Medicine for Constipation
Which One is Right for You

By Paul Schneider Jr.

Medicine for constipation may sometimes be necessary, but preferably only as a last resort.

According to the Gastrointestinal Diseases and Disorders Sourcebook (Second Edition), “Even though how a person is treated is dependent on the duration, severity and cause, most of the time changes in diet and lifestyle are helpful for relieving constipation symptoms or can help to keep it from occurring.”

I couldn't agree more. A diet for constipation containing 20-35 grams of fiber per day can help bulky, soft stool to form. Food choices have a great impact on constipation, either for bad or good. Add to fiber a daily mineral supplement high in magnesium, and it may just do the trick.


An Overview of Medications that
are Available for Constipation

Laxatives

Individuals experiencing only mild constipation probably don't require a laxative. Most people who are mildly constipated may not need Laxatives.

But if a person has not made a diet or lifestyle change (drinking enough water and liquids, exercise etc.), and still are constipated, doctors may recommend medicine for constipation, such as an enema or a laxative, for a short period.

It is best for a doctor to decide whether a person should take laxatives, and the one they should take. There are numerous forms of oral laxatives available. They come in granulated form, a powder, a chewing gum,a tablet or a liquid.

1. Stimulant laxatives

Stimulant laxatives irritate the colon, which stimulates it to contract and move feces along. Common brands of stimulant laxatives are:  Senokot, Purge, Dulcolax and Senokot.

A chemical called Bisacodyl is the active ingredient in Fleets Laxative, Feen-a-mint, Evac-U-Gen, Dulcolax, Correctol, Carters little pills, as well as many other brand name laxatives used to treat constipation. Doctors choose Bisacodyl for emptying out the colon to get it ready for rectal examinations or surgery.

Bisacodyl may be purchased under a generic label. You should not take any medicines within two hours of taking a laxative.

Commonly used herbal stimulant laxatives

  • Cascara sagrada
  • Senna
  • Purging buckhorn


Stimulant laxatives can be habit forming.  They may result in the colon to become lazy, dependent on their stimulation. They, along with most medicine for constipation, should not be used on an ongoing basis.

Aloe latex, a component of the aloe vera plant, is a powerful stimulant laxative. Although a natural compound, it and other herbal stimulant laxatives can also result in a lazy colon.

In the book Herbal Prescriptions after 50, by David Hoffmann, it states:

“it cannot be stressed enough that constipation
is a symptom requiring skilled diagnosis if it is
unresponsive to herbal treatment or is a longstanding
condition.  Laxative herbs are very effective."


He goes on to say that if (stimulant) laxatives, whether herbal or chemical, are used over a long time period, the bowels are becoming dependent on them, and without their stimulation a bowel movement becomes very difficult. 
This is why laxatives are one of the most common indirect causes of constipation.

It is suggested that people who have developed a laxative dependency should ween themselves off of them. An easy way to do this is by taking anywhere from 1 to 4 tsps. of a magnesium supplement for the period of time that it takes the bowel to regain natural contractions. For most, normal peristalsis may be restored within a few months. You can ask a doctor to assist you in doing this, if you like.

2. Bulk forming laxatives

One of the safest laxatives is a bulk-forming laxative, although these may interfere with absorption of some medicines. This kind of laxative is taken with water.

It makes the stool softer by pulling in water into the stool.

Common brands are:

  • Serutan
  • Konsyl
  • Citrucel
  • Metamucil


Fiber rich foods and some herbs are natural bulk formers. These are safe for long term use. 
It is best to take them in the morning or evening and gradually increase the dosage.

Herbal examples are black and blonde psyllium, and flax seeds.

3. Stool softeners (emollient laxatives)

These provide extra moisture that helps to keep the stool from drying out. A chemical called Docusate is the active ingredient in Colace and Correctol Soft Gel Extra Gentle. Generic docusate capsules are also available.

Surfak is another stool softener. It is one of the medicine for constipation that can help prevent constipation and straining or discomfort associated with hard or dry stools.  

4. Lubricants

These lubricate stool, making it easier for it to pass through the colon. The most commonly used lubricant laxative is mineral oil. This type of laxative also seals off the colon, keeping it from extracting too much moisture from the stool.

On the downside, they also hinder the colon from absorbing nutrients.

5. Saline laxatives

This type of laxative draws moisture into the colon from surrounding soft tissue. This extra moisture bulks up stool, and makes it softer and more slippery.

Examples of these medicine for constipation are:  

  • Epson Salt
  • Milk of Magnesia


Although these are one of the safest laxatives on the market, they are not recommended for regular use because of the high amount of magnesium or sodium they contain.

However, there is a mineral supplement containing an amount of magnesium recommended for daily use that can still effectively do the job. Magnesium offers other benefits, too. The water it draws in not only moistens the stool, but it serves as a lubricant for easy elimination.

Magnesium is particularly suited to the elderly. Since it is estimated most people aren't getting enough magnesium through food, some extra magnesium would do most of us good. My wife and I have been taking this supplement for years, and it has all but eliminated our constipation problems.

Magnesium can help to relieve constipation, plus they are used to cleanse the bowel before medical procedures.

6. Secretory laxatives

These are herbs that produce bile through the liver that helps with defecation. Bile is a necessary component that helps the colon to function properly. Yellow dock and dandelion root are two examples.

A gentle laxative that can be made and avoids dependency problems is:  

  1. Yellow dock / 2 parts
  2. Dandelion    / 2 parts
  3. Aniseed       / 1 part

As Tincture:  take 1 tsp. (5 ml) of this mixture three times a day. As dried herb:  add 2 tsp. to a cup of water and drink three times a day.

Common Natural Laxatives

Gary Null, Ph.D. in the complete Encyclopedia says; "For those who are constipated, the following herbs may be used temporarily".

  • Red raspberry leaves
  • Goldenseal root
  • Bayberry root bark
  • Flaxseed
  • Senna (a non-prescription drug)
  • Cascara sagrada bark

Bifidobacteria is a probiotic that may be taken once daily for constipation.

Should I use enemas?

Commercially available enemas are generally of the stimulant class, and should only be used occasionally.

For extreme constipation, a water enema may be a good choice for breaking up blockage and forcing it out.


Prescription Drugs for Treating Chronic Constipation

Linzess

This is a prescription treatment option.  It is one of the medicine for constipation used to treat adults who have irritable bowel syndrome with constipation and chronic idiopathic constipation.

Linzess is also effective and safe in children.

Amitiza (lubiprostone)

This is a treatment for constipation where the cause is unknown.

Drugs may cause constipation

Up to 40% of people who are taking opioids for pain relief experience constipation that is severe enough to cause them major limitations in their quality of life.

Anticholinergic drugs can cause side effects including constipation.  There are other drugs that are available and safer.

(Return from Medicine for Constipation to Treatment for Chronic Constipation)

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