Solving the constipation side effects of opioids

[frozenborderline]

Prucalopride

What is this

 

[frozenborderline]

So I'm post surgery , an intense spine/back surgery, so straining on the toilet is already painful. But I'm even more worried about my !asshole! . I really hope its resilient bc I dont want some embarrassing awful thing like a !prolapse! I've never had that. And I've had my rectum examined , hemorrhoids and all, by a PCP after a time that it was so swollen and pained from a bowel movement that I was worried about that.

Bc of the surgery and previous surgeries I am on a high dose of opioids. On one hand this is terrible for constipation, on the other hand i wouldnt be able to get to the bathroom and sit up without some pain meds. I mean that's not the only problem. I wouldnt be able to do pt without 5he pain meds, I wouldn't be able to sleep or to be up for doing virtual doctors appointments. But I highlighted the getting to the bathroom thing bc it illustrates the catch 22. Of opioids making u have a harder time shitting but the pain of sitting on toilet or moving there being impossible without meds. Movantik, which I'll mention later, is a possible solution to that catch22 but comes with issues.

So far I've relied on cholase. My doc4or said it's an excellent stool softener and that 3vem if it doesn't make u go, when u do it's not painful. This was true for awhile and the effect seems to have worn off. Also I never really figures out anything for motility besides coffee or magnesium or whatever, senna seems weak.

Tonight is an emergency and then I will need advice and reevaluate everything after that. The damage done by unsuccessfully straining on the toilet was like three pt sessions or more, so now Its not like I'm going to cut down on opioids tonight.

Is there a better stool softener than cholase ? I guess anything people complain about giving them diarrhea or working too well, I want that. This is more for the future than tonight and tomorrow though.

Fiber doesnt seem to matter bc its bulking something that isnt moving much and has a lot of bulk already but I can still keep trying.

For extreme situations where u are close to passing but there is lots of pain bc of a hemorrhoid or something, what to do? Take something to stimulate bowels even more and just force it? I know I cant sit on the toilet this long again but it 2wanted to come out. I wqsnt only straining, my bowel was moving it was just such hard stools and painful hemorrhoids that it couldn't get past q certain point. If you are close to that point can you use gloved fingers to help it along? It is gross to me but I'd rather have that than be in hospital with a nurse doing it for me.

I am going 5o try my movantik which is a drug that causes pretty noticeable and quick increases in gut motility by blocking opioid receptors in the gut. It's not supposed to increase pain in general bc its supposed to only be absorbed in the gut, not the brain. But theres a decent chance it.would cause some peripheral pain increase. That's why I domt use it all the time. It's a last resort for me. But tonight feels like a last resort and then I need to be more proactive.

I need to be on this large dose of opioids until my muscles and incision heal more. Tonight already set me back a ton lol , it's possible to overdo it after surgery and believe it or not sitting on toilet straining can do it. Most likely two weeks to be on this particularly high dose and then starting a taper. So its two weeks of trying to shit normally. I wouldn't be so concerned with regularity, eg going every day or every other day, if I had softened stools , but it seems cholase no longer does that for me.


So there movantik. And then one other idea which is kind if extreme maybe gross, I will spoiler tag it as soon as I can for this reason; what about using gloves and coconut oil/safe lube, and ones finger to help it out? Just thinking. Thanks

Okay so this post is two parts. 1. How do I get through pushing out this existing really hard shit.

2. How do I make a change in next couple weeks so this doesnt happen again ? Movantik I could take more proactively. I already took milk of magnesia once. I could megadose vitamin c which I need for mcas anyway. I've never tried Miralax. Since I've never had a doctor recommend it and I have weird allergy issues I assumed maybe I shouldn't but I'm down. Down to try anything. Would rather get anaphylaxis or an irritable gut for a bit than another night like this one . Senna has always seemed useless to me but at least it seems harmless. I dont want to take movantik all the time bc it negates some of the effect of the pain meds but i haven't found anything to help motility much yet. Ugh. There were times I was on high doses of meds and did sort of fine.

 

[frozenborderline]

I'm wondering if Miralax is safe or would cause mcas reaction, but also is it effective?

 

[frozenborderline]

So it seems stool softeners are important for when it's bad to strain , post surgery or pregnancy or when you have hemorrhoids. Right. Well I'm in two of those categories at least. Laxatives are generally more to force things to move out , rather than soften them. It's probably too late to soften a stool that is already there. But I learned something important today. Cholase, or stool softeners in general, do cause tolerance generally. My PCP had told me they don't. This explains a lot of what I've experienced. I mean opioids are bad for motility but I was able to use colase to counteract any hard stools for quite awhile. Like over a month. Just doesnt work any more.

