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Constipation & IC Constipation & IC Constipation, difficulty passing feces, hard stool, or incomplete evacuation, can be a Why is Constipation a Concern? serious problem for many interstitial cystitis (IC) Constipation can interfere with the normal patients. elimination of bodily wastes; if left untreated, it can become painful; and repeated straining to Bowel regularity is an individual issue. It may be produce a bowel movement can lead to or “normal” for one person to have several bowel aggravate hemorrhoids or anal fissures (tears) movements daily, while for another person, that may require surgical repair. For the IC “normal” bowel function may mean one bowel patient, the added pressure that constipation movement every day and a half. Constipation, produces in the pelvic area can be a source of therefore, is a relative term that each individual increased pelvic pain and discomfort, and needs to define for him- or herself, with the contribute to pelvic floor dysfunction. assistance of a physician. Constipation Related to IBS Possible Causes of Constipation in IC Patients Irritable bowel syndrome (IBS) is a disorder of The limitations of the IC diet demand that most the entire gastrointestinal tract, the symptoms fiber-rich fresh fruits and some vegetables be of which include abdominal pain, constipation limited. Coexisting food allergies may require and/or diarrhea, abdominal bloating, and that patients also eliminate many of the even nausea. A higher percentage of people remaining sources of fiber such as whole grains. with IC also suffer with IBS. Ask your doctor about IBS. Find out if you need to take Many medications commonly used to treat IC medicines or adjust diet because of a have the side effect of constipation. These diagnosis of IBS. For more information about IBS include the tricyclic antidepressants and many go to www.iamibs.org. pain compounds, including opioids. Constipation Related to Specific Medications While it is a good idea for persons with IC to Your constipation can be related to a specific maintain a normal level of fluid intake, many IC medicine, and your doctor may be able to patients limit their liquids in an effort to reduce prescribe an alternative medicine that is less the number of bathroom visits each day, or constipating. The classes of medications that because they associate bladder filling with commonly cause constipation problems in pain. Additionally, since so many commonly some chronic pain patients are: consumed beverages—tea, coffee, sodas, Non-steroidal anti-inflammatory juices—are not IC-friendly, it may often be medications (NSAIDs) such as ibuprofen difficult for the IC patient to find something to (Motrin) drink. Tricyclic antidepressants such as amitriptyline (Elavil) People with chronic IC pain may find it difficult Opioids (narcotic pain medicines) such to get adequate exercise. Physical activity as codeine, Vicodin or Lortab, Darvocet, contributes to bowel regularity, as well as to morphine, Oxycontin,methadone, general health and well-being. Dilaudid Constipation is a component of the condition It is important that IC patients have a good known as irritable bowel syndrome (IBS), which bowel regimen. Stool softeners (e.g., is one of the most common of the IC-related docusate/Colace) and a mild fiber-based diseases and conditions. cathartic (e.g., senna/Senokot) help some, but most IC patients need to use laxatives such as Another condition related to IC, pelvic floor milk of magnesia, magnesium citrate, or dysfunction (PFD), is known to be exacerbated lactulose/Duphalac. by chronic constipation. Interstitial Cystitis Association © 2012 www.ichelp.org RFQ/ Updated July 2012 Printed July 2012 These laxative agents are safe and not ‘habit- limits. Bulking agents such as bran or psyllium forming’ like the stimulant laxatives. Some provide needed fiber and, because they are patients with interstitial cystitis notice a essentially food substances and not drugs, are decrease in their bladder symptoms with the suitable for long-term use. Some of the psyllium successful establishment of a daily regimen. products (Metamucil, Citrucel) may contain additives and flavorings that may irritate Bulk laxatives, such as Metamucil, may not be sensitive bladders. If this occurs, try Konsyl, or appropriate for patients on large doses of unadulterated psyllium fiber. The most opioid pain medications. Consult your common side effects of bran and psyllium are healthcare provider before taking any bloating and flatulence. medication—over-the-counter or prescription— along with opioid pain compounds. Starting with a low dosage and gradually increasing your body’s tolerance to the bran or Constipation Not Related to Medications psyllium can help you to avoid excessive gas or For individuals whose constipation is not the bloating. If hardening of the stool is a problem, result of a particular medication and who do stool softeners (such as Colace) can also be not suffer from IBS, the suggested methods for used from time to time. Mineral oil is an old alleviating the constipation are home remedy that is effective as a softening relatively straightforward: agent, but it may also decrease absorption of fat-soluble vitamins. It can also produce rectal Drinking a moderate amount of water incontinence. You may find that increasing every day is essential for good health, but your fluid intake and adding a small amount of especially the health of your bladder and tolerable fiber to your diet will be enough to bowel. promote regularity. Others may need to pursue Physical therapy may correct the a more aggressive regimen. tightness and weakness of the pelvic floor that can cause constipation. You may find that a simple and easy way to Exercise not only promotes good bowel relieve symptoms of constipation is to use an function, but good health in general. If over-the-counter magnesium supplement. Be you can participate in regular aerobic sure the magnesium is not combined with exercise, such as walking, it is a good calcium or other substances that may reduce idea to do so. its effectiveness or affect your IC. Over-the-counter laxatives are the most common treatments for constipation in the US. Unfortunately, they are also one of the most misused treatments. Long-term use of the type of laxatives known as “stimulant laxatives” can result in laxative dependency. Some conventional laxatives can also interfere with the The Interstitial Cystitis Association (ICA) is the only non-profit health association body’s absorption of various medicines. For these reasons, IC patients with chronic dedicated to improving the quality of healthcare and lives of people living with constipation may want to pursue other interstitial cystitis (IC). avenues of relief. The ICA provides advocacy, research The most “natural” way to prevent constipation funding, and education to ensure early is to eat a diet with a variety of fiber-rich diagnosis and optimal care with dignity for foods—whole grains, various types of bran, people affected by IC. broccoli, raw vegetables and fruits, dried fruits such as prunes, etc. Unfortunately, for those Your donation dollars also enable the ICA to whose IC is aggravated by diet or who have continue to fund new IC research projects, food allergies, many of these foods may be off- as well as work closely with Congress to ensure ongoing IC-specific research funding Interstitial Cystitis Association © 2012 at the federal level. www.ichelp.org www.ichelp.org RFQ/ Updated July 2012 Printed July 2012 [email protected] 800-HELP ICA (800-435-7422) .
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