hi donnarae - i had a good friend w the problem you mentioned who tried everything - meds, fiber, whole-wheat bread...and found the most success adding coffee to his diet, believe it or not. don't know whether you drink coffee or whether you'd think about adding it in if you don't, but he's never had as many problems since. if you already drink coffee, you could consider going stronger (like, bump it up to espresso drinks).

a doctor i know recommends this: orange juice concentrate. straight out of the can, not mixed into juice. something about the high vitamin c content, i think.

are you also taking vicodin or something like that? i can vouch for vicodin having the power to back you up - could be the pain meds rather than the coumadin.

Give your local 24-hour pharmacist a call and ask for suggestions. They can tell you what is safe to take while on warfarin. I hit up the guys at my Walgreens all the time for info and they are great!

Donnarae, are you saying that you're more constipated since being on Coumadin?

I'm not on any pain meds at this time. I don't know that I'm any more constipated than before taking coumadin, but as my INR levels are a little up and down, I think that being able to rule out any internal bleeding thru being more 'regular' would ease my mind. I'm eating a lot of fiber, drinking coffee and trying more things than I did before my PE without much success. I did call my local pharmacy and ask about Milk of Magnesia and they said OK with coumadin. I'll call the coumadin clinic tomorrow and ask them also.

i gathered from the fact that a doctor ordered a laxative for me in the hospital that they want to make sure that you don't get "stopped up" which can cause bleeding hemmeroids. She misunderstood what I said however - constipation wasn't a problem for me. I noticed while in the hospital, though, that I didn't "go" the whole time I was there and attribute that to the diet I was receiving while there. My INR really changed when I got home and was "regular". During a conversation with my doctor about something else, he said that Warfarin is absorbed in the bowel (or something to that effect) and a lightbulb went off for me. I've been making a point of eating healthy meals like they fed me in the hospital (but with a better selection of foods that have vit. K - they gave me none or just some broccoli) and I eat vitamin K (leafy greens, spinach, broccoli, blueberries) daily in the amounts suggested on the handout the hospital gave me and I have had no problems with any type of irregularity. I'm consistent about it and my INR level has been the same for many weeks and I was released from the hospital on 12/18. Maybe instead of just increasing fiber you could try some really balanced meals that don't eliminate vegetables and fruits that have vitamin K (as long as your dr, approves and you have some sort of guide to use insofar as how much vit. K you're allowed daily which shows amounts, tyoe of foods, etc.).

A lot of it actually can stem from physical inactivity, from not being mobile, as well as not eating your normal diet. I think increasing fiber rich foods is fine, but sometimes you can overdo it and it can back you up even more.

I have a really crappy GI system due to having ulcerative colitis, so I'm often messed up in that regard. Plus, warfarin can cause GI upset. I've taken miralax and milk of magnesia without an INR issue. Also, even adding a fiber supplement, like Benefiber may help.

Also, make sure you're drinking plenty of water and getting some activity which is probably difficult considering the ankle.

The clinic said that Miralax was fine. I actually 'resolved' some of the problem today (finally). I agree that the lack of exercise is not helping. I had been working out every day prior to this,,, even with the bad ankle. I'm still trying to get a better diet going here. Being alone now, I do so hate to cook so eat salads (spareingly now), sandwiches, soups. My INR numbers have been good for 4 reads now, so guess I'm doing OK. I actually added 6oz of wine over the course of the week and was OK (Dr. said was fine).... just need to get into a routine for the next 6 months I guess (hope only 6, should be as traced to the ankle). Thanks for all input... so glad to have found this site.

The idea with warfarin and diet is to be somewhat consistent in what you eat. So if you eat salads and lots of veg, that's ok as long as you don't binge eat them out of the blue and are all over the place with it. If you wanted to introduce more plant based foods to your diet, you can. You just may want to get your INR checked more frequently when you start so that they can make any necessary adjustments based on how you want to eat.