How Constipation Causes Paradoxical Diarrhea
Many people with diarrhea assume it’s caused by a virus or something they’ve eaten. Most people don’t realize that diarrhea can actually be caused by constipation.
Constipation may only last for a few days. In some cases, though, it can become chronic. When you don’t pass stool for an extended period of time, it may build up in the digestive tract. This can result in whats called fecal impaction.
Fecal impaction is when there is a large, hard mass of stool in the intestine. This stool is so hard and so stuck that it cant be passed.
Fecal impaction might also be called impacted stool, impacted bowel, or impacted colon.
A person who has a fecal impaction may find they have watery stools but are not really moving their bowels. In fact, it might be difficult to contain the stool in the rectum. It may leak, leading to bathroom accidents or incontinence.
This happens because there is watery stool behind the fecal impaction. It is seeping out around the hard mass of stool. This liquid stool is often foul-smelling.
This can lead some people to think theyre having diarrhea when the real problem is the impacted stool.
The problem is worsened when the rectum is distended, or enlarged. The internal anal sphincter muscle relaxes and stool leaks out. This happens because of the greater volume of stool.
The large intestine may respond by producing more fluid. This results in even more watery stool that cant be contained.
Take Your Supplement After Exercise
People who exercise are probably no stranger to the effects movement can take on their GI tracts. In fact, some 30 to 50 percent of athletes experience intestinal problems related to exercise, according to a May 2014 review in âSports Medicineâ.
“Exercise notoriously gets things going,” Dr. Jouhourian says. She recommends taking a supplement after a workout, and perhaps more importantly, while eating, which can help settle the stomach.
When Should You Use A Stool Softener
Stool softeners are helpful when straining to have a bowel movement could cause harm. This could include certain heart conditions, hemorrhoids, after surgery, or after having a baby. Stool softeners are also sometimes used in preparation the day before surgery.
Relief of temporary constipation can also be a reason to use a stool softener. Constipation includes hard to pass and painful bowel movements.
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Drug Interactions Of Colace Vs Dulcolax
Colace and Dulcolax should be used cautiously in patients on loop diuretics such as furosemide or torsemide. These diuretics are potassium wasting, and that potassium loss combined with the potential electrolyte imbalance that can result from diarrhea when taking Colace or Dulcolax could lead to hypokalemia.
Colace should not be taken with mineral oil because it can increase systemic absorption of mineral oil. Inflammation of the intestine, liver, spleen, and lymph nodes could occur from mineral oil deposits at these sites leading to a foreign body reaction.
Dulcolax is enteric coated and designed to have delayed dissolution. Taking Dulcolax with antacids, H2 blockers, and proton inhibitors may cause the enteric coating to dissolve prematurely leading to stomach irritation or dyspepsia. Dulcolax should be spaced away from the administration of these drugs by at least one hour.
This is not intended to be an all-inclusive list of potential drug interactions. Please consult your pharmacist or healthcare professional for a complete list.
Risks Associated With Laxative Abuse
After taking laxatives for a period of time, the body begins to rely on the help of the laxative in order to move waste through the body. People become both psychologically and physically dependent on laxatives, more quickly than many realize.
Constipation: Laxatives are used to treat constipation, but when abused, laxatives can actually cause constipation to worsen. Laxatives work by artificially stimulating, or irritating, the nerves in the large intestine. This stimulation makes the intestinal muscles contract and move the stool out of the body. But when used for too long or at too high of a quantity, laxatives can damage the nerves.Keeping the colon empty is also risky. When the muscles in the colon are prevented from working as they should, they weaken over time. Together, these side effects interfere with normal bowel movements. The person may become dependent on higher and higher doses of a laxative to move stool out.
Constipation is defined as having fewer than three bowel movements a week, and/or bowel movements with stools that are hard, dry, and small. People who have abused laxatives can go weeks without a bowel movement. Constipation can be extremely uncomfortable. Symptoms include bloating, abdominal pain and overall discomfort.
Electrolyte abnormalities: Electrolytes such as sodium, potassium, and chloride are lost at abnormally high rates in diarrhea. This can lead to weakness, irregular heartbeats and sudden death.
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The Side Effects Of Laxatives
Like most medicines, laxatives can cause side effects. They’re usually mild and should pass once you stop taking the laxative.
The side effects you may get will depend on the type of laxative you’re taking, but common side effects of most laxatives include:
- tummy cramps
- feeling sick
- dehydration, which can make you feel lightheaded, have headaches and have pee that’s a darker colour than normal
Ask a GP for advice if you get any particularly troublesome or persistent side effects while taking laxatives.