So now, what does work, especially to soften stools, that isnt colase ?

 

[pamojja]

...Mg.

The other thing with definitely liquifies every stuhls is high enough pure ascorbic acid powder by titrating to bowel-tolerance: http://doctoryourself.com/titration.html

But don't use caps or tabs for such high doses, because of the not so heathy binder and fillers.

So now, what does work, especially to soften stools, that isnt colase ?

I'm always amazed at the resistance even to try something as simple, cheap, safe and effective, as Mg and ascorbic acid. And instead prefer to stick with the suffering...

Though even my ~80 years old father, totally averse to supplements, out of desperation when constipated for weeks with nothing helping prescribed by his doc, finally did try it. Though he did find it somwhow too extreme to have a bowel movement every day. Therefore he got creative, left out the Mg, and only went with 1 teaspoon of ascorbic acid powder ever second day. Works like a charm to heave a bowel-movement every second day for him. And never experience constipation again.

 

[frozenborderline]

I'm always amazed at the resistance even to try something as simple, cheap, safe and effective, as Mg and ascorbic acid. And instead prefer to stick with the suffering...

Though even my ~80 years old father, totally averse to supplements, out of desperation when constipated for weeks with nothing helping prescribed by his doc, finally did try it. Though he did find it somwhow too extreme to have a bowel movement every day. Therefore he got creative, left out the Mg, and only went with 1 teaspoon of ascorbic acid powder ever second day. Works like a charm to heave a bowel-movement every second day for him. And never experience constipation again.

bro, don't speak wrongly and judgment ally. I have tried magnesium and vitamin c and lots of "natural " things , like carrot salad a la ray peat. So its a weird assumption I have resistance to it. Just bc I didn't mention it necessarily while going over the most recent stuff and having a general emergency


Anyway, what I most need ,more than a laxative , is a stool softener , natural or unnatural I don't care. I have tried malic acid and magnesium and vitamin c but maybe not in high enough doses. I used to take Epsom salts , magnesium sulfate orally and that seemed to work well, sometimes even made things liquid. But that's an okay tradeoff. at some point I switched to milk of magnesia which worked well in hospital and it was what they have. I'm just trying b to not overdose systemically on magnesium and cause an arrhythmias. I know with some forms its hard to do that but I'd be mixing b forms if I tried everything ppl say. People say magnesium citrate but that one in particular seems riskier than Epsom salts. What form do you recommend ? Vitamin c and malic acid have worked well for me in the past but that was before such extreme opioid regimens.

The most important thing I've learned today for medium term going forward is my doctor is almost totally wrong about colase, the stool softener, not causing tolerance. Maybe she thought I meant like addiction or dependencd or withdrawals but I just meant tolerance, working less well, and every article on stool softener , most of which are colase, says it causes tolerance.


i have basically no respiratory depression issues from ooioids even at a high dose id say their biggest issue is constipation, which can really be serious
don't read following if squeamish about talking about stools or whatever. I don't like it but have to discuss
Anyway:
1. I need help immediately today passing this stool which is fairly hard. I am probably going to take Movantik which has the unfortunate effect of blocking a lot of the opioid receptors outside the gut... When its supposed to only do it in the gut. Worsening general pain, but it certainly is concentrated more in the gut than elsewhere , its like it halves your pain medicine peripheral feeling in all of your body except gut , and in the gut it 100% blocks it. So it makes ur gut move intensely and you can t stop it once u start. If it didn't cause some pain elsewhere it would be an almost perfect drug. But also it doesn't make ones anus not sore, it also isn't a stool softener. Its basically just for motility.

What are some things people resort to when desperate but not enough to go to the er. I am willing to use GLOVED fingers with coconut oil for lubricant to try and get in rectum and help some of the shit out. I'm not sure it'll help and it's inconvenient and gross but ill do it. I might do a sitz bath and enema in the morning before shitting.

2.what do I do going forward. I don't want to be on high dose opioid forever anyways , but I was literally just asking my Pcp for an INCREASE bc hospital discharged me post surgery with too low a dose... By which I mean drastically lower than the oral dose I was on, not a gentle step down or taper. I was planning on staying at this general high dose for two weeks post surgery bc of swelling and pain from surgery etc , and then starting a taper . so If I can get thru two weeks without another emergency like this, things should be alright.

