How to Never Be Constipated Again

• Definition
  • What facts should l know about constipation?
  • What is constipation?
• Symptoms & Signs
  • What are constipation symptoms and signs?
• Chronic Constipation
  • When should I seek medical care for chronic constipation?
• Causes
  • What causes constipation?
  • What medications crusade constipation?
  • What are other causes of constipation?
• Diagnosis
  • What exams, procedures, and tests help diagnose the crusade of astringent constipation?
• Treatment
  • What are treatments for the causes of constipation?
  • What other over-the-counter (OTC) drugs treat constipation?
  • What prescription drugs care for constipation?
  • Does biofeedback, practise, and surgery help relieve symptoms of constipation?
  • What is new in the handling of constipation?
• Remedies
  • What natural or abode remedies salve and treat constipation?
• Foods
  • What kind of loftier-fiber diet treats constipation?
• Laxatives
  • What types of laxatives treat constipation?
  • What OTC laxatives treat constipation?
• Center
  • Constipation Center
• Comments
  • Patient Comments: Constipation - Home Remedies and Treatments
  • Patient Comments: Constipation - Feel
  • Patient Comments: Constipation - Causes
  • Patient Comments: Constipation - Cobweb and Laxatives
  • Patient Comments: Constipation - Medication Causes
  • Patient Comments: Constipation - Symptoms
• More
  • Constipation: Foods to Eat, Foods to Avoid FAQs

A woman sits on the toilet while suffering from constipation. Source: Getty Images

What facts should l know about constipation?

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What is the medical definition of constipation?

Constipation is divers medically every bit fewer than iii stools per week and astringent constipation is less than one stool per calendar week. Some of the symptoms of constipation include lower abdominal discomfort, a sense of incomplete evacuation (the feeling that you still accept to "go") after a bowel movement, straining to have a bowel movement, hard or modest stools, rectal bleeding, and/or anal fissures acquired by hard stools, physiological distress and/or obsession with having bowel movements.

What causes constipation?

Constipation normally is caused by the wearisome motility of material through the colon (large bowel). Two disorders that cause constipation are

1. colonic inertia, and
2. pelvic floor dysfunction.

At that place are many causes of and associations with constipation, for example, medications; poor bowel habits; depression fiber diets; perhaps abuse of laxatives; hormonal disorders; diseases primarily of other parts of the body that also affect the colon; and high levels of estrogen and progesterone during pregnancy.

What are the signs and symptoms of constipation?

Signs and symptoms of constipation may include rectal bleeding and/or anal fissures that are caused by hard or small-scale stools, lower abdominal discomfort, and straining to take a bowel movement.

Telephone call your md or other health care professional person for treatment for constipation if yous accept a sudden onset of symptoms that come on suddenly that are astringent pain that worsens and are associated with other worrisome symptoms such as suddenly losing weight, or is not responding to simple, safe and effective treatments.

What exams, tests, and procedures cause constipation?

Tests to diagnose the cause of constipation may include a medical history, physical examination, blood tests, abdominal X-rays, barium enema, colonic transit studies, defecography, anorectal motility studies, and colonic motion studies.

What are the goals for constipation therapy? Is there a special diet plan for it? How is it cured?

The goal of therapy for constipation is one bowel movement every two to three days without straining. Treatment may include foods loftier in fiber, non-stimulant laxatives, stimulant laxatives, enemas, suppositories, biofeedback preparation, prescription medications, and surgery. Stimulant laxatives, including herbal products, should be used as a last resort because they might harm the colon and worsen constipation.

Superlative Foods to Forestall Constipation

Fortunately, there are many foods you can eat to help salvage constipation, and foods to avoid that can make constipation worse. Here is a list of 12 foods to eat to aid relieve your constipation. When planning a good for you diet, it helps to include plenty of high-fiber choices to help you stay regular.

• Flax seed
• Beans
• Kiwi
• Berries
• Pears, plums, and apples...

Infographic stating less than 50% of adults have a one bowel movement a day. Source: iStock/MedicineNet

What is constipation?

Constipation means different things to dissimilar people. For many people, information technology simply ways infrequent passage of stool (feces). For others, however, it means difficult stools, difficulty passing them (straining), or a sense of incomplete emptying after a bowel motility. The cause of each of these symptoms of constipation vary, so the arroyo to each should exist tailored to each specific patient.

Constipation besides tin alternate with diarrhea. This design commonly occurs as part of the irritable bowel syndrome (IBS). At the extreme end of the spectrum for it is fecal impaction, which is when the stool hardens in the rectum and prevents passage (although occasionally diarrhea may occur even with obstruction due to colonic fluid leaking around the impacted stool).

The number of bowel movements generally decreases with age. Near adults take what is considered normal, betwixt iii and 21 times per week. The most common pattern is one bowel movement a day, but this design is seen in less than half of individuals. Moreover, nearly are irregular and don't have bowel movements every day or the same number every twenty-four hour period.