Using laxatives too often or for too long can also cause diarrhoea, the bowel becoming blocked by large, dry poo , and unbalanced salts and minerals in your body.
Potential Side Effects Of Taking Stool Softeners
When considering temporary hemorrhoid treatment options and lifestyle changes to help battle hemorrhoid flare-ups, stool softeners are almost always recommended. Because hemorrhoids often develop as a result of constipation and overstraining during bowel movements, taking stool softeners is an efficient short-term option for easing stool passage.
However, every drug has its side effects. While stool softeners are generally well-tolerated by hemorrhoid patients, there are a few potential side effects that can cause discomfort. Stomach Cramps
Because the ingredients in stool softeners aim to soften your stool for easier bowel movements, theres a chance that youll experience stomach/intestinal cramps. Your digestive tract, which was previously constipated, is now suddenly being affected by changing stool habits. Make sure to drink plenty of water while taking stool softeners to help prevent cramping. Diarrhea
If you exceed the recommended dosage for your stool softener, your stool may become overly runny and loose, potentially leading to over-passage of stool. If diarrhea does occur, drink plenty of fluids to avoid dehydration Nausea & Vomiting
Whenever your digestive tract is affected, theres always the risk of nausea and vomiting. If vomiting occurs, stop taking the stool softener immediately, as severe vomiting can lead to dehydration and more extreme digestive issues. Allergic Reaction
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How Do Laxatives Work
There are several different kinds of laxatives. Each one works a different way. These are the most common types.
These laxatives add soluble fiber to the stool. This causes the stool to absorb more water. It creates larger, softer stools. The larger stools help trigger the bowel to contract. This moves the stools out. Bulk-forming laxatives generally are the safest type of laxative.
Examples of bulk-forming laxatives include:
To reduce your risk of side effects, you should start slowly. Make sure to drink plenty of fluids while taking bulk-forming laxatives. Gradually increase how much you use until you get the results you want.
These coat the surface of the stools to make them slippery. Doing this helps the stools move out of the body more easily. Glycerin suppositories lubricate the inside of the anus . This makes it easier to pass hard stools out of the body.
These help mix fluid into stools to soften them. This makes stools easier to pass out of the body. An example of a stool softener is docusate .
These cause the intestine to hold more fluid. This softens stools and helps the bowel move them out. Examples include polyethylene glycol and magnesium hydroxide solution .
Which Laxatives Work Fastest
Stool softeners may be best when a person does not need immediate relief but is looking to regulate their bowel movements within the next few days.
The type of laxative a doctor recommends may also change based on how quickly a person needs relief. Individual result times may vary, but in general, the following applies:
- Quick relief: Saline laxatives tend to work very fast.
- Medium relief: Stimulant laxatives are fast-acting, but they still take some time to work.
- Slow relief: Other laxatives, including bulk-forming fibers, stool softeners, and guanylate cyclase-C agonist laxatives, take longer to work.
The authors of a 2015 study looking at constipation in older adults observe the following:
- Osmotic laxatives, including magnesium citrate and magnesium hydroxide, may produce a bowel movement in 30 minutes to 6 hours. Others may not take effect for 2448 hours.
- Stimulant laxatives, such as Dulcolax and Senna, may take 612 hours.
- Stool softeners, such as Docusate, may take 2448 hours.
- Fiber-based laxatives, including Fibercon and Metamucil, can take 1272 hours.
often recommend that people struggling with constipation make lifestyle changes to help ease their symptoms. Many people can find relief from constipation by drinking plenty of water and getting regular exercise.
A person can increase their daily fiber intake by including more fruits and vegetables in their diet. Fiber-rich foods that can help with constipation include:
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Stool Softeners Vs Laxatives
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Constipation can be extremely uncomfortable, and it can affect anyone due to many different causes. There are also many types of over-the-counter laxatives, so choosing the right one may seem a little tricky. How does each type work? How is each used? Whats the difference between a stool softener and a laxative? Let us help you sort some of this out.
Stool Softener Or Another Laxative
Stool softeners are intended for short-term use. They can treat occasional constipation, but other laxatives may be better suited for the task, as they typically work faster.
For instance, if you have not had a bowel movement for several days and are cramping, the following laxatives may be used instead:
- Stimulant laxatives like Ex-Lax and Ducalax, increase intestinal contractions but may increase intestinal cramping.
- Hyperosmotic laxatives like Miralax, increase water in the intestines so stools can exit more rapidly.
- Saline laxatives like Phillips’ Milk of Magnesia use sodium to draw water into the intestines to help stools get through more easily.
Healthcare providers rarely recommend saline laxatives because there are safer and more effective alternatives. If you have heart disease or kidney disease, you should talk with your healthcare provider before taking Milk of Magnesia.