Opioids cause constipation , and I already have hemorrhoids. But I think there should be options besides Movantik . I mean in the last two months before this recent surgery , I had far less constipation issues . colase helped while it worked.

so I need to find a way to treat opioid induce constipation as I'm not going from 180 mg or more to 0 overnight no matter what my goal or plan is.

Anyway , u wonder if hemorrhoid cream is helpful as well. Bc all of this makes me sore down there.

finally, I do want to find non opioid analgesics to help rotate ih, but it might be optimistic to assume they WILK totally replace opioids. IV lidocaine, IV magnesium, some supplements like quercetin, gabaoentin, ketamine , oxytocin (the hormone, not the narcotic ), memantine,those are all interesting ideas but you can't just assume theyll aork, opioids are a bit simpler and more time tested. Anyway , request for help and rant over

 

[pamojja]

So its a weird assumption I have resistance to it. Just bc I didn't mention it necessarily while going over the most recent stuff and having a general emergency

Look, no bad intentions at all.

Titration to bowel-tolerance always works, by taking however much it takes. If you tried it.

I have tried malic acid and magnesium and vitamin c but maybe not in high enough doses.

By definition you tried ascorbic acid, but not by titrating to bowel-tolerance in high enough doses to experience a flush, as I informed clearly. Here the best definition and explanation of 'titrating to bowel-tolerance': http://doctoryourself.com/titration.html

In the following table therein (worth reading the whole article though, for understanding what it impies) one can see bowel-tolerance limit is high individual, worse it can fluctuate greadly from day to day:

       TABLE I - USUAL BOWEL TOLERANCE DOSES
 
                               GRAMS ASCORBIC ACID      NUMBER OF DOSES     
CONDITION                  PER 24 HOURS           PER 24 HOURS
normal                       4 -  15              4 -  6
mild cold                   30 -  60              6 - 10
severe cold                 60 - 100+             8 - 15
influenza                  100 - 150              8 - 20
ECHO, coxsackievirus       100 - 150              8 - 20
mononucleosis              150 - 200+            12 - 25
viral pneumonia            100 - 200+            12 - 25
hay fever, asthma           15 -  50              4 -  8
environmental and                                       
 food allergy              0.5 -  50              4 -  8
burn, injury, surgery       25 - 150+             6 - 20
anxiety, exercise and                                   
 other mild stresses        15 -  25              4 -  6
cancer                      15 - 100              4 - 15
ankylosing spondylitis      15 - 100              4 - 15
Reiter's syndrome           15 -  60              4 - 10
acute anterior uveitis      30 - 100              4 - 15
rheumatoid arthritis        15 - 100              4 - 15
bacterial infections        30 - 200+            10 - 25
infectious hepatitis        30 - 100              6 - 15
candidiasis                 15 - 200+             6 - 25

Someone in good health can only tolerate 4-10g before a flush. Someone with something harmless as a seasonal rhinitis, which I have, can easily tolerate 50g in devided doses throughout the day, until the flush comes. With an additional cold it adds up easily to 150 g, where it starts to become really difficult to reach.

Because ascorbic acid is acidic, one has to delute 1 teaspoon in at least 100ml of water. Assuming 5g per teaspoon, thats an additional 4.5 liter of water a day! Clearly too much, making one having to urinate troughout the night.

One workaround I found, just put 1 teaspoon full straight on the toungh, and swallow down with a gulp of water. Or simply use more per glass of water, and mask the sour taste with enough of stevia-extract.

The huge difference to just trying ascorbic acid is: one takes it per 1-2 teaspoons up to every 20 minutes throughout a day.

Only beneficial side-effects. Never had the occasional hemorrhoids again. In fact, an allgedly irreversible walking-disabitity for PAD went into remission. Took in average 25 g/d for 13 years now.

What form do you recommend ? Vitamin c and malic acid have worked well for me in the past but that was before such extreme opioid regimens.

Since I need about 3g of elemental Mg throughout the day (additional to 600mg from diet), just to keep very pain-ful muscle cramps away (without increasing Mg-tests in blood from deficient) I use all of them and find no difference. But thats an individual thing. Only malate I don't tolerate before sleep. To get more Mg in a naturally occuring form, I drink 1 liter of a Mg-rich mineral water a day (1 g/l elemental Mg, in the form of sulfate). All I personaly know can only drink 1 glass of it, before having to go to the toilet. https://en.wikipedia.org/wiki/Donat_Mg Thats also the amount my father took, before finding its not even needed additional to the ascorbic acid every 2nd day.

