Citrucel Instructions

[JudeD59]

I'm still having issues with frequent stools and unpredictability over a year after my reversal. I want to take metamucil or citrucel, but the warnings all over the packages about choking if you don't wash it all down quickly with 16 ounces of water freak me out. I always feel like my throat tightens up when I have to swallow a large pill, so swallowing something that can swell in your throat makes me nervous.

So I haven't started taking either yet (I'm leaning toward Citrucel because it supposedly causes less gas and cramping). I went to the MD Anderson site to read through their bowel training instructions after colorectal surgery and it says to take a teaspoon of Citrucel with only two ounces of water and to not drink anything else for an hour. I respect MD Anderson a lot, but this is contrary to everything it says on the Citrucel bottle and on their website.

Has anyone tried this and is it safe? Has anyone here had any problems with Citrucel or Metamucil swelling up in their throat? Please say no.

I was worried sick about swallowing the giant Xeloda pills and handled that without a problem. I'm sure once I get past my first dose, I'll be fine. I just hate medicines with twenty warnings on them, especially ones concerning things swelling in your throat. I'm funny like that.

Anyone here try the one teaspoon in two ounces of water plan from MD Anderson and did it help?

My surgeon's only advice was if I was having constipation, take the fiber early in the day and then drink water all day long and if I was having loose stools take it at bedtime when I wouldn't be drinking as much instead. But in both cases, I was supposed to take it with the full sixteen ounces of water recommended on the medicine bottle.

Thanks in advance for any answers you can give me.

Judy

[peanut_8]

Hi Judy,

I was thinking about you recently, and was wondering how you were doing. Then I read your reply in one of the other threads. So sorry that things aren't going well for you.

Now on to one of my favorite topics, fiber supplements. My oncologist is a big fan of Metamucil. Works for diarrhea and works for constipation! I use it to get some sort of control over my colostomy output. I really prefer not to have to get up in the middle of the night to empty the bag, so a tablespoon of Metamucil in the morning helps avoid that. An added benefit is that the fiber helps make the output less sticky and easy to clean out the bag (apologies if this is to much information).

If you mix up your fiber, about a tablespoon, and water, and then wait about 5 minutes, you'll notice it starts to thicken, sort of along the line of applesauce. If you start with a teaspoon, I don't think you would have any issues with it sticking in your throat, and causing choking. That would also lessen any issues with gas also. You could build up to a larger dose over time if necessary. I've never heard of anyone choking with fiber supplements.

I don't know what to think about the MD Anderson advice regarding 1tsp and 2 oz water. I've always thought more water was better. Maybe you could try more water at first, and if you don't have any issues try the 2 oz method.

Best Wishes,
peanut

[mypinkheaven]

"Here, we're going to slow down the bowel activity by giving them 3.4 grams of psyllium or 1 teaspoon of methylcellulose, which is Citrucel®, in 2 ounces of water, after meals and at bedtime. And then they take no fluid for one hour afterwards." This quote is from a transcript of a video on bowel training from MD Anderson.

https://www.mdanderson.org/transcripts/ ... Bisanz.htm

[JudeD59]

Hi Judy,

I was thinking about you recently, and was wondering how you were doing. Then I read your reply in one of the other threads. So sorry that things aren't going well for you.

Now on to one of my favorite topics, fiber supplements. My oncologist is a big fan of Metamucil. Works for diarrhea and works for constipation! I use it to get some sort of control over my colostomy output. I really prefer not to have to get up in the middle of the night to empty the bag, so a tablespoon of Metamucil in the morning helps avoid that. An added benefit is that the fiber helps make the output less sticky and easy to clean out the bag (apologies if this is to much information).

If you mix up your fiber, about a tablespoon, and water, and then wait about 5 minutes, you'll notice it starts to thicken, sort of along the line of applesauce. If you start with a teaspoon, I don't think you would have any issues with it sticking in your throat, and causing choking. That would also lessen any issues with gas also. You could build up to a larger dose over time if necessary. I've never heard of anyone choking with fiber supplements.

I don't know what to think about the MD Anderson advice regarding 1tsp and 2 oz water. I've always thought more water was better. Maybe you could try more water at first, and if you don't have any issues try the 2 oz method.

Best Wishes,
peanut

Hi, Peanut! Nice to chat with you again!

I posted in the other thread because it's frustrating to me that so many people think once your treatment is finished and your scans are good, you should be jumping right back into your pre-cancer life (by people I mean people in our lives who've never had cancer). They don't understand the toll the treatments themselves take on you and how they can permanently change you. It's true that I don't have very much of a life right now and I need to try some new things to get this all day pooping under control, but I don't want to sound all doom and gloom.

