Severe Constipation and Dysbiosis?

[Issie]

When I had paralyzed gut after many surgeries, the only thing to help was a stool softener and Mineral Oil. Works every time. A glass of orange juice is helpful too.

 

[Susana]

Thanks, Issie.
What kind of mineral oil did you use? There's something called liquid paraffin in the UK but I don't know if this is the same thing. This was used when I was a child.

 

[Issie]

Thanks, Issie.
What kind of mineral oil did you use? There's something called liquid paraffin in the UK but I don't know if this is the same thing. This was used when I was a child.

I tried looking it up and it seems it is similar. I don't know if it is exactly the same. But looks like it is used as a laxative there too. It's only used when desperately needed and not all the time. The stool softener can be used more. The best medicine for me is Bentyl. It is given for IBS and it helps my colon relax and not be spasm up and I go very regularly. But with my many abdominal surgeries, using mineral oil and stool softener worked when no other medicines did.

 

[Not dead yet!]

Many thanks for this long post. I'm getting used to this forum so I may have posted a thanks already but two does no harm! we shall look into this and see where we can buy it in the UK. People are reluctant to talk about constipation but it's a part, an essential activity of the body, and we shouldn't be so squeamish, I think.
Thank you again! Susana

I'm sorry it took a while to reply. I'm going through a "crash" at the moment. Sometimes I can't even tolerate the light from my computer screen. I'm really pleased the advice helped you, though.

The ingredients of mag citrate should be something like this: Active Ingredient: Magnesium Citrate (1.745 G Per fl oz). Inactive Ingredients: Blue 1, Citric Acid, Flavors, Purified Water, Red 40, Saccharin Sodium, Sodium Bicarbonate. From: https://www.cvs.com/shop/cvs-health-magnesium-citrate-oral-solution-10-oz-grape-prodid-789407

However, I noticed they have new formulas in US stores. Now they use sorbitol or sucralose, instead of saccharin. This is a problem for me because it causes long term diarrhea that doesn't resolve for a week. If possible try to find one that doesn't have sorbitol or sugar alcohols. They are a food for bacteria and if a person is dealing with dysbiosis, like me, it's a problem to eat things containing it.

 

[Not dead yet!]

I have two things that work fairly well with me, but they sure won't work fore anyone!

The first one I discovered is eating a piece of fresh papaya with (before) every single (protein containing) meal. About 100 grams a day spread over the meals does the job for me.

It has good digestive enzymes that break down proteins. It is one of the few that start working from the moment they are in the gut. Most others are deactivated so that they would not damage the stomachs wall. I can't guarantee that these enzymes can't damage the stomach wall. But fresh papaya is eaten as a fruit in much larger quantities so it is relatively safe-ish *for most healthy people*. Other comparable enzymes are found in grapefruit, but these tend to interact more with conventional drugs. Either choice you make, consult on safety with your doctor first.

It gave me a good improvement in health within one to two weeks. I won't say it will improve constipation directly, but improved health in ME is a bonus to start with. And improved digestion is often good.

I have written on the topic in Healthrisings forum before this and I must admit no one reported similar good results as I had. But due to now writing these comments I may see what makes it work with me: I am one of the rare ME / gut dysbiosis patients that also has constipation problems. In the previous comment I wrote that one of the disadvantages of diarrhea to get food out of the body is that you risk to get more undigested proteins in your blood. So the body may turn to constipation to prevent that. Using this fruit helping with protein digestion starting already in the stomach would reduce the amount of undigested protein in the bowel. With it, it would reduce the need to resort to the mechanism of constipation rather then diarrhea for countering gut dysbiosis problems. That is, there would be less undigested proteins that can enter the bloodstream during a diarrhea reaction. Note this is an untested hypothesis!

By any chance, would "Doctor Myhill’s low-carb Paleo diet" be high in protein? There are two commonly used types of paleo diets: one with much protein and another type with limited protein only. Both have different advantageous and disadvantageous.

Another thing that helps me is psyllium husk. Yes, I know it made him worse and I respect Not Dead Yet! her experiences. But know that most psyllium husk sold contains more then that alone. Very often it has plenty of added fiber or pre-biotics. That is a clear no-no in my case! And pro-biotics are bad for me too. So check labels!

Also, my psyllium husk is packed in stomach acid resistant capsules. That makes it a lot more expensive. But psyllium husk is closely related to cellulose. Cellulose can irritate the stomach and cause mast cell degranulation. That is a common problem with ME patients and makes them worse. The tomach acid resistant capsules prevent that. They are more expensive, but taking 4 capsules (as indicated maximum on the label) with in total 1500 mg only a day does a fine job for me. That is much lower then the amount typically taken with the powder containing also pre-biotics. Sure it is no miracle cure but it helps slowly improve my gut. The effect of it is far more something building up over time then the quick papaya effect.

