For the many people who finally found relief from chronic constipation or irritable bowel syndrome with constipation with Zelnorm, the FDA's voluntary recall of the product was like a slap in the face. If you were one of the people left floundering, you may not know what to try next. Luckily, you have several alternatives to Zelnorm. Talk with your doctor about which ones may work for you.
History
In 2002, the FDA approved Zelnorm, the first prescription medication approved to treat irritable bowel syndrome with constipation. From the beginning, though, Zelnorm was plagued with problems. In 2004, the FDA required Novartis, the makers of Zelnorm, to add labeling to the Zelnorm package to warn about potential serious side effects from the drug. In 2007, the FDA asked for a voluntary recall of Zelnorm due to research that indicated the medication could cause heart attacks in some patients.
Medications
In the wake of Zelnorm's departure, Amitiza is the only prescription drug specifically for treatment of chronic constipation and irritable bowel syndrome with constipation. Talk to your doctor about whether Amitiza may work for you. Be aware that nausea is a common side effect.
Over-the-counter laxatives may help on occasion, but they shouldn't be taken regularly. Bulk laxatives, such as Metamucil, may be the safest type. Osmotics, such as MiraLax, are another good alternative. Stool softeners, lubricants, saline laxatives or stimulants are other options for occasional use.
Alternative Remedies
Several herbal or mineral remedies may help with constipation or may help relieve the pain and bloating that accompanies chronic constipation or irritable bowel syndrome. Magnesium supplements, either magnesium oxide or magnesium citrate, may be a helpful alternative. Acacia is an herbal remedy that many have found helpful. Fennel may help with bloating, and peppermint may relieve stomach pain. Homeopathic treatments such as byronia or sulfur may offer relief.
Other alternative remedies that may help are massage or acupuncture. Some constipation sufferers have found relief through a hypnotherapy program directed at relieving constipation.
Lifestyle Changes
In some cases, lifestyle or diet changes may be enough to treat, or at least manage, your constipation. You may want to start by adding foods high in fiber to your diet. It can also be helpful to keep a food diary and notice which foods make your constipation worse or improve it. Drinking lots of water will always help. Some people have found relief through a gluten-free or dairy-free diet, but you should discuss this with your doctor before experimenting with it too much.
A regular exercise program will probably help relieve chronic constipation. You may find, too, that stress increases your trouble, so massage, deep-breathing or other relaxation techniques may help.
You can help yourself re-train your body by trying to have a bowel movement at the same time each day and by allowing plenty of time for it. Having to rush will only make things worse.
Considerations
If none of these alternatives help and your constipation is serious enough to require immediate treatment, you may have another option. The FDA is working with Novartis to make Zelnorm available on a limited, emergency basis for those who are in a low-risk category and don't get relief from any other therapy. Talk with your doctor about whether you fall into this group and proceed if you do.
Tags: bowel syndrome, chronic constipation, irritable bowel, irritable bowel syndrome, with constipation