Lactulose Did It

Constipation can be a pain, more so when my bowel control is impaired. My spinal cord injury is at C-5/C-6 (fifth and sixth cervical vertebrae). An injury above the T-12 (twelfth thorasic vertebrae) level loses the ability to sense when the bowel is full. It will empty by reflex or automatically. This is called the upper motor neuron or reflex bowel.

I follow a programme where I empty my bowel every third day with suppositories. This enables me to plan my routines and activities. My bowel programme usually lasts about ninety minutes – from insertion of a suppository into the rectum to the conclusion. However, for the past few weeks, I have been suffering from constipation. I suspect that Sangobion, the iron supplement that I have been taking, could be one of the causes. I have been spending two to four hours inside the toilet huffing and puffing without much success and have been feeling miserable lately because of that unfinished business.

To counter constipation, Wuan has been adding more vegetables to my meals and fed me with papayas, oranges and bananas. Additionally, I have been eating prunes. This is something that I do not fancy eating if not for its bowel easing properties. All that were in vain. Nothing worked. Laxatives and enemas could help but those are options that I would rather not resort to if I had other choices.

I first came to know of Lactulose when the doctors prescribed for Mum. She was taking Dihydrocodeine Tartrate to relief her pain during those last few months. One of the side effects of Dihydrocodeine is constipation and Lactulose was to counter that. Lately, I have also discovered that Lactulose has been prescribed to people with spinal cord injury. That made me consider it as one of the options to help ease the recurring problem.

Lactulose looks and tastes exactly like sugar syrup. It is a synthetic sugar, used to treat constipation. It is not metabolised or absorbed by the body. Bacteria in the colon breaks it down into acids. The acids draws water to the colon and softens the stool. A quick research with Google confirms that it will not produce adverse effects on people with chronic renal failure. In fact, Lactulose also draws ammonia from the blood into the colon where it is excreted with the stool which helps people with liver disease.

I had my first dose on Wednesday. As I did not know how I will react to it, I took the minimum recommended dose of 10ml. I increased it to 15ml on Thursday. A short while after I had my second dose, I had the urge to move my bowels. There was still some hints of constipation but as my bowel gradually cleared, it became easier. Today is the first time in many weeks that I have really felt relieved. And here I am telling the whole world about it.

Author: Peter Tan

Peter Gabriel Tan. Penangite residing in the Klang Valley. Blissfully married to Wuan. A LaSallian through and through. Slave to three cats. Wheelchair user since 1984. End-stage renal disease since 2017. Principal Facilitator at Peter Tan Training specialising in Disability Equality Training. Former columnist of Breaking Barriers with The Borneo Post. This blog chronicles my life, thoughts and opinions. Connect with me on Twitter and Facebook.

16 thoughts on “Lactulose Did It”

  1. Peter – I am always following your blog without fail. I am glad you have Wuan by your side at all times. I truly hope you will labor on and hope you will continue to pen your inspiring thoughts whenever possible. Take good care of yourself and my regards to Wuan from all of us in Penang.

  2. For you to have the courage even to share this with us, to maybe empathise or even learn along with you – I don’t know how to copmplete this sentence. I would definitely make a horrible copywriter =P hang in there buddy

  3. If you are constipated and you eat bananas, you will be in more trouble. Bananas do not soften your stool but on the contrary they will harden your stool. Papayas, on the other hand, will do the trick. I don’t know about oranges.

  4. thank you for sharing, even abt stuff like this. it helps me understand better the challenges you (and other ppl in similar situation) face. take good care.

  5. We all know how it feels when our bowels are overloaded. At least this post, we learnt something new.

  6. haha petes, the best way is to mix/jumble all 3 fruits together + some shandy or beer =p i did just that during first day of CNY lately, and believe it anot, i started rushing to the loo at 4 in the morning.. and it didnt end until the 3rd day *lol* wat a way to spend CNY, haha.. all in all, i hope u do get better soon enuff dear *hugz*

  7. Hi Peter,
    Lactulose is an osmotic agent used in constipation.
    I suggest you use psyllium husk which is a natural sources of soluble fibers. It may take few days to perform, but it certainly works.(like Hokkien ppl say: you pih, you eng, you chu bee= cheap, easy and cute) =D

    Iron is one of the medication which can cause constipation.

    The other main ones are:
    -opioid analgesic(codeine, morphine, dihydrocodeine)
    -cough supressants (codeine, dihydrocodeine, dextromethorphan)
    -drugs with anticholinergic effct (antihistamine, TCA,)
    -cations in antacid
    -antihypertensive

    If you need any information of any medication, pls let me know. I can always give you a solid information. ^_*

  8. Oh, I hope the constipation would be totally gone by now.
    Btw, I read some where that banana sometimes causes constipation esp when eaten raw (some baby website which I checked on Zara’s constipation problem). Maybe you should avoid it when face with such problem.

    Anyway good luck and take care.

  9. Thank you all for your kind words and advice. I am much better now. Bananas cause constipation? That is one of my favourite fruits wor. How?

  10. Babanas are very rich in minerals esp sodium. When we eat it , it hyper-tonics the large intestines and makes our stool ‘dry’. However it depends on the type of bananas.
    Papayas are much better at inducing regularity.

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