Monthly Archives: September 2008

To Operate Or Not To Operate?

Hubby had passed the MCUG film (of Baby C’s kidneys and urinary tract system) to his cousin who went to London last week.  The MCUG film has been passed to hubby’s uncle who is a heart surgeon in London, who will then pass the film to his friends who are pediatric nephrologists.  We will get the opinion on Baby C’s condition from the British nephrologists before we come to a decision.

Yesterday, hubby and I spoke to our friend who is a anesthesiologist in one of the private hospitals here.  He advised us to seek as many opinions as we can get from doctors.  He told us to never ever settle with the advise from just a single doctor.  When asked what the risks are of a baby going through a surgery, he told us that babies have amazing recovery ability and are really resilient.  The major risk and concern would be the loss of blood. 

Whilst waiting for the British nephrologists to revert, I have drawn up a feeding schedule for Baby C.  What prompted me to draw up a schedule is that at times, I had forgotten to feed baby with certain things.  There are just too many things that I have to feed her everyday from her antibiotics to probiotics, different types of nutritional supplements, cranberry juice and barley water and not forgetting my milkie.  I have to space out the feeding so that she will not get too full for the next feeding.  Also the probiotics and antibiotics must be given after an interval of at least 4 hours.  This feeding thingy is really draining me out mentally and physically… but if this can prevent a UTI attack, there will not be a single complaint from me.  I will do anything to save my precious baby.

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Update On Baby C’s Kidney Reflux

This is the 5th time in 4 months that bacteria has been detected in Baby C’s urine.  So far, she has had 1 full-blown Urinary Tract Infection (UTI) and 1 ‘semi full-blown’ UTI about 3 weeks ago.  Last week, bacteria (E Coli and Klebsiella) were detected in her urine again.  The reading of the white blood cells (WBC) in her urine were 2-5, then went up to 8-10 and later shot up to 10-15.  However, our pediatric nephrologist as well as the pediatric surgeon were not too concerned and they told me not to get panicky as the readings are not too alarming. So I asked him what reading should cause a red flag and he told me a WBC reading of a few hundreds.

Our pediatric nephrologist does not want to treat Baby C this time as she’s very concerned that too much antibiotics jabs would render the bacteria resistant to the antibiotics.  So she told me to monitor Baby C  and to do the gross urine checking every other day.  If there’s fever and vomitting and should the urine be cloudy, we should bring her to the hospital immediately for treatment.

Our pediatric surgeon was really blase with Baby C’s situation and thinks it is nothing serious.  He asked us to reduce the urine culture test to once every 2 weeks instead of once a week.  He told me that at times, the urine may be contaminated and cause a false positive.  I am really uncomfortable with both these doctors’ blase attitude towards Baby C’s condition.  Perhaps they had seen many other kids with a much more serious condition but hey, as long as there’re bacteria in the urine and urinary tract, the bacteria could go up to the kidneys and scar/damage the kidney.  There’s no way I am going to risk my precious baby’s kidneys from being damaged.  What am I to do?  There are not many pediatric nephrologists (PN) in private practice.  In fact, the doctor whom I am seeing is the most senior PN in our country and she’s the one who trains other PN in our government hospitals. 

Meanwhile, my PN has recommended a nutritional health supplement to us for Baby C.  She heard about this herbal yeast supplement called Bio-Strath from a conference.  It is suitable for people on long-term antibiotics.  I have bought a bottle and have started to feed Baby C.  Shall blog about this in my next post.

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Carpal Tunnel Syndrome

I suffered from Carpal Tunnel Syndrome about 1 month after the birth of my first child, Alycia.  The Chinese would say that the lady in confinement had ‘yup foong’, which literally means that wind has ‘entered’ the body during the 1-month confinement period. 

It was so painful that I couldn’t sleep at night and for one who can pretty much endure pain, I was even in tears at night.   The pain eased a little when I used a hot pack and some deep heat cream on my affected hands.  During the attacks where I would suffer from hand numbness to a tingling sensation to a sharp burning pain on my hands, I had to shake my hands to reduce the numbness and pain.  Allevating my hands on a pillow also helped a great deal. 