I was just pointing out all the lingering problems that can be part of your new normal. Sorry if it sounded like I was ungrateful for all the positives in my life. I'm very lucky that so far all my tests have come back clean. And although I am pretty much housebound, I have wonderful support from my family and friends. I haven't been aggressive with fiber supplements and medications because I was hoping things would resolve naturally as I healed, but since that hasn't happened, I have a lot of options yet. I'm going to try the Citrucel and if that doesn't work after a few weeks, I'll try the Metamucil, and if that doesn't help, I'll add in Lomotil. I'll just keep trying until I figure out some combination that allows me to leave the house without spending hours in a public restroom.

You never have to worry about TMI with me, Peanut. I'm the one who wrote the graphic tale of waking up covered in poo from my ileostomy bag.

So you're saying that the Metamucil/Citrucel only thickens after sitting for five minutes or so and if I drink it right down, it should be fine? My surgeon told me to put it in a shaker bottle and shake between each gulp to keep it mixed. I plan to start with a teaspoon of it on the first try and increase from there like you suggested.

Thanks, Peanut, and I hope you have a magical weekend!

Judy

[JudeD59]

"Here, we're going to slow down the bowel activity by giving them 3.4 grams of psyllium or 1 teaspoon of methylcellulose, which is Citrucel®, in 2 ounces of water, after meals and at bedtime. And then they take no fluid for one hour afterwards." This quote is from a transcript of a video on bowel training from MD Anderson.

https://www.mdanderson.org/transcripts/ ... Bisanz.htm

Thanks for replying, but I'm not sure what you're trying to say. What you quoted is exactly what I said in my original post. I'm just surprised by the MD Anderson advice since the instructions on the Citrucel are clear that you have to drink plenty of water to keep the fiber from swelling in the throat and choking you. Were you just providing a link to go with my post or did you have another point you were trying to make?

Thanks!
Judy

[peanut_8]

Hi Judy,

I was thinking about you recently, and was wondering how you were doing. Then I read your reply in one of the other threads. So sorry that things aren't going well for you.

Now on to one of my favorite topics, fiber supplements. My oncologist is a big fan of Metamucil. Works for diarrhea and works for constipation! I use it to get some sort of control over my colostomy output. I really prefer not to have to get up in the middle of the night to empty the bag, so a tablespoon of Metamucil in the morning helps avoid that. An added benefit is that the fiber helps make the output less sticky and easy to clean out the bag (apologies if this is to much information).

If you mix up your fiber, about a tablespoon, and water, and then wait about 5 minutes, you'll notice it starts to thicken, sort of along the line of applesauce. If you start with a teaspoon, I don't think you would have any issues with it sticking in your throat, and causing choking. That would also lessen any issues with gas also. You could build up to a larger dose over time if necessary. I've never heard of anyone choking with fiber supplements.

I don't know what to think about the MD Anderson advice regarding 1tsp and 2 oz water. I've always thought more water was better. Maybe you could try more water at first, and if you don't have any issues try the 2 oz method.

Best Wishes,
peanut

Hi, Peanut! Nice to chat with you again!

I posted in the other thread because it's frustrating to me that so many people think once your treatment is finished and your scans are good, you should be jumping right back into your pre-cancer life (by people I mean people in our lives who've never had cancer). They don't understand the toll the treatments themselves take on you and how they can permanently change you. It's true that I don't have very much of a life right now and I need to try some new things to get this all day pooping under control, but I don't want to sound all doom and gloom.

I was just pointing out all the lingering problems that can be part of your new normal. Sorry if it sounded like I was ungrateful for all the positives in my life. I'm very lucky that so far all my tests have come back clean. And although I am pretty much housebound, I have wonderful support from my family and friends. I haven't been aggressive with fiber supplements and medications because I was hoping things would resolve naturally as I healed, but since that hasn't happened, I have a lot of options yet. I'm going to try the Citrucel and if that doesn't work after a few weeks, I'll try the Metamucil, and if that doesn't help, I'll add in Lomotil. I'll just keep trying until I figure out some combination that allows me to leave the house without spending hours in a public restroom.

You never have to worry about TMI with me, Peanut. I'm the one who wrote the graphic tale of waking up covered in poo from my ileostomy bag.

So you're saying that the Metamucil/Citrucel only thickens after sitting for five minutes or so and if I drink it right down, it should be fine? My surgeon told me to put it in a shaker bottle and shake between each gulp to keep it mixed. I plan to start with a teaspoon of it on the first try and increase from there like you suggested.

Thanks, Peanut, and I hope you have a magical weekend!