Medically speaking, constipation usually is defined equally fewer than three bowel movements per calendar week. Astringent constipation is defined every bit less than one bowel movement per week. There is no medical reason to have 1 bowel movement every 24-hour interval. Going without one for two or three days does not cause physical discomfort, only mental distress (in some people). Opposite to popular belief, there is no evidence that "toxins" accumulate when movements are infrequent or that constipation leads to cancer.

Information technology is important to distinguish astute (recent onset) constipation from chronic (long duration) constipation. Acute constipation requires urgent assessment because a serious medical illness may exist the underlying cause (for instance, tumors of the colon). Information technology also requires an immediate assessment if it is accompanied past symptoms such as rectal haemorrhage, abdominal pain and cramps, nausea and vomiting, and involuntary loss of weight. The evaluation of chronic constipation may not be urgent, peculiarly if simple measures bring relief.

A doctor examines a female patient'southward abdomen. Source: Getty Images

What are constipation symptoms and signs?

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Signs and symptoms of constipation include

1. infrequent bowel movements,
2. straining when going to the bathroom,
3. difficult and/or pocket-sized carrion,
4. a sense of incomplete evacuation later on going to the bathroom,
5. lower intestinal discomfort,
6. intestinal bloating,
7. occasionally distension (bloating),
8. anal bleeding or fissures from the trauma caused by difficult feces,
9. occasionally diarrhea due to obstacle of the colon by difficult stool,
10. rarely,
11. colonic perforation,
12. psychological distress and/or obsession with having to go to the bathroom, and possible aggravation of the diverticular disease,
13. hemorrhoids, and
14. rectal prolapse.

When should I seek medical care for chronic constipation?

If the chief problem is straining to push button the stool out, chronic constipation should probably exist evaluated early. This difficulty might be due to pelvic floor dysfunction, and the treatment of choice is biofeedback training, not laxatives. If it is not responding to the simple measures discussed previously with the addition of hyperosmolar products or milk of magnesia, it is fourth dimension to consult a md for an evaluation. If a primary doctor is not comfortable performing the evaluation or does non have confidence in doing an evaluation, he or she should refer the patient to a gastroenterologist. Gastroenterologists evaluate constipation frequently and are very familiar with the diagnostic testing described previously.

What causes constipation?

Theoretically, constipation can be acquired by the slow passage of digesting food through any function of the digestive system. Most of the time, notwithstanding, the slowing occurs in the colon

A pharmacist explains medication side effects to a patient. Source: iStock

What medications cause constipation?

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Medications are frequently overlooked equally a cause of constipation. Common medications that crusade constipation include narcotic pain medications, for example, codeine (for example, (Tylenol #3), oxycodone (for example, Percocet) and hydromorphone (Dilaudid), antidepressants such as amitriptyline (Elavil, Endep) and imipramine (Tofranil), anticonvulsants, for example phenytoin (Dilantin) and carbamazepine (Tegretol), iron supplements, calcium channel blocking drugs (CCBs), for case, diltiazem (Cardizem) and nifedipine (Procardia). Aluminum-containing antacids such as aluminum hydroxide suspension (Amphojel) and aluminum carbonate (Basaljel)

Many other drugs tin can crusade constipation. Elementary measures tin be used to care for constipation, for example, increasing fiber in your diet or taking stool softeners. If constipation is caused by a medication, talk to your medico about discontinuing medications that may not exist non necessary. If simple measures don't work, it may be possible to substitute a less constipating medication, for example, a nonsteroidal ant-inflammatory drug (NSAIDs), for case, ibuprofen (Advil, Motrin, Nuprin) and naproxen (Aleve, Anaprox, Naprelan, and Naprosyn), or one of the newer and less constipating antidepressants.

QUESTION

You are constipated if you don't have a bowel motion every 24-hour interval. Run across Answer

A line of runners waits in line to utilize portable toilets. Source: iStock

What are other causes of constipation?

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Habit: Bowel movements are under voluntary command. This means that the normal urge you experience when y'all need to have i can be suppressed. Although occasionally information technology is appropriate to suppress an urge to defecate (for case, when a bathroom is not available), doing this too oft can atomic number 82 to a disappearance of urges and result in constipation.

Diet: Fiber is important in maintaining a soft, bulky stool. Therefore, eating foods low in fiber can cause constipation. The best natural sources of fiber are fruits, vegetables, and whole grains.

Laxatives: One suspected crusade of astringent constipation is the over-use of stimulant laxatives, for case, senna (Senokot), castor oil, and many herbs. An clan has been shown between the chronic use of these products and damage to the nerves and muscles of the colon, possibly resulting in the condition. It is not clear, nonetheless, whether the products accept caused the damage or whether the damage existed prior to the use them. However, because of the possibility that stimulant products tin impairment the colon, nigh experts recommend that they be used as a last resort afterward non-stimulant products have failed.

Hormonal disorders: Hormones tin affect bowel movements. For instance, as well little thyroid hormone (hypothyroidism) and too much parathyroid hormone (by raising the calcium levels in the blood). At the time of a woman's menstrual periods, estrogen and progesterone levels are high. However, this is rarely a prolonged status. Loftier levels of estrogen and progesterone during pregnancy also cause constipation.

