Health Organization for Pudendal Education

No doubt the most significant quality of life issue from the PN damage for me has been constipation.
Never even thought about going to the bathroom prior to the PN issues, everything, in that regard, 100% normal.

I know from previous posts that others are dealing with this same issue.

My doctors insist that the only safe laxative for long term use is Miralax (adding water to the stool).

For me, the Miralax is somewhat helpful in that when I do finally go, I will typically do not get a fissure from a hard stool (had that several times now), but going is still a BIG problem.

The believe that the nerves responsible for push things through are just not working properly, and the spasms at the opening, are not helping. Of course, any straining causes the PN to stretch and thus get worse, so getting the constipation issue resolved would be a huge help for me.

I recently tried ex-lax (stimulant laxative) which the doctors are all very against as they cause things just to get worse long term (paralyzing the nerves even more), but I find it is incredibly helpful.

So my question is, is there any natural food, drink, etc, that would have a stimulant effect analogous to ex-lax, but that would not be harmful long term. Caffeine is a little helpful, but not great, for me at least. I am drinking several cups of coffee a day, which I think might help a little, if any.

Thanks all...have not posted for a bit..hope all is well with everyone.

Rob

I completely agree with you. Constipation sucks. I spend WAY more time than I want to on the toilet. And a distended tummy puts pressure on my pelvis and adds to my pain levels. I have to completely stay away from opiates because of it. (I will take one if I'm desperate, or travelling. But then I pay for it for days.)

Unfortunately I don't think you'll find any "natural" product that has the same effects as a laxative. Try doubling up the Miralax that you're taking. I think that at one point Calluna was taking up to six sachets a day! I sometimes have to take two to get things moving. I also take 1 - 3 docusate sodium tablets at night. They are also safe for long term use, I think.

Enemas are also helpful to get things moving. And the odd time I have taken a tablespoon of mineral oil at night. I have never taken ex-lax.

Try searching "constipation" on the right hand corner above to get more ideas.

PN Person, have you ever had a painful colonoscopy? I am trying to figure out if some of my symptoms are diagnostic of another condition, e.g. hernia.

Good luck with your toilet troubles.

I was indeed taking a lot of Movicol/Miralax before I had the mesh surgery to repair prolapse - 3-12 sachets a day - my problems then were due to prolapse, not PN. I don't recommend it. PN started when I woke up after the mesh surgery.

After the mesh surgery I was on a regime of Movicol + senna for a while, gradually decreased it down to nothing and all was basically ok in that department - apart from the PN pain. I was told that senna is ok for a few weeks (3 - 4) but no longer than that or else the bowel becomes dependent on it, and you start to need more and more to get the same effect.....

Nowadays I am having problems again - the previous mesh was taken out and rectopexy with new mesh to prevent further prolapse, the bowel seems to have forgotten how to work. Back on the Movicol again at first, but difficult to get the balance right, because unfortunately I'm also having continence issues now. Seems to be a control issue, related to nerve damage - no surprises there. I have been referred for biofeedback, haven't got an appointment yet. In the meantime my best help has turned out to be Magnesium capsules, if I take 400mg a day then mostly I'm fine.

Other things that help - a couple of prunes or dried figs, can't have this every day as I have PCOS and need to stay away from carbs. Also, we eat lots of green leafy veg. And we do keep the fluid intake up - 1.5 to 2 litres a day, and I don't include coffee there.

I hope you find a solution that works for you.

Rob, there's a bunch of ideas at this link: http://pudendalhope.org/node/32

A doctor of oriental medicine recommended magnesium citrate tablets and my regular physician thought it would be fine to take them indefinitely so I've been taking them for about 5 years now with no problems. If I eat a high fiber diet I can get by with 800 mg. a day but if you are on narcotics you might need more. The goal is to keep your stools the consistency of applesauce and adjust the amount you take accordingly.

using senna (ex-lax), and HUGE help...understand stimulant laxatives long-term is NOT recommended as it might become a dependency, but hey, I figure gotta do what you gotta do, and nothing has help like this...miralax keeps it from getting hard (sorry about the details), definitely important, but when the nerves that move things along are not working properly, the senna has been great..been a few weeks, taking 15mg of ex-lax 2x/day..along with a single dose of miralax

will try to reduce at some point, but right now, I am going to stick with it

All of the above responses are really good. I'd like to add GRAPES to list. I personally prefer the white, seedless ones.

here in New Zealand I buy and drink ''alpine tea''
its a miracle!!

thanks all for the suggestions!!!

guess it is a matter of finding what is best, and can be used consistently without doing harm

still using the miralax + the senna (ex-lax)...miralax adds water, and the senna moves things along

seems, at least for me, no matter how much water is added with miralax or something similar, without the stimulant, it is not much use...would still have to strain exacerbating the perineal decent, stretching the PN, and making the condition worse (mostly numbness for me)

going to try and substitute prunes/prune juice for some of the senna, since the prunes act as a stimulant also..not sure if the prunes are less harmful, but natural is always better I would think

already started with one glass of prune juice today..gonna see how it goes..if I can get off the ex-lax, I will feel that is progress

bloated to some extent all the time...feels hoorrible, and makes all symptoms worse

hard to believe that just over a year ago, I did not even know what the PN was, lol, and going to the bathroom never entered my mind..had to go, went..wow, the new reality sucks!!!!

have to experience it to understand as all of you do..try and explain it to a "normal" person, they cannot relate

I hear things like just increase fiber, etc, lol, they have no idea...I include the VAST majority of doctors in this category

I suffered for YEARS from very severe constipation, had to have surgery for anal fissures, and still have to work hard at going regularly. Five things have made a huge difference for me: 1. keeping a fiber/water/bladder & bowel diary so I can see how much fiber I'm really getting with daily goal of 35-40g; 2. taking a daily non-stimulant supplement whether it's Miralax, magnesium or a Colace-type product; 3. eating a mixture of applesauce and uncooked oat bran every night (some use wheat bran instead and add prune juice); 4.) making sure I go when I feel the urge with absolutely no pushing or straining and giving my body enough time to sit, relax the muscles and go (apparently lots of people rush the process) and 5.) doing the I L U colon massage every night before bed (absolute number one thing that has helped me). My PT gave me all these tips, and done together, boy was she right!