 

[Crux]

Hi ,

Such terrible misery you have, constipation.
Sorry to read of this.

I don't know if this will help you, but the fat and butyrate in butter keeps me regular.
I'll cook my food in at least 2tbl. Perhaps more is better for severe constipation.

The butyrate is good for the colon too.

 

[frozenborderline]

By definition you tried ascorbic acid, but not by titrating to bowel-tolerance in high enough doses to experience a flush, as I informed clearly. Here the best definition and explanation of 'titrating to bowel-tolerance':

I took huge doses, maybe my bowel tolerance on opioids is like 15g lol

 

[kangaSue]

Low dose naltrexone often enables you to get effective pain management with taking a lower dose of opiod and that in turn can also mitigate the constipating effect of opioids to some degree.

It's not unusual for GI's or colorectal surgeons to prescribe aggresive use of Miralax for however long it takes to soften the stool enough to move it along in fecal impacted cases - as much as six or eight sachets a day and disimpaction of fecal loading with the likes of Miralax usually takes 3-5 days).

Fibre just binds you up more so you should just give that a miss until things are moving again. Unless of course you take it as pectin which ferments to butyrate. A synbiotic relationship is suggested to occur between pectin and bifidobacteria and is said to help relieve constipation;
https://www.mdpi.com/2072-6643/8/10/605/htm

Prucalopride is a motility med often used in gastroparesis when other measures don't help, but it has been found to help in some cases of postoperative ileus;
https://www.frontiersin.org/articles/10.3389/fphar.2020.583422/full

Some physical therapies worth trying are just abdominal massage, or even more specifically, ileocecal valve massage as autonomic dysfunction often affects the efficient functioning of this valve.

Transabdominal interferential current therapy has had some success in helping with functional constipation in clinical trials (more so in women and children). Vagus nerve stimulation with TENS device at some acupressure spots such as ST26 is sometimes helpful;
https://onlinelibrary.wiley.com/doi/abs/10.1111/apt.15642

Perineal acupressure is another option;
https://www.sciencedaily.com/releases/2014/11/141119101852.htm Suffering from constipation? Self-acupressure can help. (perineal acupressure) (2014)
[ Technique; Use your first two fingers to press your perineal skin. It's the area between the anus and either vagina or scrotum.

1. Push on the skin in the direction of your anus.
   
2. Continue pushing in pulses of 3 to 5 seconds each.
   
3. Do this massage when you feel the urge to have a bowel movement.]

A physical finger up the bum disimpaction can sometimes be what's to initiate the process of emptying the bowel;
https://canadiem.org/a-constipation-cocktail/

 

[frozenborderline]

Low dose naltrexone often enables you to get effective pain management with taking a lower dose of opiod and that in turn can also mitigate the constipating effect of opioids to some degree

If I took low dose naltrexone at the dose range it is , like .5 mg to 4 mg I would immediately have precipitated withdrawal and horrible pain most likely. One has to work up to it and ULDN is also supposed to be effective at a lower dose. Nobody really knows this besides besides rat studies but the human anecdotes and my own experiments suggest it will do this harmful thing in 5he range of .5 mg to 4 mg. now, if you are on a more moderate dose of pain meds and you start the LDN before taking the pain meds, it will do what you say. but I'd you33 on 180 mg oxycodone a day and just 5ake an LDN pill it will 5throw you into hell most likely. Have to take uldn or vldn

 

[frozenborderline]

It's not unusual for GI's or colorectal surgeons to prescribe aggresive use of Miralax for however long it takes to soften the stool enough to move it along in fecal impacted cases - as much as six or eight sachets a day and disimpaction of fecal loading with the likes

Thanks. Miralax will be next thing I try. What I really need is another stool softener bc straining 5his much is bad for my surgical wound and back

 

[frozenborderline]

But they dont have any other stool softeners besides colase huh?

Anyway I wonder if relistor works better than movantik in terms of less peripheral blocking of pain meds, not in terms of efficacy, movantik is extremely effective even at low doses. Problem is it just worsens pain too

 

[frozenborderline]

So I have to say, today I had the worst bowel movement I think ice ever had, it was extremely hard. This is gross stuff so trigger warning dont read past this if you are squeamish sh.