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A colored contrast barium enema 10-ray. Source: Getty Images

What exams, procedures, and tests help diagnose the cause of severe constipation?

Medical history

Many tests can diagnose astringent constipation, and most people merely need a few bones tests. First the doctor or health care professional will take a medical history and concrete test to allow the doc to define the type of constipation that's present; uncover whatsoever supplements or prescription products you are taking; or diseases or other health issues yous have. This, in turn, directs the diagnosis and therapy. For example, if defecation is painful, the doctor knows to look for anal problems such every bit a narrowed anal sphincter or an anal fissure. If pocket-sized stools are the trouble, eating foods low in cobweb may be the cause. If the patient is experiencing significant straining, then pelvic flooring dysfunction is probable.

A careful dietary history-which may crave keeping a food diary for a week or ii-tin reveal a diet that is low in fiber and may direct the physician to recommend a high-fiber diet. A food diary also allows the physician to evaluate how well an individual increases his dietary fiber during treatment.

Other tests are available for people who have severe constipation that doesn't respond easily to treatment.

Physical examination

A physical examination may identify diseases (for case, scleroderma) that tin cause constipation. A rectal examination with the finger may uncover a tight anal sphincter that may be making defecation difficult or it may detect that the muscles of the pelvic flooring do not relax normally. If a cloth-filled colon tin can exist felt through the abdominal wall, information technology suggests that it is severe. Stool in the rectum suggests a problem with the anal, rectal, or pelvic flooring muscles.

Blood tests

Blood tests may be appropriate in evaluating your condition. More specifically, blood tests for thyroid hormone (to observe hypothyroidism) and for calcium (to uncover excess parathyroid hormone) may exist helpful.

Intestinal X-ray

Big amounts of material in the colon unremarkably tin can be visualized on simple 10-ray films of the belly, and the more severe constipation, the more visualized on X-ray.

Barium enema

A barium enema (lower gastrointestinal [GI] series) is an Ten-ray study in which liquid barium is inserted through the anus to fill up the rectum and colon. The barium outlines the colon on the X-rays and defines the normal or aberrant anatomy of the bowel and rectum. Tumors and narrowings (strictures) are among the abnormalities that can exist detected with this test.

Colonic transit (marker) studies

Colonic transit studies are simple X-ray studies that decide how long it takes for food to travel through the intestines. For transit studies, individuals eat capsules for one or more days. Within the capsules are many pocket-size pieces of plastic that tin be seen on X-rays. The gelatin capsules deliquesce and release the plastic pieces into the pocket-size intestine. The pieces of plastic and so travel (equally would digesting food) through the pocket-size intestine and into the bowel. After v or seven days, an X-ray of the belly is taken and the pieces of plastic in the dissimilar parts of the bowel are counted. From this count, it is possible to make up one's mind if and where in that location is a delay in the colon.

In people who are not constipated, all of the plastic pieces are eliminated in the feces and none remain in the colon. When pieces are spread throughout the colon, it suggests that the muscles or nerves throughout the colon are non working, which is typical of colonic inertia. When pieces accumulate in the rectum, it suggests pelvic floor dysfunction.

Defecography

Defecography is a modification of the barium enema examination. For this procedure, a thick paste of barium is inserted into the rectum of a patient through the anus. 10-rays so are taken while the patient defecates the barium. The barium clearly outlines the rectum and anus and demonstrates the changes taking place in the muscles of the pelvic floor during defecation. Thus, defecography examines the process of defecation and provides information virtually anatomical abnormalities of the rectum and pelvic flooring muscles during defecation.

Anorectal movement studies

Anorectal motility studies, which complement defecography tests, provide an assessment of the office of the muscles and nerves of the anus and rectum. For anorectal motility studies, a flexible tube, approximately an eighth of an inch in diameter, is inserted through the anus and into the rectum. Sensors within the tube measure the pressures that are generated by the muscles of the anus and rectum. With the tube in identify, the private performs several unproblematic maneuvers such as voluntarily tightening the anal muscles. Anorectal motility studies can help decide if the muscles of the anus and rectum are working usually. When the function of these muscles is impaired, the flow of material through the GI tracts is obstructed, thereby causing a condition similar to pelvic floor dysfunction.

Magnetic resonance imaging defecography

The newest test for evaluating defecation and its disorders is magnetic resonance imaging (MRI) defecography and is similar to barium defecography. However, MRI is used instead of 10-rays to provide images of the rectum during defecation. MRI defecography appears to be an excellent way to study defecation, but the process is expensive and somewhat cumbersome. As a result, information technology is used in but a few institutions that accept a detail interest in constipation and abnormalities of defecation.

Colonic move studies

Colonic motility studies are similar to anorectal motility studies in many aspects. A very long, narrow (one-eighth inch in diameter), flexible tube is inserted through the anus and passed through part or the entire colon during a procedure called colonoscopy. Sensors inside the tube measure the pressures that are generated past the contractions of the colonic muscles. These contractions are the result of coordinated activeness of the colonic nerves and muscles. If the action of the nerves or muscles is aberrant, the blueprint of colonic pressures will exist abnormal. Colonic motility studies are near useful in defining colonic inertia. These studies are considered research tools, just they can assistance make decisions regarding treatment in individuals with astringent constipation.

