How to manage Gabapentin's constipation
 

Okay,

I feel silly posting this since I posted a similar question 6 months ago, and never thought to read the Gabapentin literature to discover constipation occurs in 3.9% of folks. How luck I am being one of the few! Actually, I am more upset with my GI doc and my pain doc who never suggested this unlikely cause. Isn't that THEIR JOB? :mad:

As a refresher, I have idiopathic neuropathy of both feet and ankles, and have so far not found a mechanical or metabolic cause. But we'll keep searching...

These days I am on Gabapentin 1800mg/day, which is working well; ramped up over time from 100. 8 months after I hit 1500 mg/day I began with GI problems: reflux, upset stomach, bloating, burping. Now it is worse on 1800. Because I experienced this twice before in my life I immediately saw a GI doc.

I am now on Magnesium oxide and Amitiza to combat the constipation. They are doing well on the bloating but after a moderate sized meal things seem to linger in my GI track for hours with cramping and pressure.

Can folks recommend something else to help manage the constipation?

Depends on who you ask. Is it theirs? Your PCP's (who is supposed to coordinte the others)? The pharmacist's? Yours for not reading the literature that came with your prescription?

I don't know. I believe in fixing the problem -- not the blame.

There are a lot of threads on just that question. It's one of the perennial ones, and not just for gabapentin. It's a common (vs. unlikely) S/E of opioid pain medications too. Some folks use OTC remedies, and some can benefit from Yakima fruit paste (recipe in archives).

Doc

I am on gabapentin and I,too, experience constipation, bloating, feeling full after eating small amount of food. I counter this with Metamucil before bedtime, at least 2 hours after taking the gabapentin. It helps too to eat more veggies and I am on Kefir daily.

I have been using Metamucil Clear & Natural (the kind you can use in cooking & baking), 1 heaping tsp. in am and bedtime, for a few years. The large size says 56 doses, so it lasts about a month and is about $12. I just dissolve in plain tap water and take it with my meds. Practically tasteless and no grit. I usually order 4-5 at a time from drugstore.com, or Rite Aid on-line, and get free shipping.

Thanks for all the good ideas.

At one time I was on ClearLAX (aka MiraLAX) (polyethylene glycol 3350) but that did not do the trick, so the GI doc had me use Amitiza and drop the ClearLAX because he thought it might be too much. I also think my constipation is order of magnitude worse than most since I already follow the proper diet (high fiber diet, drink lots of water, etc.).

Starting today I am adding in the ClearLAX again. My understanding is it is an equivalent alternative to Metamucil. Can anyone confirm my thinking on this, or is Metamucil better in some way?

I have always had severe constipation issues. Miralax aka clear lax has been many, many times better than Metamucil. Especially if you already follow a high fiber diet, Metamucil can actually make things worse by creating bulk that is too big to pass (tmi, I know!) i just accept the fact that I take 1.5 doses every day, and never have a problem. I had severe fissures and the miralax cleared those up as well, resolving many months of intense pain.

Mine is the powder and sugar free (i think orange flavor) version. I buy it from Sams. I forgot the price but definitely its more than $20 for 2 bottles.

I take it at least 2 hours after my medicines. I am under the impression that fiber supplements should not be taken with medicines because of its bulk, it will somehow "bind" the medicines and will "wash-it-away".

Thanks for the post, it helped.
 

Thanks for the info, it really helped. My GP did not warn me and I found myself dealing with fecal impaction, a very horrible experience. Youtube has some videos on the subject but when it happens to you it's just horrible. To make it short you have to remove the fecal matter with your finger or rush to a hospital. Be prepared, make sure you have enough meds/supplements/enemas to deal with it when and if it happens.

Well for me, I avoid the drugs that cause so many other issues and for sure the horrid constipation mess. I've never taken the Gabapenten and a friend who took it for years is off it now as the Grape Seed Extract she's been taking for probably 8 yrs is helping in her neuropathy issues...

And for me, I keep a good amount of magnesium citrate going for a life history of sluggish blocked bowels. Vit C too.