Laxative help!

[Maya142]

M is taking Tramadol 3-4 times a day for joint pain, and as a result is really constipated.
What are the best laxatives to use for constipation?

Miralax does not help, neither does Senna. A combination of Miralax and sennokot didn't help either. Her IBD nurse suggested increasing the Miralax to 3 capfuls a day and that didn't work. She then suggested Dulcolax (2 pills) and we're still waiting for that to work.

Just wondering, if Dulcolax does not work, what's next?! :confused2:

 

[nogutsnoglory]

Have you tried magnesium citrate for her? It usually works in an hour.

 

[Farmwife]

Have you tried magnesium citrate for her? It usually works in an hour.

This also worked for Grace...for awhile but then stopped helping and the cramps came.
Grace was three full caps a day of miralax. Now she's down to one cap.
This is still the best but it doesn't work every day.

I'm interested in what others have used also.

 

[Maya142]

We've never tried magnesium citrate, that's a good option thanks!

 

[theOcean]

Maybe Milk of Magnesia if the Miralax won't help. It's a stimulant laxative though, so be careful how much they take. Also make sure to follow up with drinking lots of water, at least 500ml. I found tea really helpful for this.

 

[Maya142]

We've tried that, forgot to add it to the list. Even the maximum dose didn't help.

 

[theOcean]

Oh jeez. What's her diet like, if maybe that's impacting it?

Also I know there's Amitzia and Linzess. I haven't tried them myself but I've heard good things.

 

[Maya142]

Her diet is pretty good, she's trying to add fiber back in. She doesn't eat raw vegetables because they give her cramps but is pretty good about eating cooked ones.

I think it's just the pain medications causing the constipation so I'm hesitant to add more meds, since we're hoping that the Remicade will help enough so that she's able to get off the Tramadol. We just need to find a laxative that works.

 

[kimmidwife]

Mag citrate and also try to get her moving around. Exercise really helps with constipation. If she can swim or walk whatever she can tolerate.

 

[theOcean]

Hopefully she can. I found dried fruits really helped with my constipation as well. Maybe you could try multigrain breads as well?

I hope the Remicade helps!

 

[my little penguin]

We done lots of miralax - pear juice
Plenty of cooked pears ( fruit cups)
Mag citrate once when things were bad - lots of cramping though.
DS gets constipation as part of crohn's for him - formula was key-
3 shakes a day and the miralax is enough 2-a day not enough .

Does she drink a lot of water ?
What about fatty foods ?
High fat tends to make you go more ?

 

[Maya142]

Interesting MLP - she has just reduced Peptamen jr to one a day (from 3 a day) because she's sick of them. I'll try to get her to drink more but it's hard since she's 17 now and is convinced she doesn't have to drink them since she's in remission.

The ducolax started working (phew) so I'm hoping it'll do the job and we won't have to resort to mag citrate.

Fatty foods tend to make her nauseous but I'll keep that in mind.

 

[my little penguin]

DS adds chocolate syrup to the peptamen jr to vary the taste .
I put two together for his breakfast so it's easier to just drink it at once .
The third one is tricker to get in.

He also adds honey or maple syrup to vary the taste.

Let her know use of en has a lower rate of relapse when added to biologics .

 

[Tesscorm]

When S was much younger (8, 9, 10??), he had some problems with constipation - his GP recommended glycerin suppositories and they worked immediately (within minutes)! However, his constipation was not caused by any meds or crohns at that time. :ghug:

 

[Maya142]

MLP - do you add chocolate syrup to unflavored Peptamen? Right now she's drinking chocolate and sometimes strawberry but she doesn't like either.

Tesscorm - M won't have anything to do with suppositories or enemas. She has a bad stomach ache from being so backed up but still refuses to try them. Teenagers...:ybatty:
Dulcolax hasn't done much so I suppose we'll try Mag citrate tomorrow.

 

[my little penguin]

DS takes peptamen jr vanilla with prebio - the prebio is suppose to help with the constipation . Plus our dme only stocks vanilla flavor - since it's covered by insurance he only drink vanilla -
I add chocolate syrup to the vanilla shakes so they are choc flavored - he has been drinking them everyday since age 7.
Straws help a little .
I also show him lots of pics of crohn's kids who don't drink formula .
DS is aware of other Ibd kiddos who are a lot smaller and lighter than he is so for now he drinks the shakes .

