Gastro Issues and Options/Opinions
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Hello all,
I am hoping someone can shed some light on my somewhat “unique” situation. I’m a 38yo male and live in NJ- USA. I’ve had bowel issues for quite some time-the primary constipation.
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About 3 years ago, a Dr. suggested an antidepressant, so I started Lexapro. I didn’t “love” how I felt mentally and experimented throughout the time, but always resorted back to Lexapro.
During this quarantine things exasperated so, I used the downtime to experiment.
I discovered, though Lexapro does help my constipation, it certainly does nothing for my mood or cramping and bloating. I’m not sure if the Lexapro is causing/worsening the cramps and bloating (since I’ve always had them) or if the symptoms are just part of my pre-existing problem and Lexapro is not helping or worsening them- it’s just not enough to control it all.
I recently experimented with Prozac first 20mg and then 10mg (20 was too much for me). I discovered the Prozac helps my mood (a lot) and it controls the cramping bloating, etc. the downfall is that it worsens my constipation, even when I take laxatives, I find myself constipated.
My standard regimen for years has been to take a laxative at night so that in the morning I go to the bathroom. Taking it at night also helps avoid side effects during the day- I often end up waking up throughout the night to go to the bathroom which I have grown accustomed to. Furthermore I’ve always taken my Lexapro in the morning along with my daily vitamins etc.
Since they both have pros and cons I don’t know what to do.
My thought was to reduce the Lexapro from 10mg to 5 and take it with my laxative before bed (since it helps my regularity and does cause some drowsiness) and then take 5mg of Prozac in the AM since it helps with my mood and TREMENDOUSLY helps control my GI issues. I have not tried it yet as I’m afraid to over-do it.
I am awaiting a call back from my doctor but I figured I’d get some other opinions in the meantime.
Any thoughts are much appreciated as I’m pretty desperate for answers at this point.
Albert
0 likes, 2 replies
emma86470 albert_99155
Edited
Hi, I wonder about what you refer to here as your 'regimen'. It's a really bad idea to take laxatives longterm as this eventually leads to worsening the problem rather than improving it. You're quite correct that many antidepressants do also worsen constipation, and moreover they're generally contraindicated longterm unless you are significantly clinically depressed throughout that time, and this doesn't sound to be the case (but correct me if I am misunderstanding). So, my reading is that you could be best going gradually off all your laxatives and anti-depressants and trying to find out whether there is some food intolerance triggering the cramping and bloating (which can also affect your mood). Given that you say these are long-standing symptoms I would look at identifying any diet sensitivities first--perhaps by means of an exclusion diet, carefully monitored. Antidepressants certainly can help in IBS in low doses--too low to affect your mood though. Good luck and I hope you find some improvement.
albert_99155 emma86470
Edited
Thank you so much for responding. You are correct in that I am not severely depressed. I actually have no mental issues aside from some anxiety and being. Particular about things. I guess my post was a bit vague.
I have diverticula and I do have muscle damage from using stimulant laxatives long term. I also have a prolapsed rectum which causes a blockage when inflamed. Unfortunately the combo of muscular damage, diverticulitis, and inflammation is just an unfortunate coincidence. Also every-day stress and anxiety add to these problems.
When I say laxatives I mean prescription aides such as Mirilax, Trulance and Linzess- non stimulating laxatives (maybe laxative is not the correct term).
I have anatomical damage which I do need surgery to correct, I did every food/allergy etc. test and played around with various “diets.” Naturally, being well hydrated and taking in sufficient fiber is a factor and having a balance certainly helps, it can only do so much for the issue.
It seems the Lexapro helps prevent some negative side effects and helps me digest and to go to the bathroom whereas the Prozac seems to eliminate cramping bloating etc.
I will ultimately need surgery but for now this seems to be what is helping. I did clear it with my Dr. he said he is ok with me trying it as long as both are taken at a low dose and spread apart. It’s been three days and it’s the best I’ve felt in ages.
Not my ideal but adequate for now I guess.