A whole lotta...constipation

Hello wise wls folks...hoping for some solid advice as I am getting fairly desperate. I am going to call my Centre tomorrow but not hopeful as their last advice hasn't helped much. Essentially I am dealing with a whole lot of constipation and it just keeps getting worse. It has been ongoing since surgery but worse in the last two months and particularly the last month has been near torture. For the last three weeks I have only had one bowel movement that was not forced with milk of magnesia. Basically I try to make things happen but end up resorting to MOM once a week which produces cramping and very loose stool and then it gets right back to the point I need it again in a week to get any movement, even if I try an odd restoralax here or there. I was trying not to use MOM more than once a week as I know the bowels can become dependent upon it to function if taken too often but the last few weeks it has been weekly I have had to take it which even that concerns me.

I am not taking any calcium supplements since surgery (which I know I will get flogged on here for but don't know how to fix this at this point)...within days of surgery the centre's dietician told me to stop taking it because the constipation was bad and to only start again once it was under control as the calcium contributes to constipation. Well...it's never gotten under control and every time I try it's really bad BM wise. When I say really bad I mean nearly passing out and having to use extraction methods (TMI...I know, but I don't want everyone to think I'm just being lazy around vitamins, I take all my others daily). I want to implement the calcium but was thinking once it was reasonably under control I would slowly add it in.

I have a kidney issue so using restoralax daily is not adviseable. I could try that but am concerned about it's impact on kidney functioning over the longer term. I am drinking three litres of water daily, on occasion I only make it up to two but most days it is three.

The dietician at my three month appt told me I needed to add carbs to address the constipation. Advice which I have ignored because I am trying to stick to the mostly protein diet (I do eat some veggies and fruit daily, which I know isn't advocated on OH but it is what works for me regarding being able to maintain better eating over the long term). Given this and the calcium issue I'm not thrilled with seeking their advice.

I am concerned that I am straining so much I will cause a hernia or other damage. I am literally desperate at this point and hoping maybe others have some thoughts.

How much are you drinking? Remember that the recommended 64 ounces daily is the minimum amount you should be drinking. I have to drink about 120 ounces daily to feel really good. Dehydration is the biggest culprit in constipation problems.

When you take calcium you need to add magnesium to your vitamin list too. I take 500 mg of magnesium , twice daily. Magnesium supplementation helps with constipation.

Taking Miralax may help too. It is not habit forming like MOM. It's not a stimulant laxative so you can take it everyday. It works by pulling fluids out of your bowel to make the stool soft and easier to "go". Remember that you must drink plenty of water for it to work properly.

I am drinking three litres so I believe that is about 96 oz a day, I thought it was a liquid thing so increased about a month ago to that bit still struggling.

Thanks for the magnesium tip, I will add extra to my supplement list.

I believe miralax is the same as the Canadian Restoralax...I have to do some searching to find out why it's not recommended for those with kidney issues or what impact it has. It's probably better than the MOM at this point.

Thank you for replying, I appreciate the suggestions!

This. Magnesium supplementation has solved my problem. I just wish I had tried it sooner. The only thing I would caution, since you have kidney issues, check with your doctor.

Thanks, I did a little reading tonight on magnesium supplements and kidney issues and am going to call my nephrologist to double check. I am really hoping though that it's okay for me to add in as it sounds like several people found it helpful!

Hi - respectfully, MOM is not habit-forming. It's called Milk of Magnesia because it's literally water and magnesium oxide ("hydroxide")... the same magnesium you take in pill form (and btw, only magnesium OXIDE works - there are different types - get the one that works). It's excellent for post WLS and if I don't take it 2x day I'm in big trouble. I take 1000mg 2x day and my PCP has said it's fine. You can also supplement with Colace which is basically mineral oil. Again, natural, non-habit forming, and can take long-term. Personally, all the stuff my surgeon told me about using the tea, and the fiber (Miralax etc), did nothing for me (and I've heard the same from others), but to each their own.

My two cents worth.

add in a stool softener,any brand. Use them every night, without fail.

You will need more than the recommended dosage of two. I started out taking six caplets every night. Add another caplet each night or subtract one each night until you get the stool you are comfortable with.

Stool softeners are not habit forming and you can't overdose on them. At one point, I was taking 12 caplets a night because I had to take TWO meds that cause constipation plus calcium.

Dont be surprised if you have to use this bowel program permanently. Many of us have constipation indefinitely after WLS, but it is a small price to pay for the health we are gaining.

Thanks, I had picked up some ducosate sodium pills and was thinking the two daily wasn't making a difference, will definitely try increasing these and playing around a bit with a good combination.

Adding in some "fattier" foods can help too. Chicken thighs instead of breast, butter on veggies, full fat yogurt, etc. The calorie count will go up quicker, but...

Good luck!!

Hmm...I always like a little extra fat (well...not on me of course lol) so this could be a win win! But you're right I'll have to keep a close eye on calories, which already stresses me out!