SLIDESHOW

Digestive Disorders: 23 Constipation Myths and Facts See Slideshow

A doctor discusses constipation treatments with a male patient. Source: Getty Images

What are treatments for the causes of constipation?

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There are several principles in approaching the evaluation and treatment of constipation. The showtime principle is to differentiate between acute (contempo onset) and chronic (long elapsing) constipation. Thus, with acute constipation or constipation that is worsening, it is necessary to assess for the cause early and so equally non to overlook a serious affliction that should be treated urgently. 2) starting time treatment early of constipation and use the treatments that have the least potential for impairment, which will foreclose constipation from worsening, and it will prevent potential damage to the colon that can exist caused past the frequent use of stimulant products. 3) know when it is time to evaluate the crusade of chronic constipation. Evaluation for the cause of chronic constipation needs to be done if in that location is no response to the simple treatments.

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A person holds laxative capsules. Source: iStock

What natural or home remedies salvage and treat constipation?

Natural and home remedies to salve pain and stop constipation?

Don't suppress urges to defecate. When the urge comes, find a toilet. With the aid of your doctor and pharmacist, make up one's mind if in that location are drugs that you are taking that could be contributing to constipation. Run into if the drugs tin be discontinued or changed.

Increase the fiber in your diet past consuming more fruits, vegetables, and whole grains. (There are other health benefits from this recommendation as well.) Information technology may be difficult to get enough fiber in the diet to finer treat constipation, so don't hesitate to take fiber supplements if necessary (wheat bran, psyllium, etc.). Use increasing amounts of fiber and/or modify the type of fiber consumed until there is a satisfactory result. Don't expect fiber to work overnight. Allow a few weeks for acceptable trials.

What if constipation does not answer to natural and dwelling remedies?

These efforts should not be discontinued simply other measures should be added. If it is infrequent, that is, every few weeks (as it can be when due to the menstrual cycle), it probably doesn't affair what other measures are added-emollient, saline, or hyperosmolar laxatives, enemas, and suppositories. Even stimulant laxatives every four to six weeks are unlikely to damage the colon. Unfortunately, the tendency when using stimulant products is to unconsciously increase the frequency of their apply. Earlier you know it, y'all're taking them every week, or more often, and there is a concern (though no proof) that permanent colonic impairment might result.

If constipation is a continuous rather than an intermittent problem, probably the safest products to take on a regular basis are the hyperosmolar laxatives. Their apply should be supervised by a physician. As with fiber, increasing doses of different hyperosmolar products should be tried over several weeks until a satisfactory type and dose of laxative is found. Hyperosmolar laxatives, withal, can be expensive. Milk of magnesia is the mildest of the saline laxatives, is inexpensive, and provides a good alternative. Nigh patients tin can adjust the dose of milk of magnesia to soften the stool adequately without developing diarrhea or leakage of stool.

Prunes and clip juice have been used for many years to treat balmy constipation. There is no evidence that the mild stimulant furnishings of prunes or clip juice damage the colon.

Stronger stimulant products ordinarily are recommended only as a concluding resort after non-stimulant treatments have failed. Many people have herbs to treat the trouble considering they feel more comfortable using a "natural" product. Unfortunately, most of these herbal preparations incorporate stimulant products and their long-term use raises the possibility that they also may damage the colon.

An array of salubrious fiber foods. Source: iStock

What kind of loftier-cobweb diet treats constipation?

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The best style of calculation cobweb to the nutrition is increasing the quantity of fruits and vegetables that are eaten. This means a minimum of five servings of fruits or vegetables every day. For many people, however, the corporeality of fruits and vegetables that are necessary may exist inconveniently large or may not provide adequate relief from the status. In this case, fiber supplements tin can be useful.

Cobweb is divers every bit cloth fabricated by plants that is non digested by the human alimentary canal. It is one of the mainstays in the treatment. Many types of fiber within the intestine bind to water and keep the water within the intestine. Information technology adds bulk (volume) to the stool and the water softens information technology.

There are different sources of fiber, and the blazon varies from source to source. Types can be categorized in several ways, for case, by their source.

The virtually common sources include fruits and vegetables, wheat or oat bran, psyllium seed (for case, Metamucil, Konsyl), synthetic methyl cellulose (for instance, Citrucel), and polycarbophil (for example, Equalactin, Konsyl Fiber). Polycarbophil often is combined with calcium (for example, Fibercon). However, in some studies, the calcium-containing polycarbophil was not as constructive equally the polycarbophil without calcium. A bottom known source of fiber is an extract of malt (for example, Maltsupex). However, this excerpt may soften the cloth in ways other than increasing cobweb.

