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Cant eat anything bloating & CIC


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Hi 

I have been suffering with CIC for 16 years, have done my endoscopy, colonoscopy, MRI and found that I have pelvic floor dysfunction due to dissengeric defecation. I am glycerin suppository dependent to pass bowel everyday for years that it has now formed into laxative abuse.I have tried motegrity, trulance for bowel movement.  Tried some SSRIs no help, bentyl, an anticholergenic drug used to help before, but now gives me severe acid reflux. 

Trulance helps a bit but still need to use laxatives, I have a raging acid reflex situation being handled by pentaprazole. I  cannot eat anything but yoghut, icecream, smoothies and maybe rice with omelet.

what should I do should I test for my microbiome test or a SIBO test, everything apart from yoghurt and icecream creates bloating please advise

 

ash


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Jeffrey Roberts

Hi Ash,

Welcome to our community.

That sounds really awful and very limiting to be on such a restricted diet. It does seem like you have tried an awful lot of medications. One medication that seems to only be available in Canada right now is called IBSRELA (tenapanor). It was also approved by the FDA in the US, but won't be available until the 2nd quarter of 2022. IBSRELA is actually different than any of the others that you have tried. Might be worth discussing with your doctor.

The other medication that you didn't list was LINZESS. IBS-C patients rave about that one.

Lastly, PIZENSY (lactitol) is an osmotic laxative that is available by prescription. I don't know much about it because it is new. I don't think it will help with abdominal pain.

As for microbiome or SIBO test, I'm not sure what you will discover from that. My understanding is that SIBO is something that happens and then resolves and it isn't a lifelong condition. You'd think by now that SIBO might have got better and then perhaps got worse again and you would have noticed some good days. I think the treatment for SIBO is the antibiotic XIFAXAN which is also the treatment for IBS-D, so I'm not sure you would want to go that route. That's just my thought.

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Interesting, Jeffrey. 

I've tried all the prescriptions, Dulcolax and Linzess stopped working in December, and the latest gastro had me on Motegrity, again, and it failed.

I am now on Citrate of Magnesia while I deal with another health issue but I am due to return to a new gastro who has a colonoscopy in my future.

What does IBSRELA do? I can't find it on Google. 

If lactilol is like lactulose, it will be useless for me.

Thanks.

 

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Jeffrey Roberts
2 hours ago, primosprimos said:

What does IBSRELA do? I can't find it on Google. 

If lactilol is like lactulose, it will be useless for me.

Thanks.

 

IBSRELA (tenapanor) belongs to the class of medications called sodium/hydrogen ion exchanger 3 (NHE3) inhibitors. It works by decreasing the amount of sodium that the bowels absorb, which in turn increases the amount of fluid in the bowels. It causes the stool to be softer, so the material in the intestines and colon can pass through the digestive system more quickly. This increases the number of bowel movements and is said to help to ease stomach pain.

Lactitol is a simple monosaccharide sugar alcohol that exerts an osmotic effect, causing the influx of water into the small intestine leading to a laxative effect in the colon.

Lactulose expels the trapped ammonium ions and possibly other nitrogenous substances from the colon. The osmotic effect of the organic acid metabilites of lactulose solution causes an increase in water content of the stool and a softening of the stool.

So it seems that Lactitol and Lactulose are a little different in how they work.

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