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Movicol Powder Sachets: Did you hear about the constipated accountant, he couldn't budget.
Movicol Powder Sachets
Member Name: loulabelle17
Movicol Powder Sachets
Advantages: Effective but gentle, dose can be built up, works for acute and chronic constipation
Disadvantages: Salty taste, can take a bit of trial and error to get dose right
I'll apologise now for the content of this review. It's probably going to be far too much information and worse still, it may well put you off your dinner but I want to provide as much information as I can.
Right, constipation, not really the nicest of subjects to talk about. The topic in question often seems to be the butt of many a joke (even I can't resist). Jokes aside, constipation can be an unpleasant, distressing and painful experience. Frankly, I find it all a bit embarrassing to talk about. So why then am I sitting here writing about it? The reason being, I hope that my experience might be able to help somebody. Movicol Powder Sachets have and do still make a massive difference to me. I just wish they would have found their way to me sooner.
First things first, I suffer from constipation which for me is an infrequent bowel movement and difficulty when going. As a result of regularly straining when going I also have anal fissures. These are small tears in the skin around the opening of my bottom which bleed and cause sharp pains. Constipation can occur for many reasons, for example, reasons such as: lack of fibre and fluid in the diet, inactivity, stress and because of certain medical conditions. In my case, constipation occurs as a result of me regularly taking pain relieving medicines such as morphine and codeine (not at the same time) for chronic illnesses, which I have had for several years. Just in case you don't know these types of medicines are opioid analgesics and constipation as a result of taking them, especially if they are taken for a long periods of time, is very common. One of the main reasons this occurs is because these types of pain relieving medicines have an adverse effect on the gastric system. For a long time I found myself in a catch 22 situation. I was needing to take the opioids because of pain I was in, I'd got used to the side effects of nausea and feeling zombified (I don't think that's a real word but it's the best way I can describe it) but the side effect of constipation and subsequent anal fissures was just too much discomfort for my liking. Basically, it wasn't much fun.
I now know that if you regularly take opioids it is often necessary to also take a laxative regularly, in order to avoid getting constipated. Laxatives are a type of medicine that work on the bowel in order to relive constipation. Initially, because I was embarrassed I didn't want to bother my consultant or doctor with my problem. If I'm honest I thought it all seemed a bit trivial to be bothering them with. This in itself was stupid, as each time I saw them they asked me how my bowels were coping with the opioids. Instead of admitting there was a problem, I'd just smile politely and say I was fine. Instead, I attempted to self manage the constipation. This basically involved me upping my fibre and fluid intake, this didn't really have the desired effect. I then bought some Senna (the only brand of laxative I knew at the time) from Tesco. Because I was embarrassed I didn't ask for any advice from the pharmacist, instead I had a quick read of the information that came with the Senna to check I was safe to take it, I was, so I did. Half and hour after taking them I had awful tummy cramps that lasted the whole night. They did make me go to the loo though but it was all a bit frantic and painful for my liking. I carried on with the Senna but really they were not helping and I just ended up feeling worse. So by this point I decided embarrassment wasn't really my friend and headed to my doctor.
My doctor prescribed me Movicol Powder Sachets which are manufactured by Norgine. Movicol is an osmotic laxative which increases the quantity of water within the stool, as it passes through the large bowel. The increase in water makes the stool bulkier which then means the muscles in the bowel contract in order to produce a bowel movement. It is also much easier to pass the stool as it becomes much softer and lubricated as a result of the increase in water. My doctor explained that this type of laxative would be a much gentler option for me as opposed to the Senna. This is because Senna is actually a stimulant laxative and the harshest kind. This explained why I suffered from the tummy cramps and immediate urge to go.
Although I get my Movicol on prescription, I believe it is also available to buy without a prescription. It can only be purchased from a pharmacy though. You have to ask the pharmacist for it as it is kept behind the counter and is not available to just pick up off the shelves. I find places like Boots and Tesco pharmacies seem to regularly keep it in stock. I have checked on line chemists and it is available from places like Chemist Direct (www.chemistdirect.co.uk) who sell a box containing 30 sachets at a cost of £11.77. This works our quite a bit more expensive though than getting it via prescription, as the current prescription charge is £7.20.
The sachets come in a big white box bearing the Movicol name and the Norgine logo. I have to say it's not the most discreet of boxes, it has 'Effective relief from constipation' written in quite large letters on the front of it. The box I get contains 30 sachets in total but they are also available in different amounts (2, 6, 8, 10, 20, 30, 50, 60 or 100 sachets in a box). Each 13.7g sachet contains: Macrogol (13.125g), Sodium Chloride (350.7mg), Sodium Hydrogen Carbonate (178.5 mg) and Potassium Chloride (46.6g). This concoction of ingredients means that the laxative can work without the body loosing or gaining significant amounts of sodium, potassium or water (www.netdoctor.co.uk). A box of 30 sachets may sound like a lot but they do have quite a long shelf life. For example, the box I have at the moment expires at the end of 2012. One sachet equates to one dose for adults and adolescents who are over the age of 12 years. They are not recommended for children under the age of 12 but there is an alternative treatment available for children which is called Movicol Paediatric. The oral dose can be taken at any time in the day, with or without food and drink. Inside the sachet is a white powder (looks a bit like talc). The powder should be diluted in 125ml of water. Though it can be difficult to mix in with the water, it often fizzes a bit and then stays quite lumpy for a while. It doesn't look like it will dissolve at all, it just looks like a white gloop sitting on top of the water. I give it a good stir, the water then starts to look hazy, at this point I leave it for a couple of minutes after which time the powder has dissolved.
