Constipation? Or something else...help!

[Max Potter]

Recently I started properly taking my medicine (about two months ago). Then one night I woke up with a lot of lower back/ pelvic pain and constipation....is this a side effect of now appropriately taking my enzymes? It's now moved from my lower back to the front but still constipation.

 

[azdesertrat]

Hi Max.
First, I hope you're feeling better.
Second, it sounds like you either took too much or too little enzymes for what you ate.
If you're just starting to take enzymes, you may have to kinda experiment with the amount you have to take with each meal.
What kind of enzymes are you taking?
I take Pancreaze MT-16 & MT-10. I take one MT-16 with a bowl of cereal. I usually take four with my big meal of the day, supper, or lunch, whichever is the biggest meal I eat.
When I eat a sandwich, I'll take one of the MT-16's & one of the MT-10's.
I've got my dosing pretty well perfected.
Of course, there are times I still screw up. When I do, I pay dearly.
Like you, backache, bellyache & the whole bit.
Usually I can clear things out by doing a couple of doses of Miralax.
When having to 'clean out' I'll take one dose of Miralax every 5-7 hrs. until it all goes away. Then, I'm good until the next time I screw up!
Recently, my CF doc told me to do a dose of Miralax daily, for maintenance so to speak. It has been working great!
Maybe you should ask your doc if this might be right for you.
Best of luck to you, I hope I've been of some help.

 

[TreasureGoddess]

I agree with Pat. The enzyme dosing is kind of a guessing game, you get better as you go. I'd do some extra miralax to get relief and clean things out a bit. Then daily use 1 cap of miralax to keep things working well.

 

[LittleLab4CF]

Wow! Pancrease is back, I keep forgetting to try it again. Now four years ago I devoted the better part of three years learning everything possible about bowel health, specifically CF bowel motility. Enzymes can be dialed in or titrated using tests like fecal elastase and steatorrhea and some black magic.

My experience has been this. Lack of good bowel habits will result in constipation regardless of CF but CF can raise hell with the gut. Hydration, a gallon of liquid a day, electrolytes for hydration as well as excess magnesium, calcium, salt and potassium from foods are a must. Myrilax or PEG, Lactulose and natural bulking laxatives are gravity plungers that soften feces and keep slow transit from absorbing too much water. The longer our food remains in the bowel, the more water is drawn out making for painful fecal adhesion to the bowel epithelia. We often peel the inside of the bowel when a dry, hard stool passes. Ooh! Bulking laxatives hold water as a gel that are inert and a solid to the stomach.

Enzyme balance is something you'll figure out soon. I hope. I found that too much enzymes leans into constipation and some report a fine limit between just right and getting blocked up. This is standard hard constipation. Not enough enzymes or if the timing is off and my stool is very sticky inside and out. This adhesive poop results from maldigestion mixed with all the sticky mucus from our head and lungs along with unbelievably adhesive mucus produced by the pancreas, stomach and the large and small bowel.

This soft, peanut butter mess is behind DIOS or Distal Intestinal Obstruction Syndrome. It isn't illusion that maldigestion mixed with malabsorption produces more fecal mass than food volume. Our own sticky walled intestines can latch onto some under digested mush and you know real quick that enzymes need adjusting. DIOS usually is just extremely miserable but it a true bowel obstruction that could require emergency medicine. Adjusting enzyme supplements up should result in a firm regular bowel movement and floating/gassy feces and oil floating on the water should go away.

Starting out with enzymes almost always results in constipation until everything is adjusted. A bout of the scoots isn't uncommon either in the beginning. A topic post recently discussed Creon's delayed release. An enteric coating on the bits inside the capsules delays their release an hour or two, I don't remember. The point is Creon and probably Pancreacarb want to delay working until it and food arrive in the duodenum, where the pancreas and bile would deliver enzymes. The topic post and threads suggest that at some time, try taking enzymes beforehand by fifteen minute increments and after eating by the same amounts if taking them as directed is not ideal.

Good luck,

LL