By Dr. Shrey Lakhotia, BDS
Mild cases of constipation can easily be managed by modifying one’s lifestyle, changing one’s diet and drinking more water. However, when the problem more is severe then medications may be necessary.
For constipation relief, 5 kinds of laxatives that may be purchased without a prescription.
These may contain psyllium, polycarbophil or methylcellulose.
A couple of brands are Metamucil and FiberCon.
This is the most popular type of laxative. Bulk-forming laxatives function by increasing stool diameter by causing more water to be absorbed into the stool. A bulkier stool stimulates peristalsis, the wave-like action of the colon that moves stool along.
This class of laxative is may be used every day if needed, as it is non-habit forming. It is also safe for elderly patients to use.
Brands: Phillips' Liqui-Gels, Surfak, Colace.
Docusate sodium acts as a stool softener. Stool softeners draw fluid into the stool. This makes them softer more easily passed. Stool softeners are available as liquid, tablets or as an enema. People usually take them before going to bed.
Constipation relief can generally be expected anywhere from 2 to 5 days. If you are experiencing nausea, stomach pain or vomiting, you should talk to your physician before taking them. They should not be taken for more than a week.
These place a slick coating over stool to help it pass more easily. They also coat the walls of the intestines so that more water is held in the stool. This type of laxative is taken before going to bed or when one gets up. It may take anywhere from half an hour to 8 hours to be effective.
Glycerine suppositories can be taken at any time during the day and act in 15 minutes. It is not recommended to take these products for longer than a week, since longer term use can result in vitamins and other nutrients not being absorbed by the body.
These products contain castor oil, sennosides or bisacodyl.
Popular brands: Senokot, Ex-Lax and Dulcolax.
Stimulants cause irritation to the bowel. This in turn causes the intestinal muscles to contract, pushing stool along, resulting in bowel movement. Stimulant laxatives are generally taken right before going to bed, and are expected to produce a bowel movement the next morning.
Use of stimulants can result in cramping of the stomach. Their main use, under doctor's orders, is to get the bowel ready for a doctor's exam or to prevent a person from straining following surgery.
It is not advisable to take a stimulant laxative for longer than a week. When taken for an extended period of time, the bowel can lose its natural muscle tone and can become dependent on the stimulant for contractions.
This includes products that use a form of phosphate, sodium or magnesium as an active ingredient.
Popular brand names: Epson Salt, Milk of Magnesia, Ceo-Two Evacuant, Miralax
Osmotic Laxatives work with an osmotic action. They draw fluid from surrounding tissue into the colon. The extra moisture makes stools softer.
These may be purchased in enema, suppository, liquid or tablet form. It is not recommended to take osmotic laxatives in excess of 7 days due to the high dose of magnesium, sodium or phosphate.
Amitiza is used for the treatment of chronic idiopathic constipation. Amitiza works by softening the stool by increasing its water content, causing stool to pass more easily. It is taken twice daily with food.
However it may cause the following side effects:
Linzess helps in constipation relief by increasing the frequency of bowel movements. It is taken once daily on an empty stomach 30 minutes in morning before eating. It is not approved for patients younger than 18 years of age.
The most common side effect it causes is diarrhea. Linaclotide is moderately effective and studies show that it can help in pain associated with constipation.
Lactulose is available under many brand names. It acts by drawing water into the bowel to soften and loosen the stool. However it causes side effects like gas, diarrhea, upset stomach & stomach cramps.
It is an osmotic laxative which can be taken over-the-counter as well. However it is mainly given through prescription. It causes water to remain in the stool which results in softer stools. It is especially beneficial for patients who cannot tolerate dietary fiber supplements.
Medicines are a short-term answer to the problem of constipation. For long-term relief, it is best to adopt lifestyle changes, like getting more fiber, exercising, and drinking more water.
As a constipation medication, magnesium is an osmotic laxative.
However, when magnesium is taken in daily smaller doses as a nutritional supplement, chronic constipation may disappear.
Taking a magnesium supplement can be an important lifestyle change helpful for constipation relief. For the 80% of Americans who don’t get enough magnesium, it may also result in other health benefits.
Note: As with any over-the-counter remedy, talk with your doctor before starting on a magnesium supplement. Supplemental magnesium may interfere with certain prescription medications. Those with kidney disease should not take a magnesium supplement unless instructed to do so by their doctor.
Medications are useful for temporary relief of constipation. However, they not recommended for prolonged use.