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What Causes Incomplete And Frequent Bowel Movements While On Amiodarone?

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Posted on Tue, 13 Jun 2017
Question: I sometimes have a difficult time having a bowel movement. I am a rectal cancer survivor since 2000 and have had regular colonoscopies since then and all is always well. My stool is not hard but sometimes i wonder if my muscles are too weak. In the last month I have had to use a fiber drink and even a stool softener because I don't want to strain. Anyway in the last month I have had smallish BMs mostly but three or four times I expell a lot. Tonight I expelled about one and half foot of B.m., it was straight, not curved, color is fine etc. and it was pointy at the tip. Which I hear is how it ought to be. Is it normal to do this? I know it sounds goofy but it does concern me. I would like to go back to having normal BMs daily or so. any ideas? April 3 2017 I had a bad reaction to heart medication. Pulse was 20 and I was very close to loosing consciousness. Airlifted to Rapid City and spent a few days in Cardiac ICU. They reduced that medication to one a day INSTEAD of four a day. This problem with bowels started while on four a day.The medication is Amiodarone HCL 200 mg in a.m. I was on 400 in a.m. and 400 hundred in pm. Could that have caused it?
doctor
Answered by Dr. Sunil (1 hour later)
Brief Answer:
Can be side effect of high dose amiodarone.

Detailed Answer:
Hello,
Thanks for choosing HealtrhacareMagic for your query.

Incomplete and infrequent bowel moments is one of the commonest side effect encountered with amiodarone therapy. 800mg a day is a bit high dose of amiodarone.
Right now you are on a stool softner. I would suggest you to shift to Laxative.Laxative are substances that loosen stools and increase bowel movements.Laxative usually irritates the rectal mucosa and cause expulsion of stools.Stool softeners prevent or treat constipation by making the stools less hard. They do not directly cause bowel movements by contrast, laxatives like lactulose act by directly producing bowel movements by stimulating the rectum.As from your history its clear that you are experiencing problem having a bowel moment(Laxative will help you).

On the other hand take in person appointment with a surgeon and go for digital rectal examination to check for the patency of anal and rectal muscles.If required an anorectal manometry can be performed -This test measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements.

Bowel moment can vary from day to day. Stools impacted into a single mass and lumped together by fiber components and some bacteria(As in your case large piece of stool).It can cause anal canal laceration, hemorrhoidal prolapse in long terms.Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstruction, or perforation of the small and large intestine.Extra fibers is the cause of expelling a lot each time you go to bowel.
So keep your fiber intake at about 25-30 gram daily.
Take 1 cup of fruits like orange banana pears that is enough to meet your extra fiber requirement.
Take lots of curd and probiotic rich food.
Avoid oily and spicy food.
Drink on glass of XXXXXXX warm water 15 min before going to washroom.
keep yourself hydrated.Water increases the motility of stools.
Take a probiotic regularly.
Linseed oil and fish is good for you.
Avoid meat,egg and dairies.
No smoking and alcohol.

Hope i answered your query well.
Feel free to follow up.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sunil (18 hours later)
My rectal cancer was right between the two sphincter muscles and was very painful. It was called squamous cell carcinoma. The reading material on it said it can even be in the lungs or anywhere in the body. It was about the size of a nickel and chemotherapy (directly into the vein in the chest above the heart) and about 36 radiation treatments and I was declared cancer free.
This has been very helpful.
I will talk to my family doctor and will ask him to direct me to physician that specializes in that area. I was beginning to wonder about the extra fiber. The cereal was fine until I was put on that 800 mgs and even now on the 200. The pharmacist even called the cardiologist to check that 800 mg prescription. Thank you for your help. I will keep this opened ok? When you said surgeon ... is that what we call a physician. I have a friend in Cornwall in the UK and she says "I will see the surgeon next week." and it is more of an family doctor. Are you from England?
doctor
Answered by Dr. Sunil (8 hours later)
Brief Answer:
Folow up advice.

Detailed Answer:
Hi,
Thank you so much Dear.
I am from XXXXXXX but from last 10 years i am at UAE.
Here we have two different types of doctors the first one is general physician and the second one is surgeon.
Surgeons perform many of the same duties as other physicians, recording patients' medical histories and diagnosing illnesses, injuries and other conditions. However, while physicians therapies typically encourage the body to heal itself(by medicines), surgeons act directly(often surgically) to correct illnesses, injuries and deformities.

There is a old proverb too much of anythig is good for nothing,No doubts fibers are good but intake should be increased gradually and in no case total fiber intake should be more then 30-35 gram per day.
800mg twice daily is too high a dose and infact frankly speaking this was i doubt a correct dose and this dose was responsible for severe bradycardia in your case.So XXXXXXX opinion is try to get a second opinion from a cardiologist too.