For 2-3 months, my hands felt weak and I could not even hold a milk bottle or open the door.  I did not know that I was suffering from Carpal Tunnel Syndrome until I read about the symptoms from the internet.  I didn’t know why I had suffered from Carpal Tunnel Syndrome but I was lucky that the pain subsided after 3 months without medication.   However, I would still have pins and needles and numbness on my hands occasionally up until today.  I realize that this normally happens when I sleep in a room that’s too cold or I had been sleeping on my hands on my sides.

Treatments and drugs
Some people with mild symptoms of carpal tunnel syndrome can ease their discomfort by taking more frequent breaks to rest their hands and applying cold packs to reduce occasional swelling. If these techniques don’t offer relief, carpal tunnel syndrome treatment options include wrist splinting, medications and surgery.

Nonsurgical therapy
Most people with carpal tunnel syndrome experience effective treatment with nonsurgical methods, including:

Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Splinting is more likely to help you if you’ve had only mild to moderate symptoms for less than a year.

Nonsteroidal anti-inflammatory drugs. NSAIDs may help relieve pain from carpal tunnel syndrome if you have an associated inflammatory condition. If no inflammatory condition is involved, NSAIDs are unlikely to help relieve your symptoms.

Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid, such as cortisone, to relieve your pain. Corticosteroids decrease inflammation, thus relieving pressure on the median nerve. Oral corticosteroids aren’t as effective as corticosteroid injections for treating carpal tunnel syndrome.

Prevention
There are no proven strategies to prevent carpal tunnel syndrome, but to protect your hands from a variety of ailments, take the following precautions:

Reduce your force and relax your grip.
Most people use more force than needed to perform many tasks involving the hands. If your work involves a cash register, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink. This way you won’t have to grip the pen tightly or press as hard on the paper.

Take frequent breaks.
Every 15 to 20 minutes give your hands and wrists a break by gently stretching and bending them. Alternate tasks when possible. If you use equipment that vibrates or that requires you to exert a great amount of force, taking breaks is even more important.

Watch your form.
Avoid bending your wrist all the way up or down. A relaxed middle position is best. If you use a keyboard, keep it at elbow height or slightly lower.

Improve your posture.
Incorrect posture can cause your shoulders to roll forward. When your shoulders are in this position, your neck and shoulder muscles are shortened, compressing nerves in your neck. This can affect your wrists, fingers and hands.

Keep your hands warm.
You’re more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.

Information taken from mayoclinic.com.

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A Few More UTI Attacks And My Baby Would Need Surgery

We brought the MCUG film (MCUG done at HUKM 2 months ago) to our pediatric nephrologist at SJMC today.  Upon looking at the film, Dr Indon told us that Baby C’s ureter is positioned slightly lower than where it should be, thus the cause of the frequent urine reflux.   She then referred us to a pediatric surgeon at the same hospital.

The surgeon told us that if Baby C keeps having recurring (breakthrough) UTI, it’s best that a ureteral reimplantation be performed.  This will be a major surgery and the ureter would be reimplanted (repositioned).  Success rate is 99%.  The surgeon said that Baby C is still quite young and he wants to give her body a chance to outgrow this reflux.  It is hoped that the ureter will become longer as she grows, thus reduces the reflux.  However, if Baby C keeps getting UTI attacks, it’s best that the surgery be performed to prevent further UTI attacks, thus prevents her right kidney from being scarred.  

The bill came up to almost RM520 today which consists of consultation fees for 2 doctors (surgeon’s consultation fee is RM100!), immunization (6-in-1 jab and Rotavirus) and miscellaneous charges.  Cut-throat charges eh? 

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Sciatica During Pregnancy

I started to have Sciatica during my 2nd pregnancy.   The symptoms started to creep out towards the end of the 2nd trimester and persisted until Sherilyn was born.  As the baby grew bigger inside my womb by the day, the sharp shooting pain I experienced on my leg also intensified.  I couldn’t stand or walk too long, otherwise the pain would be more intensed.  I thought I would not suffer from Sciatica during my 3rd pregnancy as the pregnancy was quite trouble-free but I was wrong and I got the attack towards the beginning of the 3rd trimester. 

With Alycia, I was spared from Sciatica during my pregnancy as I was on partial bed-rest almost throughout my pregnancy.

