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What Causes Constipation While On Epilive?

Posted on Tue, 5 Jan 2016

Question: My uncle has a serious constipation problem (not refreshing for 10~12 days). All tests (colonoscopy) indications are normal. He is 72. He takes strong epilepsy medication (epilive). Is that the cause and how can it be treated. He is also weak and frail. He also suffers from diabetes but his sugar is well under control currently. I had asked this question and neurologist Dr. XXXXXXX Panwar suggested this may be caused by Autonomic neuropathy which is a complication of diabetes. If so is there any kind of test that can be done to confirm it? Is it treatable and is there a medication for it?

Answered by Dr. Dr. Erion Spaho (7 hours later)

Brief Answer:
Autonomic neuropathy causes other symptoms besides constipation.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Constipation is not a common side effect of Epilive ( Levetiracetam ) use, it is reported only in a small number of cases using it.

Autonomic neuropathy causes a number of other symptoms, besides constipation such dizziness and/or fainting when standing, urinary problems, sweating abnormalities, physical activity intolerance or inability to increase heart rate when exercising, other digestive problems such heartburn, feeling of fullness, nausea.

So, if there coexist these other symptoms, besides constipation, it is reasonable to think about autonomic neuropathy and further tests are needed to confirm it.

Tests include tilt-table test about blood pressure and heart rate during changes in body position, gastric emptying tests, tests that asses/measure sweating function, urinary function tests, and breathing tests (Valsalva maneuver and response of heart rate).

If autonomic neuropathy is confirmed after these tests, treatment consists on controlling the underlying cause ( in this case diabetes ) and symptoms relief according to organs affected. ( eg. constipation could be improved by high fiber diet, exercise, high fluids intake and over-the counter laxatives, drop of blood pressure can be improved by high fluids and high salt diet, or drugs such pyridostigmine etc.)

If autonomic neuropathy is excluded after these tests, Epilive may be the culprit and there might be a weighting of benefits and negative effects of changing it.

All these issues should be discussed with your uncle's treating Doctor.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Erion Spaho (2 hours later)

Dr. Spaho,

Thanks for your response. Who can do these tests. What specialist (neurologist or gastroenterologist) should we take my uncle to? What kind of facility should we take him to? Is there a way to reverse autonomic neuropathy?

Sincerely,
XXXXXXX XXXX

Answered by Dr. Dr. Erion Spaho (6 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Welcome back and thanks for being on follow up.

These tests can be performed by an internal medicine specialist, only gastric emptying tests need to be done by a Gastroenterologist.

Best way to treat autonomic neuropathy is to treat or control the underlying cause.

Since there are damaged small nerves, only stopping the damaging condition could give the possibility for these nerves to regenerate.

Hope I've been of help.

Take care.

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Above answer was peer-reviewed by : Dr. Sonia Raina