As far as drinking the treatment goes, I must say it's not the most pleasant of tastes. It does take a bit of getting used to. It mainly has a salty taste which I assume is down to its sodium content. It comes with an added lemon and lime type flavouring, this makes it a bit more palatable. I tend to mix my sachets with a little squash as well as the water (this is allowed). Taste wise, this makes them much easier to drink. If you do drink it with just water it might be worth having a mint or sweet to suck afterwards to remove the salty dry taste it leaves in the mouth. The treatment can make you feel quite thirsty so it's good to have a drink on hand also. To make things a bit easier, I sometimes make up the treatment with water in advance. I then cover it and place it in the fridge (it needs to be stored at 2-8°C) so it's ready for me to take later in the day. It does need to be consumed within a 6 hour period though, unfortunately after the 6 hour period has passed it should be thrown away.
The dose can be varied depending on your needs. The directions on the sachet recommend taking between 1-3 sachets per day. Of course, this amount does depend on how severe the constipation is and how the individual responds to the treatment. Please note, if you suffer from a heart condition then no more than 2 sachets can be taken in any one hour. The maximum dose is up to 8 sachets a day, but really this amount is only needed if you are suffering from severe constipation. Luckily, this only tends to happens to me after I have had surgery when I have to up my dose of opioids. Then, as recommended in the instructions I just dilute all of the 8 sachets in 1 litre of water. Most of the time I take it as recommended for long term management of constipation. The dose recommended for this is 1-2 sachets per day. I take this on a permanent basis because I take opioids everyday. I believe if you are suffering from a one off bout of constipation or infrequent bouts it is recommended you take between 1-3 sachets per day for up to two weeks, it can take this amount of time to get you back to being regular. If you suffer from constipation because you have Parkinson's disease or multiple sclerosis (MS) then you may need to take the treatment for longer than two weeks but as I'm sure you know this would need to be directed by your doctor.
It can take a bit of trial and error to find the level of dose suitable. On a couple of occasions, my dose has been too high and this has resulted in diarrhoea. If this happens I immediately stop taking the treatment until the diarrhoea has stopped (usually about a day) and then start taking it again but at a lower dose (for example, 1 sachet instead of 2). One of the things I find really good about this treatment is that although it definitely works it does so quite subtly. I find there is no worry of needing to madly dash to the loo, like I got with the Senna. I take the treatment first thing in the morning and it generally takes a couple of hours before I need to go to the loo. This is perhaps because I take it on a regular basis though. If you are taking it on 'an often as needed basis' I believe it can take longer for it to work (up to 24 hours). The feeling of needing to go is also a gradual one, it just feels quite natural instead of feeling immediate. So I find there is no need to be tied to the loo.
As with any medication there are a few warnings to consider. The treatment should be used in caution if you suffer from heart disease. It should not be used if you suffer from a blockage of the gut, a hole in the gut, ulcerative colitis, Ileus or Crohn's disease. As I'm sure you would know it should also not be used if you are allergic to any of the ingredients. In regards to pregnancy and breastfeeding, the safety for its use has not been established and therefore it is best to seek advice from your doctor.
The treatment does not alter your ability to drive or operate machinery. I generally don't get any side effects from the treatment but as with any medication it does depend on the individual. As with most laxatives, potential side effects include: abdominal rumbling and gurgling, nausea and diarrhoea. If you suffer from any of these it would be best to speak to a pharmacist or your doctor. If you suffer from extreme tiredness, shortness of breath, thirstiness with a headache or puffy ankles whilst taking the treatment these symptoms can indicate a disturbance in your electrolyte levels (www.netdoctor.co.uk). It would be important to stop taking the treatment and see your doctor as this would need investigating.
I would say it's definitely best to see your doctor if you think you may be constipated or have anal fissures. If you do need to take a laxative, as I have learnt, it's important to make sure you take the right type of one. Please don't be embarrassed like I was. Yes, it can be awkward to talk about and if you go to the doctors you may have to answer personal questions but it's better to get it treated sooner as opposed to leaving it, which could potentially lead to more serious problems (sorry that's the lecture over). I've been taking Movicol for two years now and I am happy to say, most of the time I can keep my constipation under control, which means I subsequently suffer less from the anal fissures. I therefore can not recommend Movicol enough.
Thanks for reading (sorry it's so long).
Summary: Don't be embarrassed and suffer in silence.
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