For people on a low-carb diet fresh papaya may contain a bit too much sugar. It contains some fructose too but for me the benefits outweigh the disadvantageous. You can also take papaine supplements, but for me the fresh fruit is superior.

Now how do I believe psyllium husk works? Psyllium husk is indigestible fiber. Many say the main difference between certain fibers is them being solvable or non-solvable. I place more importance on the difference between digestible versus indigestible fiber. The reason?

Bacteria tend to like to stick to surfaces. So I provide them surface area in the form of indigestible very fine grind (dust like) psyllium husk. The finer the grinding, the more surface area per gram. I like bad bacteria stick to psyllium husk a lot more then to stick to my gut wall and slip through it. There they can grow on the food they find and stay there. And then enjoy their ride on the way out without bothering my gut wall. That's why I believe *indigestible* to be important here. If the bacteria manage to eat all of the fiber they stick too, they'll have no surface left to stick too and release themselves and spread. I don't want that.

Other fine grind indigestible fiber may work just as well. I have no experience with it.

I also decide to take "advantage" of having constipation. Many doctors recommend high doses of oral vitamin C for ME patients. But oral dosing is limited as it tends to cause diarrhea by killing of gut bacteria. Therefore some doctors inject patients with vitamin C to get their patients high doses. It doesn't help much with constipation, but I have few problems with taking high doses of vitamin C . And when drinking water with vitamin C before a meal, the stomach becomes more acid improving digestion. Many ME patients have too few stomach acid. Producing stomach acid costs energy. After the meal I drink less water. I already drank water before the meal to hydrate. And water after the meal dilutes stomach acid reducing digestion once more. I just drink enough after a meal to rinse my mouth and throat.

If you have any changes or experiences to share, please do.

I echo the suggestion of indigestible fiber if any fiber. The one that worked before I knew I was Celiac was wheat bran. Oat bran would not be safe for someone with Celiac, but it may work the same. If you can find a "purity protocol" oat bran then it could be ok if gluten is something you avoid.

One reason I haven't fully embraced Paleo is that I know that bran layers really help my gut. There's an inherent problem with rice bran though... it accumulates arsenic in very high amounts and is grown in soil that contains it. Supposedly California rice is lower in it.

I enjoy whole grain kasha and quinoa now, though quinoa seems to have a negative effect on my triglycerides (that might be genetic). It's getting harder to find unpearled quinoa because of some nonsense that it's "bitter." It takes two minutes to rinse it, but I guess that's not instant enough.

I also like ground flax seeds which make a kind of gel that is very soothing for my gut. However, such gels can be the cause of overgrowth, so use caution. I just mix ground flax into my morning eggs. Can't taste it unless the flax is "off."

----Bentyl / dicyclomine someone mentioned taking it, I also take this, it's extremely helpful for constipation if it's the spasmodic type.

 

[Susana]

Thanks for this long reply and sorry you have had a crash.
My son finds health things confusing and sometimes disturbing so when things are at their worst I do the research for him. The Paleo diet is sadly the cause of this severe constipation, which started four months ago.
I've checked the magnesium you recommend but it's unavailable in the UK. It looks as if liquid is preferable to tablets but that's all we can find here. We're trying to work out what's the best, most suitable and in what proportion. Thank you so much for giving the break down of the one you use occasionally.
Your reference to flax seeds is also helpful as he's been taking it several times a day, although it hasn't improved matters. Maybe should cut down.

 

[Susana]

I tried looking it up and it seems it is similar. I don't know if it is exactly the same. But looks like it is used as a laxative there too. It's only used when desperately needed and not all the time. The stool softener can be used more. The best medicine for me is Bentyl. It is given for IBS and it helps my colon relax and not be spasm up and I go very regularly. But with my many abdominal surgeries, using mineral oil and stool softener worked when no other medicines did.

Thanks for looking it up. Yes, probably similar, and not recommended to be used all the time, I know.
Bentyl hasn't been suggested because this is not IBS, but the same old constipation.... Good thing you have something to help you!

 

[dejurgen]

The one that worked before I knew I was Celiac was wheat bran. Oat bran would not be safe for someone with Celiac, but it may work the same.

Now you get me all confused. Wasn't wheat the "worst" of all sorts of grain with its gluten and inulin (on the FODMAP list IMO) and wasn't oat suspected because it could have some gluten contamination if processed in the same factory as wheat? I do try and avoid wheat (bread, muesli (having often plenty of sugar too)...) and eat more oat like having it as breakfast. Could you care to explain? Thx.

I am doing well on rice too as a source of slow glucose but I worry too a bit about arsenic being high in many packs of rice. Would organic rice be any better in that respect or not? It's not like they display "Arsenic, x% of maximum safe daily intake" on the package.