I already have hemorrhoids and have blood sometimes even from fairly normal bowel movements. This one didnt actually cause that much blood. But I had to do two things to get through it and even then I havwnt recovered physically from 5he consequ2nces. I'm about 9 days out from my surgery, this hurt my back both from straining, from moving around in bathroom to grab things I needed or get onto toilet bc it's too embarrassing 6o have someone in there , but also bc it was such a long painful bowel movement. It even hurt my neck which doesnt tend to hurt since I'm 2 months or more out from the neck surgery.

So it was so hard I actually had to use a gloved, lubricated hand and dig out pieces of the stool every time I pushed involuntarily (I used movantik, which claims to block only opioid receptors in the gut , but clearly blocks some peripheral ones worsening general pain. It always works brilliantly except for causing extra pain. And it's not a stool softener. It just undoes the effects of opioids on the gut motility. Which is dramatic. But I couldn't take it every day! Bc it worsens pain. So what's the point , the pain meds I need cause constipation so I take something 5hat blocks them to undo it???). This went on for a long time before I was able to get to the point where I undid what seemed like impaction (but it may not count, since impaction is apparently something u need hospital for ), but was regardless hard stool that was stuck regardless of how my gut contracted. Finally i passed a big, hard stool without having to pull it out, that was the last of it. The whole time I was worried about blood and prolapse but actually maybe bc of randomness and where my hemorrhoids are located the blood was way less than the pain indicated. I talked about my back pain from having an incision and pained muscles from surgery now straining a ton, and my neck pain. But it did also hurt my anus a lot. I had some fear it would cause a prolapse or something but I also didnt want to get it pulled out by a nurse so I tried to do it myself and it worked but took forever , and hurt most of the time. It hurt in my rectum, I think I have internal hemorrhoids.



The problems summarized:

• hemorrhoids. Well, there could be a fissure but its probably hemorrhoids occams razor. Have gotten PCP to check them out. I get blood a LOT these days but given the harder stools it makes sense. My doctor and I can feel the hemorrhoids. But she says I need a GI specialist to rule out a fissure
• Hard stools. This was managed with a stool softener, colase at large doses, for the whole period after my first surgery and it worked great most of the period. I dont recall any traumatic, very hard bowel movements. It was such an amazing stool softener that I could go so many days without shitting , bc I was so often in bed and on opioids that I didnt have much motility, but when I did go, it wasn't hard. That was so great especially as I have idiosyncratic nutrition needs and sometimes cant even eat solid fibrous foods which would make me have to go to bathroom often. Also great bc the opioids were necessary but decrease motility. Near the time of the next (one I just had) surgery, I had a difficult bowel movement and asked my PCP "can colase cause tolerance iissues and dependence meaning it loses efficacy being on it daily?" She said definitely not. Well, after this nightmare today I looked it up and that's not true in the least. Its widely known to cause tolerance. So that would explain all of this. the problem is now finding a way to soften all my stools for the few week period of being on high dose opioids. Just going more often would naturally do that but the only way I can force better motility is to take movantik , which I will get into the problems with in next section. So, it leaves the question of is there another stool softener out there. Pharmaceutical options seem limited. It seems like everything is just different variants of docusate , which is colase, I dont think switching to the calcium salt from the sodium one will dramatically change how it acts. I also wonder if my stools would be even harder if I stopped it and if I have to keep taking it while I find another softener to work, just to be safe. If there is a pharmaceutical stool softener I missed please enlighten me. I'm writing 5his essay bc I dont want this to happen again, not bc I want to be correct. Then there are natural stool softeners maybe. If you take enough magnesium or vitamin c it can cause diarrhea which is fine, but that shows it works as stool softener. Magnesium requires more caution bc of already taking it on skin and just bc theres more of a limit and can cause arrhythmias if you go past it. however idk what's the best form for making bowels move. Epsom salts? Mag glycinate, mag citrate??(people always say that one but that's the riskiest according to many doctors x but this is short term sort of ). I used to take epsom salts orally despite the foul taste and they softened stool. But if other forms of magnesium came in powder I could dissolve rather than tablets , I would try those more. Or liquid. Then there is Miralax. It's not a stool softener officially but it can cause loose stools so that makes it one ? What are the harms ? Tldr: I need a new stool softener.
• Miralax. Polyethylene glycol. Scary name but I know it is fairly meaningless. I do have mcas though so I'm careful with things known to be allergenic and I know its chemical cousin propylene glycol is. But a lot of people say taking this regularly for a period, say an extreme period like this, will help with my exact problems. I took it and it seems to have made me a bit nauseous but I'm sleepy so I can't totally evaluate it. Would love to hear reports about it , good or bad.
• Movantik: this is the last resort but given how bad five days was, I could maybe use it earlier and consider the emergency before it develops. It blocks opioid receptors in the gut only supposedly due to some pharmaceutical voodoo. In reality I think it blocks a lot of peripheral opioid receptors. Which means it makes your gut move intensely ime no matter what, be near a toilet within the hour... but it also worsens pain for a period . I've heard an ER doc say just take oral naloxone/narcan and that it would do the same thing movantik is supposed to. haven't tried that. It just sucks that the only thing I now have that definitely works for constipation worsens pain.
• Diet. I dont think my diet is that bad. I've read lots of nutrition debates but listened to mu body too and ended up with a diet where I avoid wheat which I react to and most whole grains, but eat simple starches like potatoes, eggs, mushrooms, cooked vegetables although not enough, raw carrot salad with coconut oil and vinegar. And often shakes with frozen banana, milk and cashew butter when I have a hard time getting other stuff down. Then seafood if I'm lucky, and then I plan to introduce more beef for the iron , or liver paté. Besides the carrot salad theres not a ton of fiber in the diet , it was made before I had constipation and I was just eating what felt nourishing without worrying too much. Oh also fruit. Anyway, now I have to think more about diet. Although my diet wasnt at all terrible leading up to this traumatic bathroom experience so I feel like its dysmotility combined with the colase not working. Maybe more coconut oil will help lubricate movements
• As far as herbal things go how about emodin/cascara sagrada.
• Tried a fleet enema. Hard to say how much it helped bc of circumstances
• Tldr:need new stool softener bc colase isnt working , need to be able to use bathroom on opioids. Will try Miralax, first dose made me nauseous. So so desperate for stool softeners that work.

