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Dr. F
Dr. F, Board Certified MD
Category: Neurology
Satisfied Customers: 266
Experience:  Neurosurgeon with more than 20 years experience in practice and teaching.
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I have a real problem with constipation and fecal impaction.

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I have a real problem with constipation and fecal impaction. I am on 50 Fenanyl patch for pain associated with unidentified pain in my left knee. After many MRI's local and Toronto neurosurgeons can find nothing to operate on and I am left with pain and a major constipation problem. I have been to the hospital three times in the last seven years with fecal impaction, paralytic ileus, etc. and I do not want to go through that again.
At the moment I am using Milk of Magnesia and a high fibre diet, but must clean myself out with the Magnesia every three days or so. It is a nightmare. I am attempting to reduce my Fentanyl but that seems impossible at this juncture.
Is their a best way for spinal cord injured patients and people like me to control their elimination?
Mr. Lynn Barber

Dear Mr Barber,

Have you tried Miralax?

What have you tried to get off the Fentanyl? I fear your problems will never end as long as narcotics are in your system.

it would also help us to know:

-What other medical problems do you have?

Thank you again for trusting us with your problem. Please reply as soon as possible so that we can finish answering your question.

Customer: replied 6 years ago.

No, I have not tried Miralax, but I suspect it might have something in it I respond badly to. At least, according to my recollection that is why I have not tried it.

I am trying to get off the Fentanyl patch, but am stopped at 50 because of bad pain. No possible surbery in the offing.

I have further problems with my bowels: IBS. As well it seems that whatever is pinching my nerve may also be slowing down the aciton of my bowels.

I have had pituitary surgeries (1979, 1984) and am on replacement hormones: thyroxin, prednisone and Androgel.

Fentanyl has a lot of problems for long term treatment, including constipation. The treatment for pain that works on the nerves, such as neurontin, may allow you to be comfortable, with out as many side effects.

If you are not sure you have tried Miralax, I would give it a try. It has been quite effective for many who are otherwise untreatable, and has fewer side effects than most medications.

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