[RadiantTiger]

Managing bowel function (constipation)

by RadiantTiger on Sun Mar 01, 2015 3:08 pm

Well, I am 6 days into Revlimid / Velcade / dexamethose (RVD).

Biggest issue is no bowel movements. They told me to take Miralax. Then they told me to take more Miralax. That didn't help. After 4 days with no bowel movement, they said I could take magnesium citrate liquid, which did a major purge.

I have lots of good fiber and ample fluids in my diet (flax seeds, chia seeds, fruit, fresh greens, cooked vegetables, brown rice, quinoa). I am wheat-free and non-dairy. In the past, I have had IBS, but it has been generally manageable with diet and supplements. I have quit coffee, but still have one cup of black tea in the morning. No other caffeine during the day.

I read another post about taking magnesium (100 mg) with each meal. Which form / brand of magnesium? Are there any contra-indications for magnesium with the chemo drugs?

Do I have to just accept my fate that I will be dependent on stimulant laxatives throughout this treatment? Bought some Senokot to try, took one of those last night, and even that did not work. Maybe 2 will work.

So now I will start the trial and error process of figuring out which stimulant laxative works best, and how much to take so I don't get cramping and diarrhea.

In the past, I have found digestive enzymes helpful with constipation, but the doctors didn't want me to take those. I'm not sure why. Does anyone know what the problem with digestive en­zymes is with the chemo?

They did say I could take probiotics, so I started those again.

Any advice on specific products/brands I could experiment with, would be helpful.

Thanks
RT

[cdnirene]

Re: Managing bowel function (constipation)

by cdnirene on Sun Mar 01, 2015 4:00 pm

After a lot of trial and error, I discovered that this works well for me:

My chemo day (Velcade and dexamethasone) is Friday. I take 2 Senokot with stool softener tablets late Saturday afternoon. Starting Sunday, I have daily bowel movements, up to and including Friday morning. Then chemo stops the bowels from working again. Saturday I repeat the Senokot. I don't suggest waiting longer than that. It just makes it more difficult to have the first bowel movement if you wait more days.

[Melanie]

Re: Managing bowel function (constipation)

by Melanie on Sun Mar 01, 2015 6:22 pm

Husband uses either Senokot or Peri-Colace (docusate sodium and senna). Both do an excellent job of relieving constipation.

[Tracy J]

Re: Managing bowel function (constipation)

by Tracy J on Sun Mar 01, 2015 8:47 pm

I had horrible problems with constipation, and I have indeed accepted that I will be dependent on laxatives while I am being treated. At the worst, here's what it took to get me going, spread throughout the day: 8 Senokot, 2 Dulcolax, 2 Colace, Miralax, and prunes. I found this impressive. I never go a day without taking something for constipation.

[Rneb]

Re: Managing bowel function (constipation)

by Rneb on Sun Mar 01, 2015 8:48 pm

I would add potassium supps .....and to urge you to be proactive with anything you use. Use these things before, as has been suggested above.

[RadiantTiger]

Re: Managing bowel function (constipation)

by RadiantTiger on Mon Mar 02, 2015 1:11 am

So it sounds like the day after you have to take the Velcade shots is the worst? I will certainly take something extra the day before then.

I think I will probably have to take something every day, but maybe I can take less on the days when I'm only taking Revlimid.

Thanks for your advice everyone.

[cdnirene]

Re: Managing bowel function (constipation)

by cdnirene on Mon Mar 02, 2015 1:49 am

No, the day after the Velcade is not the worst. I found it was the BEST day to take Senokot to avoid a guaranteed constipation problem.

[Beacon Staff]

Re: Managing bowel function (constipation)

by Beacon Staff on Mon Mar 02, 2015 7:04 am

Hello RadiantTiger (and others landing here),

Thanks for your question, RadiantTiger, and thanks to everyone else for all the very helpful feedback.

In case it's helpful, this link will take you to a list of forum discussions that have been started in the past on GI-related side effects of different myeloma therapies. There may be some additional advice there that could be helpful.

The link is one of many in the "Links to previous forum discussions" posting in the "Treatments & Side Effects" part of the forum that can be quite useful if you're looking for information on how to deal with different treatment (and disease) side effects.

[EF11]

Re: Managing bowel function (constipation)

by EF11 on Mon Mar 02, 2015 2:00 pm

My husband had a hard time at the start of his RVD treatments managing his severe constipation.

He found the following to sort out his issues: 2 Colace + 2 Sena in morning, 2 Colace + 2 Sena + Miralax at night. I think he dropped the Miralax because it didn't seem to help. He felt better on his off weeks and now that he's on a break from meds to get ready for stem cell transplant.

Good luck.

[Christa's Mom]

Re: Managing bowel function (constipation)

by Christa's Mom on Mon Mar 02, 2015 6:42 pm

RadiantTiger,

I feel your pain -- literally. Between HBP and a bad thyroid, my whole system is s-l-o-w. Done the magnesium citrate liquid route -- yucky and unpleasant!

I don't have multiple myeloma, but my regimen may help you - I make sure that my daily multi-vitamin doesn't have iron in it (that's okay for myeloma, right?), and I take 250 mg of mag­ne­sium every evening.

Good luck!

Lyn