 

[frozenborderline]

Is Miralax supposed to make you feel nauseous? Experience from people who've had it especially with mcas?

Are there pharma stool softeners besides the docusate/colase ?

Would a daily enema do similar benefit to stool softeners?

 

[pamojja]

I took huge doses, maybe my bowel tolerance on opioids is like 15g lol

15g per day is a low dose, when it comes to 'titrating to bowel-tolerance. And if you've taken less than that, just maintenance and anything else than huge. It has to be taken as at least 5g every 20 minutes throughout the day. Which with 16 waking hours would give you 48g. That is 'huge', but not with further comorbities, which can drive the need up to 150 g/d or even higher. Where one has to take that much more, if one wants the benefits.

So after all you still don't understand or want to try? And my original assessment, that the resistance to try titrating to bowel tolerance is so persistant, that most would prefer to stick with the suffering many more months. Nothing judgmental, but just as it is.

I'm bowing out. Best luck to you.

 

[frozenborderline]

So after all you still don't understand or want to try? And my original assessment, that the resistance to try titrating to bowel tolerance is so persistant, that most would prefer to stick with the suffering many more months. Nothing judgmental, but just as it is.

Wait what??? What makes u think that. It's only been a day since you brought it up. I already started taking higher doses of vitamin c. Jesus...

 

[Wayne]

Hi @frozenborderline -- I haven't read in detail your difficult situation, but have you tried daily coffee enemas for both pain management and regularity? I could fill you in on my own long-term success with each using daily CEs if you're interested. -- Going down for a nap right now, but will check in later...

 

[frozenborderline]

And my original assessment, that the resistance to try titrating to bowel tolerance is so persistant, that most would prefer to stick with the suffering many more months. Nothing judgmental, but just as it is.

It is judgmental. Not even in the sense of being harsh or mean spirited but in the sense of making a judgment without enough information, about someone else. It's been two days max since I posted about this and you replied. It often takes me weeks to implement a new treatment, but in this case I've already sent my caregiver, who preps all my supplement drinks or whatever, the info on this and I've already upped my dose of vitamin c.

 

[frozenborderline]

Hi @frozenborderline -- I haven't read in detail your difficult situation, but have you tried daily coffee enemas for both pain management and regularity? I could fill you in on my own long-term success with each using daily CEs if you're interested. -- Going down for a nap right now, but will check in later...

I was interested in coffee enemas for multiple reasons, detoxification and also helping bowel movements , but I have hemorrhoids and I read stuff about them being unsafe?? I have done the medically approved fleet enemas once now... anyway I dont understand what makes them unsafe, is it that coffee is not sterile, also I managed to do a fleet enemas without causing bleeding despite having hemorrhoids, so i think maybe it's possible in general