I know, what’s a nice girl like me doing discussing this topic, but believe me, it is a major issue. I am not referring to the common (albeit, miserable) IBS with constipation, or even slow motility issues (about which I truly could write a book!) I am referring to what our society at large is dealing with when recovering from surgery, a fall, pain meds, meds such as antibiotics and viral meds, diabetes meds, etc. The graying of America will put more and more at risk for the fallout of dealing with unanticipated abdominal issues, particularly related to falls and surgeries. Many of the wonderful people in my life are discovering that there are true consequences to what is meant to help deal with a problem, causing another problem that takes the starch right out of them.
Why pain meds, etc. cause the misery they do is not my domain, although prior to my ileostomy, I feared taking an aspirin or Tylenol, let alone an antibiotic, for fear of a “shutdown.” I can only tell you that countless people suffer intractable pain and distention, loss of appetite when they need to provide nourishment for their recovering bodies, and depression from the attack on their excretory system. No doubt, a chemist could explain the impact of meds, but in my mind, it throws off the delicate balance between digestion and excretion. Additionally, the bowels have their own Central Nervous System which coordinates motility of food through the system until it leaves. This is the reason why there is such a connection between emotions and the gut.
Digestion begins in the mouth with the use of teeth, soft palate and tongue; then the production of saliva begins to break down the food even further. Down the esophagus into the stomach, thanks to peristalsis (a series of contractions) then through the duodenum or top of the small intestine. Finally, down through the bottom or the small intestine, the jejunum and ileum withdraw nutrients. The colon moves waste up the ascending colon, along the transverse and down the descending or sigmoid colon, and out the rectum through the anus. What a trip, what a challenge, and meds, stress or inactivity can impact all of it!
Probiotics are often used to assist in the breaking down of food and replacing healthy bacteria, which is frequently lost with certain meds. Since having peritonitis in 1993, I have taken them daily. When I am on any additional medication, I add more to my regular dose, believing that providing more healthy bacteria may be key to keeping digestion/excretion regular.
Stress alone can add to constipation, hence, IBS with Constipation. Add in meds for dealing with stress, and there is more of a motility issue. My recommendation for relieving stress-induced slowdown is to lay on your left side with knees up. As often as possible, sip warm water, or for ostomates, sip grape juice to break down any food-related blockages.
My hope is that the medical community will find a means of helping those who need to rely upon pain or other meds. It is not sufficient to order these meds without a way of coping with the misery that may accompany them. Fleet enemas, stool softeners can help within reason as long as prescribed appropriately, but ignoring the problem does not, alas, make it go away!