Increased gas (flatulence) is a common symptom and side upshot of loftier-cobweb diets. The gas occurs because the leaner ordinarily present inside the colon are capable of digesting cobweb to a small-scale extent. The bacteria produce gas as a byproduct of their digestion it. All fibers, no matter what their source, can cause flatulence. Notwithstanding, since bacteria vary in their ability to digest the various types of fiber, the different sources of it may produce dissimilar amounts of gas. To complicate the state of affairs, the ability of leaner to digest one type can vary from individual to individual. This variability makes the selection of the best type of fiber for each individual more difficult.

Different sources of fiber should be tried one by one. It should be started at a depression dose and increased every ane to two weeks until either the desired issue is achieved or troublesome flatulence interferes. Fiber does not work overnight, then each production should be tried over a few weeks, if possible. If symptoms of flatulence occur, the dose can be reduced for a few weeks and the higher dose tin and so be tried over again. It more often than not is said that the amount of gas that is produced by fiber decreases when it is ingested for a prolonged period of fourth dimension, although, this has never been studied. If flatulence remains a trouble and prevents the dose of fiber from being raised to a level that affects the stool satisfactorily, it is time to motility on to a different source of fiber.

When increasing amounts of fiber are used, it is recommended that greater amounts of h2o be consumed (for example, a full glass with each dose). In theory, the water prevents "hardening" of the fiber and blockage (obstruction) of the intestine. This seems like simple and reasonable advice. However, ingesting larger amounts of h2o has never been shown to have a beneficial result on constipation, with or without the addition of fiber. There is already a lot of water in the intestine and any actress ingested h2o volition be absorbed and excreted in the urine. Withal, it is reasonable to drinkable plenty fluids to prevent dehydration that would cause reduced intestinal water.

There are reasons not to take fiber or to take specific types of them. Due to concern nigh obstruction, if individuals have narrowed colons due to strictures or adhesions (scar tissue from previous surgery), they should talk to their dr. or other wellness intendance professional before making any dietary changes. Some products incorporate sugar, so individuals with diabetes may need to select sugar-free products. In some cases, the gas volition subtract over time.

From

A tray of lecithin laxative capsules. Source: iStock

What types of laxatives treat constipation?

Lubricant laxatives

Lubricant laxatives contain mineral oil as either the plain oil or an emulsion (combination with water) of the oil. The oil stays within the intestine, coats the particles of stool, and presumably prevents the removal of water from the fabric. This retention of water results in the softer stool. Mineral oil by and large is used merely for brusque-term treatment since its long-term utilize has several potential disadvantages. The oil can blot fat-soluble vitamins from the intestine and, if used for prolonged periods, may atomic number 82 to deficiencies of these vitamins. This is of particular concern in pregnancy during which an adequate supply of vitamins is important for the fetus. In the very young or very elderly in whom the swallowing machinery is not stiff or is impaired past strokes, small amounts of the swallowed oil may enter the lungs and cause a type of pneumonia chosen lipid pneumonia. Mineral oil also may subtract the absorption of some drugs such as warfarin (Coumadin) and oral contraceptives, thereby decreasing their effectiveness. Despite these potential disadvantages, mineral oil tin can be effective when short-term treatment is necessary.

Emollient laxatives (stool softeners)

Emollient laxatives are generally known equally stool softeners. They contain a chemical compound called docusate (for instance, Colace). Docusate is a wetting agent that improves the ability of water inside the colon to penetrate and mix with the material in the bowel. This increased water within information technology softens the stool, although studies have not shown docusate to be consistently effective in relieving constipation. These softeners often are used in the long-term management of the status. It may have a calendar week or more for docusate to exist effective. The dose should be increased after one to two weeks if no effect is seen.

Although docusate by and large is safe, it may increase the assimilation of mineral oil and some medications from the intestine. Captivated mineral oil collects in tissues of the trunk, for example, the lymph nodes and the liver, where it causes inflammation. Information technology is not clear if this inflammation has whatever important consequences, merely it mostly is felt that prolonged absorption of mineral oil should not be immune. The use of emollient products is not recommended together with mineral oil or with certain prescription medications. Emollient products are commonly used when there is a need to soften stool temporarily and make defecation easier (for instance, after surgery, childbirth, or heart attacks). They are also used for patients with hemorrhoids or anal fissures.

Hyperosmolar laxatives

Hyperosmolar laxatives are indigestible, unabsorbable compounds that remain within the colon and retain the water that already is in the colon. The result is softening of it. The well-nigh mutual hyperosmolar products are lactulose (for instance, Kristalose), sorbitol, and polyethylene glycol (for example, MiraLax). Some are available past prescription just. These products are condom for long-term employ and are associated with few side effects.

Hyperosmolar laxatives may be digested by colonic bacteria and turned into gas, which may result in unwanted abdominal bloating and flatulence. This effect is dose-related and less with polyethylene glycol. Therefore, gas tin can exist reduced past reducing the dose of

An case of a suppository to stimulate bowel movement. Source: Getty Images

What other over-the-counter (OTC) drugs treat constipation?

Saline laxatives

Saline laxatives contain non-absorbable ions such as magnesium, sulfate, phosphate, and citrate [for instance, magnesium citrate (Citroma), magnesium hydroxide, sodium phosphate). These ions remain in the colon and cause h2o to exist drawn into the colon. Again, the issue is to soften the carrion.