So what exactly is Sciatica? Here is some information on Sciatica taken from Women’s Healthcare Topics.

What is Sciatica and How Can It Affect Pregnancy?
The sciatic nerve is a long nerve that runs from the lower back to the back of the legs and feet. Typically this nerve allows feeling in the muscles of the legs and feet. There are times however when the sciatic nerve can become inflamed, whether from pressure in the back or injury. When this happens people experience sciatic pain. Sometimes persistent or chronic pressure to the sciatic nerve can result in weakness in the leg or surrounding areas, numbness or even tingling. Some women describe the sensation as similar to the feeling of pins and needles you get when your leg falls asleep.

Many women develop sciatica during pregnancy, though sciatica isn’t a result necessarily of being pregnant. Pressure on the sciatic nerve during pregnancy can lead to backache or other discomfort. Some women assume that the baby presses on the sciatic nerve resulting in pain or discomfort. This is not necessarily however the case. Many times sciatic pain during pregnancy results from damage to a disc in the spine. This can cause inflammation in the tissues surrounding the never or result in direct pressure to the nerve (if for example, the disc has slipped out of place and is compressing the nerve). Women who are pregnant are more prone to disc injury, hence the relationship.

Many women will have developed sciatica at some point or another whether pregnant or not. It may be coincidence that they experience pain and discomfort during their pregnancy. Some women will feel pain or tingling in their back and leg while others will only notice discomfort in one or the other area. Some women experience pelvic pain during pregnancy which is sometimes mistaken for sciatic pain.

Typically the symptoms of sciatica in pregnancy include the following:

Pins and needles in the lower back or leg, possibly the affected foot.

Shooting or burning in the leg, buttock or lower back.

Pain in the lower back or back of the pelvis that may extend into the foot.

Numbness in the leg or feet.

Treating Sciatica During Pregnancy
Many times sciatica pain or discomfort disappears on its own. Sometimes this can take as much as six weeks or more however. Routine visits to a physical therapist may help relieve some of your symptoms. Manual therapy can often help relieve pressure and discomfort associated with pregnancy back pain.

A therapist can also provide you with a list of beneficial exercises to not only improve your comfort but also strengthen the pelvic floor muscles, abdominal muscles and back muscles. These will prove beneficial for labor and delivery, and the time after.

Still others find chiropractic care helpful for relieving sciatica pain. If you do choose to see a chiropractor or other manual therapist, be certain they have experience working with prenatal patients.

Some women find massage therapy helpful for relieving inflammation and symptoms associated with sciatica. A massage can certainly help reduce muscle tension. Some theories suggest that gluteus or psoas muscles that are too tight can help contribute to sciatic pain. Massage therapy may help relieve some of this tightness and reduce the symptoms associated with sciatica.

If you do develop sciatica during pregnancy be sure to consult with your health care provider regarding possible treatment options. Your doctor may recommend applying heat to the affected area and getting as much rest as possible. Postural corrections or changes may also help alleviate some of the pressure on your disc and the affected regions of your body.

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How To Prevent Backache

What Causes Backache?
The basic causes of back pain are the following:

sedentary living habits,
weak abdominal or back muscles,
poor posture,
muscular tension,
straining of the joints
arthritis,
prolonged sitting or standing in one position,
prolonged stooping,
improper lifting of weights,
wearing high heels,
lack of exercise,
after effects of Epidural after childbirth. I suffered from bad backache after the birth of my first child, delivered via c-section (given spinal cord anesthetic).

Remedies : 

The Chamomile Tea Remedy
Chamomile tea is used to treat a lot of different ailments so it really is no surprise that it would work for a backache as well. Chamomile tea can help relieve stress, therefore help relieve back pain. Chamomile tea offers a calming relief to sore muscles. It is used best when taking a break from work or after work to relieve stress and sore muscles. Just steep one tablespoon of Chamomile flowers in one cup of hot water for 15 minutes. You can also buy the pre-packaged chamomile tea. Either way, drink one to three cups a day and it should relieve sore muscles in your back. Be careful though, chamomile contains allergy induced pollens from ragweed. If you are allergic to ragweed, ask your doctor before drinking chamomile tea.

