Is this bad?

[rollinstone]

Hey crohnie gang, so iv started Amtriptyline which has taken my headaches away but it's made me pretty damn constipated to the point where I Havnt taken a dump in like 3 days, then on the 4th day (today iv gone like 4 times) fairly well formed for the most part on the Bristol stool chart... My main concern is what could go wrong, my disease is in the colon so I don't know if you can get blockages in the large intestine but damn sometimes it hurts being so backed up... My main worry is something dreadful like perforation? Has anyone ever had that happen?

 

[Axelfl3333]

My record was 7 days!when it eventually went the radio was broadcasting shipping warnings,I didn't,t have pain really just stopped eating no space left!just remember to up your fluid intake

 

[UnXmas]

Three days is actually normal for some (healthy) people to go without going, so I don't think it's something your bowel can't handle. And if you then went four times, it doesn't sound like you could have a blockage now.

However, amitriptyline can be extremely constipating. If you go several days without a bowel movement, or it is extremely hard and requires a lot of time and/or straining to get it out, you may need to counter it with a stool softener or laxative. This is what I used to do to counter the effects of ami - and I was usually so diarrhoea-prone! The ami was far more constipating than anti-diarrhoea meds like loperamide and lomotil. Now I have an ileostomy so I can take all the ami I want without a problem.

Dose plays a role usually too - reducing the ami may reduce the constipation, but may reduce it's beneficial effects as well. I'm on a high dose of ami but have tried different doses and there is definitely sometimes a correlation between dose and severity of side effects, yet other times I get side effects regardless. I've also found that some side effects eased or disappeared over time - after several weeks of taking ami. Yet, again, other effects are just as strong now as when I started taking it over a year ago. It's just a really tricky, unpredictable med. It can do an awful lot of good, but it has a lot of side effects to manage. Don't give up - stick with it, adjust the dosage, try to counter the side effects. In this case I'd start with stool softeners, as they are usually much more gentle than laxatives, and you don't want to go too much in the other direction, especially having IBD.

Have you discussed this with the doctor who's prescribing it to you? What is been his/her opinion?

 

[SarahBear]

I wouldn't worry about perforation after three days. Three days isn't abnormal for me (I tend to go back and forth between D and C when unwell, and more C when I am well) and I've had no negative effects from it.

You might want to ask your doctor if taking a mild laxative would be okay for you, just to make things easier and more comfortable, as well as ease your worries.

Are you currently flaring?

I hope things get better for you!

 

[rollinstone]

Thx guys, can anyone recommend a mild stool softener? I'm on pred ATM so technically not flaring but not in remission.

 

[SarahBear]

Miralax is nice because you can control your dosage better than with a pill. I don't have experience with any others though, sorry.

 

[UnXmas]

Before the ileostomy when the ami made me constipated, I used to take Docusate sodium, sold under the brand name Dulcoease (in the UK anyway, you may find it under other names). It really helped with the need to strain, but it had other problems - as it draws water, and I think lipids (fats) as well, into the stool, it resulted in really voluminous bowel movements, so I later tried lactulose, a stimulant laxative. Again, this did help, but gave me bad stomach cramps at times.

I think you have to be really careful with stimulant laxatives and with fibre supplements too. Stool softeners seem much safer and less likely to cause pain or diarrhoea. Stimulant laxatives can cause urgent or unpredictable bowel movements, but I never had this problem with stool softeners like Docusate sodium, it was really just having such large, greasy bowel movements that I didn't like. I believe I would have found a better solution if I'd had time to experiment longer, but I got my ileostomy and so solved the situation that way.

So I can definitely recommend Docusate sodium as a mild stool softener, if you don't mind the unpleasantness of greasy stools. Start with the minimum dose and work up until you find what suits you.

 

[rollinstone]

Iv just been halving the dose, so 5mg can't say it's doing too much but iv been able to fall asleep which is good. And having dried figs and then a bit of exercise seems to help. cheers for the help peeps. UnXmas is your ileostomy permanent or a temp?

 

[UnXmas]

Iv just been halving the dose, so 5mg can't say it's doing too much but iv been able to fall asleep which is good. And having dried figs and then a bit of exercise seems to help. cheers for the help peeps. UnXmas is your ileostomy permanent or a temp?

Oh, you're on a tiny dose! I'm surprised it's doing anything at all, but glad if it's helping you. I'm on 150mg, but have taken up to 300mg. Believe me, that slowed my bowel down, and knocked me out too!

My ileostomy is permanent, and I'm glad, I'd never want to back to emptying my bowel the regular way again!

 

[rollinstone]

Yea it's a really tiny dose heh, just out of curiosity, how often does one usually have to empty the bag per day?

 

[UnXmas]

I usually only have to empty mine two or three times a day, but that's unusual. Several times a day would be more typical for an ileostomy. I seem to remember reading that colostomies generally need to be emptied less often than ileostomies also. Are you thinking of getting one?