Magnesium as well may accept balmy stimulatory effects on the colonic muscles. The magnesium in magnesium-containing products is partially absorbed from the intestine and into the trunk. Magnesium is eliminated from the body past the kidneys. Therefore, patients with impaired kidney part may develop toxic levels of magnesium from chronic (long duration) apply of magnesium-containing products.

Saline laxatives act within a few hours. In general, stiff saline products should not exist used on a regular basis. If major diarrhea develops with the use of saline products and the lost fluid is not replaced by the consumption of liquids, dehydration may outcome. The most often-used and mildest of the saline products is the milk of magnesia. Epsom Salt is a more stiff saline laxative that contains magnesium sulfate.

Stimulant laxatives

Stimulant laxatives cause the muscles of the modest intestine and colon to propel their contents more than rapidly. They besides increase the corporeality of water in it, either by reducing the absorption of the water in the colon or by causing active secretion of water in the minor intestine.

The most commonly-used stimulant products contain cascara (castor oil), senna (for example, Ex-Lax, Senokot), and aloe. Stimulant products are very effective, but they can cause severe diarrhea with resulting aridity and loss of electrolytes (especially potassium). They too are more likely than other types of laxatives to crusade intestinal cramping. There is concern that chronic use of stimulant laxatives may damage the colon and worsen the condition, as previously discussed. Bisacodyl (for example, Dulcolax, Correctol) is a stimulant laxative that affects the nerves of the colon which, in plow, stimulates the muscles of the colon to propel its contents. Prunes also contain a mild colonic stimulant.

Enemas

There are many unlike types of enemas. By distending the rectum, all enemas (even the simplest type, the tap water enema) stimulate the colon to contract and eliminate the material. Other types of enemas accept additional mechanisms of action. For example, saline enemas cause water to be drawn into the colon. Phosphate enemas (for example, Fleet phosphorous) stimulate the muscles of the colon. Mineral oil enemas lubricate and soften hard stool. Emollient enemas (for example, Colace, Microenema) contain agents that soften the stool.

Enemas are particularly useful when there is impaction when stool hardens in the rectum. In society to exist effective, the instructions that come up with the enema must exist followed. This requires full awarding of the enema, appropriate positioning after the enema is instilled, and retention of the enema until cramps are felt. Defecation unremarkably occurs between a few minutes and one hour later the enema is inserted.

Enemas are meant for occasional rather than regular use. The frequent utilize of enemas can cause disturbances of fluids and electrolytes in the body. This is especially true of tap water enemas. Soapsuds enemas are not recommended because they tin can seriously damage the rectum.

Suppositories

In enemas, different types of suppositories take dissimilar mechanisms of action. There are stimulant suppositories containing bisacodyl (for example, Dulcolax). Glycerin suppositories are believed to take their outcome by irritating the rectum. The insertion of the finger into the rectum when the suppository is placed may itself stimulate a bowel motility.

Combination products

There are many products that combine dissimilar laxatives. For instance, in that location are oral products that combine senna and psyllium (Perdiem), senna and docusate (Senokot-Southward), and senna and glycerin (Fletcher's Castoria). 1 product even combines iii laxatives, senna-like casanthranol, docusate, and glycerin (Sof-lax Overnight). These products may exist convenient and effective, but they also contain stimulant products. Therefore, at that place is concern virtually permanent colonic damage with the utilise of these products, and they probably should non be used for long-term treatment unless non-stimulant treatment fails.

A woman sits on the toilet while suffering from constipation. Source: iStock

What OTC laxatives treat constipation?

Saline laxatives

Saline laxatives contain non-absorbable ions such as magnesium, sulfate, phosphate, and citrate [for example, magnesium citrate (Citroma), magnesium hydroxide, sodium phosphate). These ions remain in the colon and cause h2o to be drawn into the colon. Again, the effect is softened feces.

Magnesium also may have mild stimulatory effects on the colonic muscles. The magnesium in magnesium-containing products is partially absorbed from the intestine and into the trunk. Magnesium is eliminated from the body past the kidneys. Therefore, patients with impaired kidney role may develop toxic levels of magnesium from chronic (long duration) use of magnesium-containing products.

Saline laxatives deed inside a few hours. In general, potent saline products should non be used on a regular basis. If major diarrhea develops with the apply of saline products and the lost fluid is not replaced past the consumption of liquids, dehydration may result. The most frequently-used and mildest of the saline products is milk of magnesia. Epsom Salt is a more potent saline laxative that contains magnesium sulfate.

Stimulant laxatives

Stimulant laxatives cause the muscles of the pocket-size intestine and colon to propel their contents more apace. They too increase the amount of water in it, either past reducing the assimilation of the h2o in the colon or by causing active secretion of water in the small-scale intestine.3

The well-nigh commonly-used stimulant products contain cascara (brush oil), senna (for example, Ex-Lax, Senokot), and aloe. Stimulant products are very effective, but they tin cause astringent diarrhea with resulting aridity and loss of electrolytes (especially potassium). They also are more likely than other types of laxatives to cause intestinal cramping. At that place is business organization that chronic use of stimulant laxatives may damage the colon and worsen the status, equally previously discussed. Bisacodyl (for example, Dulcolax, Correctol) is a stimulant laxative that affects the nerves of the colon which, in plow, stimulate the muscles of the colon to propel its contents. Prunes also contain a mild colonic stimulant.