The Epsom Salts Remedy
Epsom salts are another product often used as a home remedy for many things. Epsom salts ease back pain by reducing swelling. When taking a soak in the tub, add at least two cups of Epsom salts and soak in the tub for 30 minutes. Your back will fill a lot better when you do.

The Warm, Uncooked Rice Remedy
Here is a weird remedy for you. I wonder hw many people have ever heard of using warm, uncooked rice as a home remedy for a backache? Take a clean, thick sock and fill it with uncooked rice. Place the rice filled sock in the microwave for up to a minute and apply it to your back. Be careful not to make it too hot.

The Ginger Root Remedy
Ginger root has anti-inflammatory compounds which have mild-like aspirin effects. When you have a backache and you have access to Ginger root, cut a fresh ginger root into slices and put in boiling water. Cook the slices of ginger root on low heat for 30 minutes, strain, sweeten with honey or sugar to taste and drink. This should ease your backache in no time.

Diet for Backache
Minerals needed to diminish and prevent backache include calcium and magnesium. Magnesium is found in all fresh green vegetables, apples, figs, wheat germ, and all seeds and nuts, especially almonds.

Lemon juice in water, up to six glasses daily, benefits the kidneys, easing backache.

General Tips for Backache Treatment
If you are not experiencing acute backache and suffer from backache only seldom, you should anyway pay attention to your back. Follow these easy, but useful tips to prevent back pain:

If you have to sit or stand for long periods of time, do not forget to change your position from time to time.

If you have to lift heavy things, straighten your knees and keep your back straight all the time as you are lifting the load.

Choose a firm mattress to sleep on. Do not sleep face down.

Choose a chair with good back support.

Give up smoking.

Do regular exercises for back, visit swimming-pool regularly or practice yoga.

Nutrition for a Healthy Back
Backache prevention and treatment are also connected with diet. Daily meals of a person taking care of their back should contain plenty of raw vegetables and fruits (except bananas). The backache sufferer should have three to four meals every day, which include, apart from fruits and vegetables, wholewheat products, milk and fruit juice. One suffering from back pain should avoid fatty and fried food, sugar, spicy condiments, strong tea and coffee.

For those, who do not like eating plenty of raw vegetables, there exist many recipes of salads including both fresh vegetables and natural additives, like sauces, oils or cheeses, which make the salads taste very good.

Remedies for Back Pain

Excerpts taken from http://www.geniusbeauty.com/woman-health/backache-treatment-methods-physical-exercises/

If we are speaking about acute, but not chronic backache, the causes of it are commonly poor postural habits. If this is the case, the pain can be lessened by some exercises.

Exercise 1
Sit down on the floor. Bend the knee of your left leg, keep your right leg straight. Put the elbow of your right hand on your left knee from the left. Draw your left hand aside as far as you can. Push off with your right elbow from your left knee, but DO NOT push too much. During this you can feel a little crackle in your spine – this is normal. Make 5-10 pushing repetitions. Do the same to the other side with your right knee bent and your left leg straight 5-10 times. Repeat the cycle from both sides by-turn.

Exercise for Back

Exercise 2
Sit on the floor with straight legs all the time, while you are doing this exercise. Try to touch your toes with your fingers. Make 10 repetitions.

Exercise 2

Exercise 3
Stand in front of the wall with your back turned on it. The distance between you and the wall should be about 50-70 cm depending on your height. Arch your abdomen and put your palms on the wall head-high with your fingers down, so that your elbows are the highest part of you. Walk down with your palms on the wall little by little to the floor. The final position is when your palms are on the floor. Walk back upwards on the wall to the initial position. Do this exercise slowly.

Exercise for a Healthy Back

Exercise 4
For those, who cannot do the previous exercise here is another one, which is easier. Lie on your back. Bend your knees. Lean on your palms and feet, arch your chest upwards. Hold for 20 seconds and release. Make 5 repetitions.

Exercise for a Healthy Back

Exercise 5
Lie on your back, bend your knees. Press your back against the floor. Do this by only contracting the muscles of your abdominal. Stay in this position for 3 seconds and release. Make 10 repetitions.

