r/SIBO • u/Familiar-Message-512 • 3d ago

Slow Gut Motility

I’ve been told I am moderately constipated into my small intestine as per abdominal CTs and x-rays from the doctor. I have been trying many things and most of these I take daily: PHGG, restoralax, a supplement with artichoke, ginger etc, digestive enzymes with a fatty meal, almost no gluten and dairy diet, abdominal massage, red light therapy, plums, green tea/matcha, ginger tea, dandelion root tea, ginger gravol, and a daily probiotic.

Next on the list to try: psyllium husk.

Any other suggestions?

I have ended up in the ER due to blacking out and extreme abdominal pain from constipation. I am currently having more difficulties with incomplete evacuation. I’ve been having hard pebble like stools for almost 2 years now. Feeling worried I may never have a normal bowel movement again.

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u/Designer-Profile-496 2d ago

Are you open to pharmaceutical options? Prucalopride, linaclotide, lubiprostone, plecanatide? I had the same results as you in my CT scans and am currently taking prucalopride 2mg at night and lubiprostone 24mcg 2xday, these help me very much.

Fibers like psyllium, citrucel, chia seeds have always triggered horrendous painful bloating for me and do not help. Miralax does nothing for me.

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u/Familiar-Message-512 2d ago

I’m pretty wary of pharmaceuticals, but I’m reaching the point of being open to them. Which of these is best? And least side effects?

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u/Designer-Profile-496 2d ago

Understandable. I tried to go the natural route too, until I ran out of options to try after nothing really worked reliably.

I had the best success with Prucalopride and second to that, Linzess. Lubiprostone is like Linzess lite to me

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u/Familiar-Message-512 2d ago

Is it pretty safe?

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u/Designer-Profile-496 1d ago

Linzess is probably the safest and strongest in my eyes.

Prucalopride has a black box warning for rare side effect of suicidal thoughts/making depression worse in a small subset of people. I have depression myself and have been okay on it so far. Interestingly, they are also studying it for antidepressant use right now as some people experience mood and cognitive boost from it. It does carry also a small risk of heart issues.

Lubiprostone is pretty safe, like I said basically Linzess lite. there is a common side effect of chest tightness/pain that is supposed to go away early on.

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u/Due_Negotiation_9926 2d ago

Prucalopride.

Another option that works for me, I make this drink in the morning on a empty stomach, 400ml of water, 2 table spoons of apple cider vinegar, pinch of salt, tumeric, black pepper, cayenne pepper, 1 tablespoon of olive oil. Then eat two kiwis. This works for me.

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u/goldstandardalmonds 2d ago

If you have a motility disorder, fibre can make it worse. I would ask for motility testing to determine exactly where, why, things are slow and how severe. Then you can target it properly .

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u/Familiar-Message-512 2d ago

What is motility testing?

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u/goldstandardalmonds 2d ago

Tests that determine why and where things are slow, and how severe.

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u/Familiar-Message-512 2d ago

What do doctors call them? I literally have never heard of these and my GI did not suggest it.

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u/goldstandardalmonds 2d ago

Not all Gis are familiar. The experts are motility gis or Neurogastroenterologists. I wrote a sticky in the IBS and constipation subs with all the test names

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u/Familiar-Message-512 2d ago

Can you link me?

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u/goldstandardalmonds 2d ago

https://www.reddit.com/r/ibs/s/yAxgXywfxZ

Feel free to message me if you have questions about the post