Enemas

There are many unlike types of enemas. By distending the rectum, all enemas (fifty-fifty the simplest blazon, the tap water enema) stimulate the colon to contract and eliminate the material. Other types of enemas have additional mechanisms of action. For example, saline enemas crusade h2o to be fatigued into the colon. Phosphate enemas (for example, Fleet phosphosoda) stimulate the muscles of the colon. Mineral oil enemas lubricate and soften hard stool. Emollient enemas (for case, Colace, Microenema) contain agents that soften the stool.

Enemas are peculiarly useful when there is impaction, when stool hardens in the rectum. In order to be constructive, the instructions that come with the enema must be followed. This requires full application of the enema, appropriate positioning after the enema is instilled, and retention of the enema until cramps are felt. Defecation usually occurs between a few minutes and one hour after the enema is inserted.

Enemas are meant for occasional rather than regular use. The frequent employ of enemas tin can crusade disturbances of fluids and electrolytes in the body. This is especially truthful of tap water enemas. Soapsuds enemas are not recommended considering they can seriously damage the rectum.

Suppositories

As is the example with enemas, unlike types of suppositories take different mechanisms of activeness. There are stimulant suppositories containing bisacodyl (for case, Dulcolax). Glycerin suppositories are believed to have their event by irritating the rectum. The insertion of the finger into the rectum when the suppository is placed may itself stimulate a bowel motility.

Combination products

There are many products that combine different laxatives. For case, there are oral products that combine senna and psyllium (Perdiem), senna and docusate (Senokot-Due south), and senna and glycerin (Fletcher's Castoria). One product even combines iii laxatives, senna-like casanthranol, docusate, and glycerin (Sof-lax Overnight). These products may exist convenient and constructive, merely they as well comprise stimulant products. Therefore, at that place is concern about permanent colonic damage with the use of these products, and they probably should not be used for long-term handling unless non-stimulant treatment fails.

A pharmacist scans prescription medications. Source: iStock

What prescription drugs care for constipation?

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Lubiprostone (Amitiza)

Lubiprostone (Amitiza) is a selective chloride aqueduct activator that increases secretion of chloride ions from the cells of the intestinal lining into the intestinal. Sodium ions and water then follow the chloride ions into the lumen, and the h2o softens the stool. At a dose of 24 micrograms twice a twenty-four hour period, lubiprostone significantly and promptly increased bowel movements, improved stool consistency, and decreased straining. The near common side effect of initial clinical studies was mild to moderate nausea in 32% of patients treated with lubiprostone, compared to 3% of the controls.

Linaclotide (Linzess)

Linaclotide (Linzess) is an oral drug that is not absorbed from the intestine. Information technology stimulates the cells lining the small-scale intestine to secrete fluid into the intestine. The increment in fluid secretion leads to an increased number of bowel movements. In addition, when it is associated with the abdominal pain of IBS, the pain also is reduced. Although the comeback in pain may exist due to the improvement, linaclotide has been shown besides to reduce the sensitivity of abdominal pain nerves, and this mechanism of action also may account for the decrease in hurting.

Linaclotide is moderately effective, and its effectiveness depends on how a favorable response is defined. In the studies leading upwardly to its approval, linaclotide was associated with an increase in bowel movements and a decrease in hurting in approximately i-third of patients as compared with 17% of patients who received placebo. The response was better when hurting and constipation were considered separately, with responses of approximately 50% for either.

The only common side effect of linaclotide is diarrhea. It should not be used in children below the age of six because of serious toxicity (death) to very young mice in beast studies, and should exist avoided in children ages six through 17.

Miscellaneous drugs to treat constipation

Several prescribed drugs that are used to treat medical diseases consistently cause (as a side effect) loose stools, even diarrhea. There really are several small-scale studies that have examined these drugs to treat the condition.

Colchicine

Colchicine is a drug that has been used for decades to treat gout. Most patients who take colchicine note a loosening of their stools. Colchicine has besides been demonstrated to relieve constipation effectively in patients without gout.

Misoprostol (Cytotec)

Misoprostol (Cytotec) is a drug used primarily for preventing stomach ulcers caused by nonsteroidal anti-inflammatory drugs such as ibuprofen. Diarrhea is 1 of its consistent side-furnishings. Several studies accept shown that misoprostol is constructive in treating information technology short term. Misoprostol is expensive, and information technology is non clear if information technology will remain effective and safe with long-term utilize. Therefore, its role in handling remains to be determined.

