recommended with your health.