Exercise 6
Lie on your back, bend your knees. Raise your shoulders and head so far as you can. Stay in this position for 3 seconds and release. Make 10 repetitions.

If you have to stand for long periods of time and you cannot do exercises, just raise one foot on a platform.

The other exercise which I find really effective in keeping my backache at bay is exercising on my Fitball . This exercise is similar to Exercise 5 above and it focuses on exercising your back by arching your back.

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Baby C Has Another UTI And Needs Admission

but I can take home leave so that we don’t have to stay in the hospital. Baby C is attacked by the E Coli bacteria (again) and Klebsiella bacteria (which is a strong bug) this time and she needs to have an IV line on her hand for antibiotics to be jabbed through the line. As expected, the dr. could not locate the vein on baby’s chubby hands and feet and she was poked 5 times!!! This time, I requested to be with Baby C in the Procedures Room and my request was acceded as I am considered a ‘regular’ at the hospital.

It was REALLY traumatic for Baby C this time as she was poked 5 times (thrice on her hands and once on each of her foot) as the dr. and nurses searched in vain for a vein. She was screaming with all her might in pain and even her favorite frozen water-filled teething ring or my embrace could not subdue her. The sight of the dr. poking the needle into Baby C’s hands and feet and injecting the antibiotics, in the hope that he had injected it into the vein, only to be rejected when blood oozed out through the needle was just too much for me to bear. Whenever this happened, it meant that the antibiotics wasn’t injected into the vein (well, I think that’s how it works. That’s why finding a vein is very important). The procedure looked as if Baby C’s skin was being skewered as the dr. pushed and pulled the needle back and forth through her skin, like a piece of chicken meat being skewered for bbq and it takes a strong heart to see the entire procedure.

After half an hour of torture and screaming for Baby C, the dr. gave up and said he could not find the vein and said that he will administer the jab via intra-muscular, which was very painful. That was the 6th time Baby C was poked within an hour.

It was another very stressful day for both Baby C and me and we have 4 more days to go as she needs 5 doses of antibiotics jab.


Back home, Baby C was all smiles again when she saw her 2 sisters. Luckily babies have short-term memory and Baby C will not remember any of these when she grows up. See the bandage on both her feet? There were 2 more bandages on her hands but I removed them coz Baby C was chewing on them.

Baby C’s UTI attacks are so frequent that I have my drawer stocked up with urine bags and sterile bottles!

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Another UTI Or Vaginal Yeast Infection?

I woke up at 5:45am today, skipped jogging and got ready to go to SJMC. I had to be really early as it’s first come first served basis. I was the first patient to see Dr Indon but waited for an hour for her to come in. My guess was right. Dr Indon ordered another urine test to be done by way of inserting the catheter into baby’s urethra.


The catheter

Baby C waiting for Dr Indon to come into the Procedures Room to insert the catheter into her urethra.

This time, it was really traumatic for baby. The first two wasn’t that bad but I guess this time, baby’s old enough to remember the procedures and she cried big time even before the catheter was inserted. We were unlucky this time. There wasn’t enough urine in baby’s bladder and Dr Indon asked me to feed her water. So I bought 2 syringes from the hospital (I dropped one on the floor in my haste to feed her water) and squirted the water into baby’s mouth.  She cried so hard that she choked a few times.  She was wailing away really badly and was really traumatized, so much that she puked all over herself and on the bed.  My maid screamed when baby puked LOL!   Still, there wasn’t enough urine after we waited for about 15 minutes (which seemed like ages) and the catheter came out prematurely….. bummer…. double whammy!!  I then cleaned up baby as she had  vomit all over her body.  Dr Indon had to write a note to the lab to inform the lab assistant to go ahead with the 2 urine tests though the urine collected wasn’t enough.