Orlistat (Xenical)

Orlistat (Xenical) is a drug that is used primarily for reducing weight. It works by blocking the enzymes within the intestine that digest fatty. The undigested fat is not absorbed, which accounts for the weight loss. Undigested fat is digested by leaner within the intestine and the products of this bacterial digestion promote the secretion of h2o. The products of digestion besides may bear upon the intestine in other ways, for example, by stimulating the intestinal muscles. In fact, in studies, orlistat has been shown to exist effective in treating constipation. Orlistat has few of import side furnishings, which is consistent with the fact that only very modest amounts of the drug are captivated from the intestine.

It is unclear if these prescribed drugs should be used for to treat constipation. Although information technology is difficult to recommend them specifically just for the management information technology, they might be considered for patients who are constipated and are overweight, have gout, or demand protection from nonsteroidal anti-inflammatory drugs.

Prucalopride (Resolor)

Prucalopride (Resolor) is an oral drug. Information technology is the only approved drug belonging to a new form of drugs, the dihydro-benzofuran-carboxamides. It attaches to receptors within the abdominal wall that promote abdominal motion, that is, wrinkle of the muscles of the wall that move stool through the intestine.

Prucalopride is effective in patients with chronic constipation. Randomized, placebo-controlled studies have shown that at maximum doses it increases the number of stools per week by i in approximately 50% of patients compared with approximately 25% of patients given placebo. It increases the number of stools per week to more than than 3 in approximately 25% of patients compared with approximately 12% of patients given placebo. Almost of the patients in the studies were having less than one stool per calendar week before starting prucalopride.

The most common side furnishings of prucalopride are headache and gastrointestinal symptoms including nausea, diarrhea, and abdominal pain. These symptoms ordinarily are mild, ofttimes resolve with continued treatment, and infrequently cause patients to discontinue treatment.

Surgery Source: MedicineNet

Does biofeedback, exercise, and surgery help relieve symptoms of constipation?

Biofeedback

About of the muscles of the pelvis surrounding the anus and rectum are under some caste of voluntary control. Thus, biofeedback grooming can teach patients with pelvic floor dysfunction how to make their muscles work more ordinarily and amend their ability to defecate. During anorectal biofeedback grooming, a pressure-sensing catheter is placed through the anus and into the rectum. Each time a patient contracts the muscles, the muscles generate a pressure that is sensed past the catheter and recorded on a screen. By watching the pressures on the screen and attempting to alter them, patients learn how to relax and contract the muscles more ordinarily.

Practice

People who pb sedentary lives are more than oft constipated than people who are active. Nevertheless, express studies of exercise on bowel habits have shown that do has minimal or no effect on the frequency of how often you lot get to the bath. Thus, do can be recommended mostly for its many other health benefits, but non for its result on constipation.

Surgery

For patients with problematic constipation that is due to diseases of the colon or laxative abuse, surgery is the ultimate treatment. During surgery, nigh of the colon, except for the rectum (or the rectum and part of the sigmoid colon), is removed. The cut end of the small intestine is attached to the remaining rectum or sigmoid colon. In patients with colonic inertia, surgery is reserved for those who do not answer to all other therapies. If the surgery is to be washed, in that location must be no disease of the small abdominal muscles. Normal small intestinal muscles are evidenced by normal motion studies of the pocket-size intestine itself.

Electric pacing

Electrical pacing is still in its experimental phases. Electrical pacing may exist done using electrodes implanted into the muscular wall of the colon. The electrodes leave the colon and are attached to an electric stimulator. Alternatively, stimulation of the sacral skin can exist used to stimulate nerves going to the colon. These techniques are promising, but much more than work lies ahead before their role in treating the status, if whatsoever, has been defined.

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What is new in the treatment of constipation?

Each role of the intestine (breadbasket, small intestine, and colon) has a network of nerves that controls its muscles. A not bad deal of research is being done in order to gain an understanding of how these nerves command each other and ultimately the muscles. Much of this research involves the report of neurotransmitters. (Neurotransmitters are chemicals that nerves utilise to communicate with each other.) This inquiry is assuasive scientists to develop drugs that stimulate (and inhibit) the various nerves of the colon which, in turn, cause the muscles of the colon to contract and propel the colonic contents. Such drugs have neat potential to treat constipation that is due to colonic inertia. The showtime of these drugs approved for use is prucalopride. These drugs are an exciting development because they offer a new treatment for a difficult-to-treat cause of constipation.

Nevertheless, in that location are many questions about these types of drugs that must be answered. How effective are they? Volition they work in many or simply a few patients? Will they piece of work in patients who accept damaged their nerves with stimulant products? Since these medications are likely to be used for a lifetime, how safe will they be with many years of use? Will they be used indiscriminately in situations for which simple treatments (for example, fiber) or more than appropriate treatments (for example, biofeedback training) should be used?

Medically Reviewed on 3/18/2021

References

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Didactics, 2015.

United States. National Institutes of Diabetes and Digestive and Kidney Diseases. "Constipation." <https://www.niddk.nih.gov/health-information/digestive-diseases/constipation>.

U.s.a.. National Establish of Diabetes and Digestive and Kidney Diseases. "Eating, Diet, & Nutrition for Constipation." <https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/eating-diet-nutrition>.

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Source: https://www.medicinenet.com/constipation/article.htm

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