Thank you and hope to hear back from you soon.
I wish you a great luck and regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sunil (21 hours later)
Thank you for being candid. Actually it was 400 mg in a.m. And 400 p.m. So a total of 800 daily. I also read, and was told by the second cardiologist that this medication can stay in our system for weeks and even months
Last night and today I ate fresh fruit and had fish for supper. I have fish about two times a week. Love fish. I also take fish oil twice a day for cholesterol. My cholesterol has been great for five years now. I also take 20 mg of simvastatin every night. That was cut from 40 mg. all my test come back so normal. I have also lost 30 plus pounds in the last year.
This has been very helpful. Yesterday was my 75 birthday and today I started working on research fact gathering on community needs. We have our share of poor, elderly in need of immediate assistance at times. The man doing this died and a few ministers are trying to fill the gap. I am thrilled they asked me. I am a retired newspaper reporter, past social work, did an internship in a federal prison and also a shelter for abused women and children in a large city. I feel my life and excitement is returning. This kind of work is my calling. So I want to get and stay healthy. Both parents lived into their nineties I I want to also. Sorry for talking so much but I am anxious to get busy. I have already started. Yea!
doctor
Answered by Dr. Sunil (4 hours later)
Brief Answer:
Happy belated birthday.

Detailed Answer:
Hi again Dear,
Happy belated birthday to you dear.Where is my cake?
Its nice to hear back from you and i wish you a great health from the deepest corner of my heart both as a doctor and as a friend..

The usual dose of amiodarone is 200mg twice to thrice daily.Yes this drog may take weeks to clear up from blood. 20mg simvastatin is an optimal dose and its good that your lipids are in control.

Its good to hear that you are doing so much for the community.
At last would only say that-May your birthday bring you sweet memories and all the beautiful things that you deserve. While you might be getting older, you are still as strong as when you were kid.Best of luck for your life.I hope someday due to your deeds you birthday is celebrated not only by your family your loved ones but by the whole world.

Again a very happy and belated birth day;But where's my cake? ha ha.

Warm regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sunil (7 hours later)
I didn't have a cake. I did have two oatmeal raisin cookies however and a small amount of Weight Watchers raspberry ice cream. I rarely if ever use Weight Watchers products because it doesn't teach PORTION CONTROL. Most of those diet foods are higher in sodium, and chemicals. I truly try to eat fresh or frozen foods and fish and chicken. I do have beef in my freezer but pork is actually healthier. By beef is just ground beef to make hamburger patties.
I don't kn ow your religion and don't mean to be offensive but I do eat beef liver once or twice a month. I have always been slightly anemic since childhood and as an adult I tried not to eat it often because of cholesterol being too high. But now I eat it more often and feel better. My diet has changed a lot this past year and with the weight loss and feeling so much better it has been irritating to have these other health issues.
I am the kind of person who takes one step at a time. That is, for me, the path through difficulties as they arise.
So this last year I have learned portion control and using fresh foods even more than ever. I very rarely eat processed foods. I don't even use white rice. I use black rice and sometimes mix some brown rice with it. I have rice 2-3 times or more a week.
I have found that I don't have to leave anything off my diet but to control the amount. If a person FILLS UP on low calorie food they are not teaching themselves not to stuff their faces and that NEED to eat eat eat is never satisfied. I don't do that anymore and I love it.
I am changing my attitudes about food and why I eat. I love unique flavors and use garlic, onion, cumin, XXXXXXX oregano and black pepper and sage a lot. I have had curry but don't know how to use it.
BUT I HAVE TO HAVE A LITTLE CHOCOLATE ONCE IN A WHILE. THAT IS A LAW OF NATURE.. HA HA HA
Thanks again..
You are like speaking with a trusted friend and I truly value your experience and insight. XXXXXXX XXXXXXX
doctor
Answered by Dr. Sunil (1 hour later)
Brief Answer:
you're always welcome to have my assistance XXXXXXX

Detailed Answer:

I wish you a great health and a very happy life ahead XXXXXXX

Stay in touch and keep enjoying.

Best regards

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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What Causes Incomplete And Frequent Bowel Movements While On Amiodarone?

Brief Answer: Can be side effect of high dose amiodarone. Detailed Answer: Hello, Thanks for choosing HealtrhacareMagic for your query. Incomplete and infrequent bowel moments is one of the commonest side effect encountered with amiodarone therapy. 800mg a day is a bit high dose of amiodarone. Right now you are on a stool softner. I would suggest you to shift to Laxative.Laxative are substances that loosen stools and increase bowel movements.Laxative usually irritates the rectal mucosa and cause expulsion of stools.Stool softeners prevent or treat constipation by making the stools less hard. They do not directly cause bowel movements by contrast, laxatives like lactulose act by directly producing bowel movements by stimulating the rectum.As from your history its clear that you are experiencing problem having a bowel moment(Laxative will help you). On the other hand take in person appointment with a surgeon and go for digital rectal examination to check for the patency of anal and rectal muscles.If required an anorectal manometry can be performed -This test measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements. Bowel moment can vary from day to day. Stools impacted into a single mass and lumped together by fiber components and some bacteria(As in your case large piece of stool).It can cause anal canal laceration, hemorrhoidal prolapse in long terms.Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstruction, or perforation of the small and large intestine.Extra fibers is the cause of expelling a lot each time you go to bowel. So keep your fiber intake at about 25-30 gram daily. Take 1 cup of fruits like orange banana pears that is enough to meet your extra fiber requirement. Take lots of curd and probiotic rich food. Avoid oily and spicy food. Drink on glass of XXXXXXX warm water 15 min before going to washroom. keep yourself hydrated.Water increases the motility of stools. Take a probiotic regularly. Linseed oil and fish is good for you. Avoid meat,egg and dairies. No smoking and alcohol. Hope i answered your query well. Feel free to follow up. Regards.