The Paleo diet is sadly the cause of this severe constipation, which started four months ago.

Is the paleo diet giving him that good results that he wishes to continue with it despite the drawbacks?

 

[Susana]

He has stopped the Paleo diet in order to return to his wholemeal, mainly plant based diet but this did not improve his health. Any changes seem to have negative results over the years.

 

[Issie]

I react worse to oat than wheat. But avoid both.

As for rice, organic is always better choice. But there still could be higher arsenic. It's in the soil and rice tends to have it be higher. I don't do too well with rice either and just try to avoid grains as much as possible. But if I do have grains, usually corn or rice. I did check very high for arsenic one time and we discovered it was in the water and air. it was so high, doc thought someone was trying to kill me. But there had been silver mine and it was high in area. Sodium Alginate and cilantro took it down in a few months.

Grains, nightshades and legumes make me hurt much more.

 

[Issie]

Thanks for looking it up. Yes, probably similar, and not recommended to be used all the time, I know.
Bentyl hasn't been suggested because this is not IBS, but the same old constipation.... Good thing you have something to help you!

The Bentyl makes the colon relax and then movement can come.

 

[Not dead yet!]

Now you get me all confused. Wasn't wheat the "worst" of all sorts of grain with its gluten and inulin (on the FODMAP list IMO) and wasn't oat suspected because it could have some gluten contamination if processed in the same factory as wheat? I do try and avoid wheat (bread, muesli (having often plenty of sugar too)...) and eat more oat like having it as breakfast. Could you care to explain? Thx.

I am doing well on rice too as a source of slow glucose but I worry too a bit about arsenic being high in many packs of rice. Would organic rice be any better in that respect or not? It's not like they display "Arsenic, x% of maximum safe daily intake" on the package.



Is the paleo diet giving him that good results that he wishes to continue with it despite the drawbacks?

Sorry for the confusion. The situation is very confusing. I'll try to clear it up a bit.

For FODMAP, the concern is with the soluble fibers in wheat. I don't think the insoluble fibers are used by the bacteria at all, they just act as a brush / mechanical bulk. That's assuming the person doesn't have some kind of unusual dysbiosis though. It's always possible. Inulin, for instance, is a soluble fiber. And oat fiber is more soluble fiber than insoluble, but it has some of both.

Oat fiber is definitely contaminated with wheat, barley or rye gluten. Unless it was grown with something pioneered in Canada called the "purity protocol" which is a way for farmers to avoid rotating between gluten and gluten free grains on the same plots of land. There's a list of safe oat producers here: https://www.glutenfreewatchdog.org/...tocol-listing-of-suppliers-and-manufacturers/

However, 10% of people with Celiac react to avidin, the prolamin protein in oats, which means they react exactly like they do to gluten.

And some varieties of quinoa also cause the exact same reaction in Celiacs as gluten does, because their prolamins are close enough to trigger the same reaction. We can only hope that nobody's growing those varieties anymore.

There might be other plants that contain prolamins that also trigger gluten like reactions, yet aren't the three plants (wheat, rye, barley), the reaction is thought to be rare, but it's really just an assumption. If someone is struggling with a mystery, it's best to know that it's possible to get the same reaction from other sources. Corn zein is also a prolamin and many people say they have strong reactions to it. My reaction to it is there but it comes and goes and it's even more inconvenient to avoid corn than it is to avoid gluten.

I'm actually not a huge fan of fixing things entirely with diet. If the triggers are known then you can manipulate it so a person's life becomes horribly inconvenient and expensive if their only choice is avoidance. I'm really hoping for a few options, I just hope they're not too onerous (meaning, not some risky meds, but I can't imagine what else).

 

[Issie]

Hmmmm, I do awful with quinoa too. I'm like you with corn. Sometimes can get away with it. Other times react. But a good bit of corn is now GMO and foreign response in the body. So maybe that's why.

I'm not celiac and can do an occasional wheat. But do better off it. And barley, rye and oats always react.

 

[Not dead yet!]

Hmmmm, I do awful with quinoa too. I'm like you with corn. Sometimes can get away with it. Other times react. But a good bit of corn is now GMO and foreign response in the body. So maybe that's why.

I'm not celiac and can do an occasional wheat. But do better off it. And barley, rye and oats always react.

Yeah I hear that a lot about not celiac but it's better without. A piece of the mystery recently discovered, apparently gluten and neuropathy are linked, even outside the Celiac definition. https://www.ncbi.nlm.nih.gov/pubmed/30806821

I had the experience of having almost all my neurological "idiopathic" pain stop after two weeks of being strictly gluten free (meaning, fully restructuring my kitchen, expensive throwing out of wood utensils and replacement, etc). I've lived without the brain fog of opiates for more than 18 months now and it's amazing. I wish I could say that it would work for everyone.