We waited for 1.5 hours for the results to be out.  There were still 80 WBC (white blood cells) and bacteria in baby’s urine.  But Dr Indon wasn’t quite sure how to treat baby coz I told her that after applying the anti-yeast infection cream on baby’s private part, the foul-smelling urine was gone this morning.  She wasn’t sure if it was a UTI or a vaginal yeast infection and she does not want to jab baby with potent antibiotics unnecessarily.  So she told us to wait until the urine culture report comes out on Tuesday next week before the next course of action is to be taken.  If there’s a heavy growth of bacteria in baby’s urine, baby would have to endure 3 super painful intra-muscular antibiotics (Rocephine) jab again:(

I can only pray that it’s not a UTI and that the WBC and bacteria would be gone in the next urine test to be done next week.  Hubby has burnt a BIG hole in his pocket. The medical bill incurred at SJMC last week and today cost hubby almost RM400, which would have cost us less than RM100 if done at HUKM. But hubby is not complaining at all and says that he is willing to pay so long as baby gets the best treatment. I hope I can see light, bright light at the end of the tunnel soon.

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Another UTI

I am so so down today coz the urine test today showed that there are lots of WBC (white blood cells) in Baby C’s urine, which means that there is possibly another UTI attack. 

Ever since Baby C had UTI 3 months ago, I have a habit of smelling her soiled diaper each time I change the diaper. When I changed her diaper in the wee hours today, her urine/diaper smelled foul and the smell is similar to the pee of someone who had just eaten petai (stinky beans) the night before.  I was worried sick and couldn’t sleep well. This morning, her diaper looked dark yellowish and the foul smell was still there.  I immediately took her urine, which took me the whole morning to painstakingly collect, drop by drop.  Hubby then brought the urine to the hospital only to be told that the urine wasn’t enough to do both the FEME urine test and culture test, aargh…. I really wanted to cry!

I thought I had done everything to keep the UTI at bay from changing her diaper after every pee to washing her bum after every poo, feeding her with probiotics, cranberry juice and what not but still these are not enough to keep the bacteria from attacking my poor baby. I just hope that this is only a false positive for UTI  as this happened 2 weeks ago.  My paed told me today that the foul smelling and dark colored pee could just be a vaginal yeast infection as this had happened to baby 2 months ago.   I’m bringing baby to see Dr. Indon tomorrow and I just have a feeling that she will order another urine test done with the urine collected via a cathether inserted into baby’s urethra again!  If it’s truly another breakthrough UTI, my poor baby has to endure another 3 rounds of very painful intra-muscular antibiotics jab, which she just had 2 weeks ago.  Sigh…… when will our nightmare ever end?  Perhaps the only solution now is via surgery?  I hope not.

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Constipation and Piles

I used to suffer from constipation when I was younger.  Pregnancy and childbirth had also caused me to have piles.  One natural food that I find really effective in keeping constipation and piles at bay is psyllium husk. I take a tablespoon of psyllium husk everyday.  Psyllium husk is fibre and is not toxic to the body.  One should drink LOTS of water after consuming psyllium husk.

How to prevent constipation :

Eat fiber regularly.
Choose lots of high-fiber foods, including fruits, vegetables, beans and whole-grain cereals and breads. Experiment to see if particular fruits or vegetables have a laxative effect for you. Adding fiber to your diet gradually may help reduce gas and bloating.

Limit problem foods
Foods that are high in fat and sugar and those that tend to be low in fiber content, such as ice cream, cheese and processed foods, may cause or aggravate constipation.

Drink plenty of liquids.
The exact amount of water and other fluids you should drink each day varies and depends on your age, sex, health, activity level and other factors.

Increase your physical activity.
Engage in regular exercise, such as walking, biking or swimming, on most days.

Heed nature’s call.
The longer you delay going to the toilet once you feel the urge, the more water that’s absorbed from stool and the harder it becomes.

Try fiber supplements.
Over-the-counter products such as Metamucil and Citrucel can help keep stools soft and regular. Check with your doctor about using stool softeners. If you use fiber supplements, be sure to drink plenty of water or other fluids every day. Otherwise, fiber supplements may cause constipation or make constipation worse.
Add fiber to your diet slowly to avoid problems with gas.

Don’t rely on stimulant laxatives.
These include products such as Correctol and Dulcolax, which cause muscle contractions in the intestines. Habitual use can damage your bowels and make constipation worse. For occasional relief try saline laxatives, such as milk of magnesia. Saline laxatives draw water into the colon to allow stool to pass easier. Keep in mind that long-term use of laxatives can cause dependency. For constipated children, give them plenty of fluids to drink, but avoid giving them laxatives unless your doctor says it’s OK.

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