Bulk-forming laxatives like psyllium found in Metamucil and methylcellulose found in Citrucel may be the gentlest and safest options for longer-term treatment of chronic constipation.
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What Are Some Side Effects That I Need To Call My Doctor About Right Away
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash hives itching red, swollen, blistered, or peeling skin with or without fever wheezing tightness in the chest or throat trouble breathing, swallowing, or talking unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat.
What Are The Different Types Of Stool Softeners
You can take stool softeners orally or rectally. Stool softener pills come in the form of tablets or capsules. You take them by mouth . You also take syrup or liquid stool softeners orally.
Some stool softeners come in the form of a rectal enema. You inject the medicine directly into your rectum . They look kind of like a stool softener suppository. However, you dont inject a suppository. Rather, they melt or dissolve at body temperature.
In addition to or instead of medication, you may want to try natural stool softeners for mild constipation. Natural stool softeners include lifestyle changes to help you ease your symptoms. Lifestyle changes may include:
- Taking a probiotic.
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Common Signs And Symptoms
Constipation can generally be diagnosed when people experience two or more of the following signs, related to at least 25% of their bowel movements:
- hard or lumpy stools
- a sense of incomplete evacuation
- the need for manual maneuvers
- fewer than 3 bowel movements per week
People often want to know what is considered normal or ideal, when it comes to bowel movements. Although its probably ideal to have a bowel movement every day, its generally considered acceptable to have them every 2-3 days, provided they arent hard, painful, or difficult to pass.
The handy Bristol Stool Scale can be used to describe the consistency of a bowel movement, with Type 4 stool often being considered the ideal .
Constipation is pretty common in the general population and becomes even more so as people get older. Experts estimate that over 65% of people over age 65 experience constipation, with straining being an especially common symptom.
Questions To Ask Your Doctor
- What kind of laxative is best for me?
- Am I taking any other medicines that will interact with a laxative?
- Do I need a prescription laxative, or can I buy one over the counter?
- How long should I take a laxative?
- Can I use a bulk-forming laxative every day?
- Are there any tests you recommend before I begin taking laxatives?
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Causes Of Fecal Impaction
Laxatives are medicines that can help you have a bowel movement when you’re constipated.
Some types of laxatives are safe to use long-term. Others can cause dependence. This means that long-term use of certain laxatives may lead to your body being unable to have a bowel movement without them.
Laxatives that are usually safe for long-term use include:
Stimulant laxatives and stool softeners aren’t usually recommended for long-term use. Stimulant laxatives increase the movements of the muscles in the intestine. Stool softeners cause more water to be drawn into the intestine.
When these kinds of laxatives are stopped, the constipation may return or to get worse. Eventually, this could lead to fecal impaction.
Fecal impaction is a significant problem for older adults. This is especially true for those in care facilities.
Some pain medications such as opioids can contribute to constipation. This is because they slow down the action of the bowel. People who are bedridden or otherwise unable to move around may also develop constipation and/or fecal impaction.
What Are Some Other Side Effects Of Stool Softener/laxative
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
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Don’t Bomb The Bowel With Laxatives
If constipation becomes chronic, don’t keep playing laxative roulette. See your doctor for an exam.
Occasional irregularity is a fact of life, but you can minimize it with some basic steps. You should be sure you are eating a fiber-rich diet, drinking adequate fluids, and staying physically active. But when you do have constipation, start with the gentlest and safest option, like a bulk-forming laxative. If laxatives don’t work, ask for help. You should see your doctor and discuss it if you are constantly needing to take laxatives.
Constipationdefining Normal Is Not So Easy
When it comes to treating patients with constipation , Dr. Deutsch first asks a lot of questions.
I tell people that their normal may not be my normal or the next persons normal. We are all very different when it comes to bowel habits, she says. I need to know what the stool looks like, from the color to the length, and how long it takes you to go. If someone is only going once or twice a week and the stools are looking like little rabbit pellets, I need to tease that out.
To help explain, Dr. Deutsch often shows patients a bell-shaped curve from a study published in Gastroenterology. On the national average, people poop anywhere from three times a week to three times a day, she says. That is a huge range. I stress that if you dont feel good, we need to make you feel good. If you are worried that you are sitting on the toilet for an hour and passing small, hard pellets, we should see if you are getting enough fiber or physical movement every day. Or maybe we need an over-the-counter or even prescription-strength laxative.
Dr. Deutsch also doesnt shy away from sharing her own experiences. It can be TMI, but I let people know that we all deal with these problems once in a while, she says. If I dont go to the gym and I dont eat any fruits and vegetables for a week, my poop looks like something my cat would produce.
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