 

[Emily's mom]

For my daughter magnesium citrate worked hands down over miralax. I hope you get her moving soon!

 

[Maya142]

She's 5'2 and 87lbs but she says she's done growing and she doesn't care how much she weighs (even though she's lost so much weight that she doesn't fit into any of her clothes). Her GI has brought up an ng tube several times but she's very against it. I'll try the vanilla with chocolate, hopefully I can convince her to drink it.

 

[my little penguin]

You could tell her my DS is 4'9" and 86 lbs at age 10.

Maybe let her talk /chat surf the web etc while drinking vs no electronics during regular meals -I don't know -DS liked tv so he got to watch tv while drinking .

 

[Tesscorm]

It is tough when teens dig their heels in! :ybatty: It was much easier convincing S with the suppositories because he was still so young.

For the suppositories, I would try to just buy a small pack and tell her - 'I'm leaving it here (leave it in bathroom), instructions are in the box. If you're ever feeling bad enough that you want to try it, you know they're there.' And leave it at that. I know as a teen, I would have hated admitting that I wasn't invincible and needed help. But, if that help was at hand and no one would know I was 'using' it, I would've been more likely to try it. I don't think there's any way she could cause any harm by using it 'wrongly' (well, other than using the entire pack maybe - which I doubt she'd do! ). The only 'instruction' to quickly mention to her (so that she can get the full benefit) is that once she feels the urge to go, she needs to try to hold it for as long as possible (ie 10-15 minutes) and that she should be near the bathroom because, if it works, once she needs to go, she'll need to go quickly.

 

[plaidknitter]

They also make liquid glycerin suppositories for kids, which are a little more user friendly. You insert the tip and the squeeze the bulb to get the liquid glycerin in. My daughter has severe constipation from a different medical condition & nerve damage (I have IBD, she doesn't).

When she's gotten really backed up, we've had to do clean outs that are similar to a colonoscopy prep. They've had us give her cap after cap of miralax in Gatorade until she starts going, and even when we was only 40lbs it could take 5-6 full caps. For miralax to work properly, she needs to be drinking plenty of fluids with it since it draws water into the intestine. But if you do massive amounts of miralax, it will eventually cause a blow out once things get moving. But I don't know if that level of miralax bombing would be recommended for this sort of situation. Constipation in kids with neurogenic bowl can be different than kids with no GI issues or different GI issues.

We don't use mag citrate because of the cramping.


& autocorrect...

 

[Emily's mom]

She's 5'2 and 87lbs but she says she's done growing and she doesn't care how much she weighs (even though she's lost so much weight that she doesn't fit into any of her clothes). Her GI has brought up an ng tube several times but she's very against it. I'll try the vanilla with chocolate, hopefully I can convince her to drink it.

I'm sure trying to get teenagers to drink something that doesn't taste so great can be difficult. My eight year old tried different samples of drinks that the GI's dietitian gave us. She prefers the PediaSure Peptide 1.5. Actually, she gained five pounds in two weeks. Now, with the first round of Remicade done we hope to have her in remission soon to get her height going with added help of growth hormone.

Well wishes!

 

[my little penguin]

Suppositories ( OTC kind) did nothing for DS since his constipation was due to un dx crohn's at the time-not sure on how good it would help with drug induced constipation.
Ditto maybe the GI can give her more samples to try
DS tried resource breeze, kids boost , peptamen jr, elecare , eo28 splash , peptide etc...
Resource breeze and kids boost tasted the best but...
They did nt help enough at the time so the least offensive was he peptamen jr.
I will say the Dme sent a few peptamen jr plain vanilla and DS put up a fuss saying they didn't taste as good as the prebio ones. I think its all in what your used too kwim .

 

[Maya142]

The funny thing is that she's so used to Peptamen jr that she won't touch Ensure which tastes a LOT better in my opinion. But she still won't drink enough Peptamen partially because she doesn't get hungry and partially because she doesn't like the taste. I'll try the chocolate syrup idea, I think that'll work best.

The mag citrate definitely got things moving:lol:
She tends to be on the constipated side when her Crohn's is active so I'm hoping this was just the effect of the Tramadol since she's supposed to be in remission.

 

[Sascot]

Glad things are getting moving. It probably is the tramadol, it did constipate my daughter