Judy

Judy, as far as I'm concerned, you are one of the least ungrateful people around. You have legitimate concerns, and always articulate your problems well.

I'm excited for you, and think the addition of fiber can really help your problem. I think you're on the right path. Start with small amounts of Citrucel and see how it goes. If you're really concerned about choking you could mix up a dose and let it sit for a while and see how thick it gets. From my experience it takes a few minutes for the mixture to thicken, and I'm going with a tbsp as apposed to a tsp. I don't think you'll have a problem, and really hope it helps.

As far as the graphic tale of leakage, I remember it well. I didn't know if I should laugh or cry, but I did know that you have a wonderful way with words.

I'm off to the hair salon tomorrow for a cut and color so I do plan on having a magical weekend. Hope yours is equally good.
peanut

[mypinkheaven]

"Here, we're going to slow down the bowel activity by giving them 3.4 grams of psyllium or 1 teaspoon of methylcellulose, which is Citrucel®, in 2 ounces of water, after meals and at bedtime. And then they take no fluid for one hour afterwards." This quote is from a transcript of a video on bowel training from MD Anderson.

https://www.mdanderson.org/transcripts/ ... Bisanz.htm

Thanks for replying, but I'm not sure what you're trying to say. What you quoted is exactly what I said in my original post. I'm just surprised by the MD Anderson advice since the instructions on the Citrucel are clear that you have to drink plenty of water to keep the fiber from swelling in the throat and choking you. Were you just providing a link to go with my post or did you have another point you were trying to make?

Thanks!
Judy

Just posting a link for other people who may be curious about the MD Anderson information.

[JudeD59]

"Here, we're going to slow down the bowel activity by giving them 3.4 grams of psyllium or 1 teaspoon of methylcellulose, which is Citrucel®, in 2 ounces of water, after meals and at bedtime. And then they take no fluid for one hour afterwards." This quote is from a transcript of a video on bowel training from MD Anderson.

https://www.mdanderson.org/transcripts/ ... Bisanz.htm

Thanks for replying, but I'm not sure what you're trying to say. What you quoted is exactly what I said in my original post. I'm just surprised by the MD Anderson advice since the instructions on the Citrucel are clear that you have to drink plenty of water to keep the fiber from swelling in the throat and choking you. Were you just providing a link to go with my post or did you have another point you were trying to make?

Thanks!
Judy

Just posting a link for other people who may be curious about the MD Anderson information.

Gotcha! Thanks!

Judy

[Bob_Weiss]

Instead of putting Metamucil into liquid, I mix it into the food with each meal- about 1/2 teaspoon each time. I never have any choking or other unpleasant reaction in the years I have been doing this. I also usually drink 2+ glasses of water or tea during the day to minimize the gas. If I have loose stools, I may reduce the liquid intake for the day and take some Imodium.

[JudeD59]

Instead of putting Metamucil into liquid, I mix it into the food with each meal- about 1/2 teaspoon each time. I never have any choking or other unpleasant reaction in the years I have been doing this. I also usually drink 2+ glasses of water or tea during the day to minimize the gas. If I have loose stools, I may reduce the liquid intake for the day and take some Imodium.

Thanks so much, Bob. That's reassuring to know. While I don't like taking new meds because of previous bad reactions, I'm not usually such a baby about it, especially one that millions of people take all the time. I think it was just the warning warning warning all over the bottle and on the website. Freaked me out a little.

I have last minute guests who called last night to ask if they could come for the weekend, so I don't think now is a good time to try something new, but I'm going to start with a teaspoon of Citrucel on Sunday night and see how it goes.

Thanks again,
Judy

[horizon]

I didn't have any trouble with Xeloda pills but bigger pills do give me trouble. I recently had to return some multivitamins because I couldn't get them down.

I've taken Citrucel for years. After my dinner I just drink another glass of water with it. I just try to keep up with my hydration, which I honestly should be doing anyway.

It just tastes like crappy Tang (pun intended). I've never ever had a sensation of my throat being clogged. I did raise an eyebrow at the wording you are referring to when I first saw it.

I take the pill version with me when I am traveling because it's more convenient.

[JudeD59]

I didn't have any trouble with Xeloda pills but bigger pills do give me trouble. I recently had to return some multivitamins because I couldn't get them down.

I've taken Citrucel for years. After my dinner I just drink another glass of water with it. I just try to keep up with my hydration, which I honestly should be doing anyway.

It just tastes like crappy Tang (pun intended). I've never ever had a sensation of my throat being clogged. I did raise an eyebrow at the wording you are referring to when I first saw it.

I take the pill version with me when I am traveling because it's more convenient.

Thanks, Horizon!

Judy