What Types Of Laxatives Treat Constipation
Lubricant laxatives contain mineral oil as either the plain oil or an emulsion of the oil. The oil stays within the intestine, coats the particles of stool, and presumably prevents the removal of water from the material. This retention of water results in the softer stool. Mineral oil generally is used only for short-term treatment since its long-term use has several potential disadvantages. The oil can absorb fat-soluble vitamins from the intestine and, if used for prolonged periods, may lead 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 mechanism is not strong or is impaired by strokes, small amounts of the swallowed oil may enter the lungs and cause a type of pneumonia called lipidpneumonia. Mineral oil also may decrease the absorption of some drugs such as warfarin and oral contraceptives, thereby decreasing their effectiveness. Despite these potential disadvantages, mineral oil can be effective when short-term treatment is necessary.
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 can be reduced by reducing the dose of
When To See A Doctor About Constipation
If increasing fiber intake, exercise and hydration don’t solve the problem, your constipation may be characterized as chronic. Depending on the cause of chronic constipation, you may need physical therapy or even low-dose laxatives to treat the problem.
For chronic constipation, it’s important to meet with a professional who can help guide you to the right kind of therapy. This is especially important if you have any warning signs of disease, such as weight loss, bleeding or pain, or stools that become pencil-thin and stay that way.
All things considered, you should see a doctor if constipation or any other physical discomfort is interfering with your daily life.
This Factsheet Is About Constipation
Constipation is a symptom that can mean different things to different people, but the usual meaning is that a person has difficulty or infrequency with opening their bowels. Constipation affects around 1 in 7 otherwise healthy people. The two groups of people most likely to be trouble by constipation are young women and the elderly especially those who need to take regular medicines.
There is a common belief that people need to open their bowels every day, but this is not the case. Opening the bowels can vary between three times a day to three times a week in healthy individuals. Symptoms can constantly fluctuate and 3 people in every 100 adults have persistent constipation over 20 years. It is a common problem and does not usually mean that anything is seriously wrong. Most cases are temporary and will clear up with simple lifestyle measures.
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It Has Prebiotic Effects
Prebiotics are nondigestible compounds that nourish intestinal bacteria and help them grow. Researchers believe that psyllium has prebiotic effects .
Although psyllium is somewhat resistant to fermentation, intestinal bacteria can ferment a small portion of psyllium fibers. This fermentation can produce short-chain fatty acids , including butyrate. Research has linked SCFAs with health benefits (
Pelvic Muscle Training And Surgery
If you have issues with your pelvic muscles, biofeedback therapists can help you learn how to relax or tighten them. They use special devices such as tubes that measure muscle tension in your rectum. In the case of blockage, rectocele, anal fissures, hemorrhoids, or stricture, surgery might be the only treatment option. Rarely, parts of the rectum or colon need to be removed if cancerous tumors were identified as the causes of constipation.
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Defecography And Magnetic Resonance Defecography
Defecography is established as a type of radiological imaging that visualizes the anorectum and pelvic floor. For this test, barium is placed inside rectum and images can be taken as the barium leaves patient body for anorectal region function.
In addition, defecography has shown abnormalities in 77% of cases. Hence, there has been no strong evidence of correlation between abnormalities and symptoms, while limitation with these tests is desirable. Furthermore, there is not enough information regarding its values in healthy individuals. Therefore, defecography can be used as an additional tool for clinical and manometric assessment.
Furthermore, MRD is a noninvasive medical technique to illustrate the physiological processes and body structures for anorectal disorders. MRD has been really useful to define structural abnormalities like obstructed defecation syndrome and may be favorable from surgical procedures such as stapled transanal resection of rectum. It has been characterized by high soft-tissue contrast, good resolution, and lack of radiation exposure. However, its routine use can be limited due to high costs and lack of standardization.
When To Call Your Doctor
Constipation can often be treated at home, but chronic constipation that interferes with quality of life warrants a visit to the doctor.
Unresolved chronic constipation can result in fecal impaction. With impaction, the bowels cannot be evacuated just by the normal muscle contractions that push stool out of the body. Medical intervention is usually needed.
Speak with your doctor if :
- You have a fever, rectal bleeding or recent weight loss.
- Your symptoms interfere with sleep.
- You are frequently constipated and have a family history of bowel disease.
- You can feel a lump or mass in your abdomen or rectum.
- You are over 50 years old and chronic constipation is a new problem for you.
- You have severe abdominal pain and vomiting.
- You are not passing gas.
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How Does Constipation Happen
Constipation happens because your colon absorbs too much water from waste , which dries out the stool making it hard in consistency and difficult to push out of the body.
To back up a bit, as food normally moves through the digestive tract, nutrients are absorbed. The partially digested food that remains moves from the small intestine to the large intestine, also called the colon. The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. This gives the colon more time too much time to absorb water from the waste. The stool becomes dry, hard, and difficult to push out.
Pathway of food waste through colon, rectum and anus.
Complications Of Chronic Constipation In The Elderly
If left untreated for a long time, constipation can lead to several complications, including:
- Fecal impaction : The longer it stays in the colon, the drier and harder the stool gets. Eventually, it gets stuck and becomes impossible to evacuate without treatment.
- Hemorrhoids : Long-term straining during defecation can lead to hemorrhoids, which can also further become complicated by bleeding.
- Anal fissures : Large and hard stools can even lead to tears in the anus.
- Rectal prolapse : One of the most severe complications can occur when the rectum protrudes outside due to straining.
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What Exams Procedures And Tests Help Diagnose The Cause Of Severe Constipation
Many tests can diagnose severe constipation, and most people only need a few basic tests. First the doctor or health care professional will take a medical history and physical examination to allow the doctor to define the type of constipation that’s present uncover any supplements or prescription products you are taking or diseases or other health problems you have. This, in turn, directs the diagnosis and therapy. For example, if defecation is painful, the doctor knows to look for anal problems such as a narrowed anal sphincter or an anal fissure. If small stools are the problem, eating foods low in fiber may be the cause. If the patient is experiencing significant straining, then pelvic floor dysfunction is likely.
A careful dietary history-which may require keeping a food diary for a week or two-can 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.
Blood tests may be appropriate in evaluating your condition. More specifically, blood tests for thyroid hormone and for calcium may be helpful.
Colonic transit studies
Anorectal motility studies
Magnetic resonance imaging defecography
Colonic motility studies
Lower Stress With Mindfulness Meditation
The brain and the digestive tract are so closely linked that researchers have coined the term gut-brain axis.
Digestive symptoms like constipation can lead to anxiety and psychological stress. In turn, stress strongly affects the gut.
Chronic stress is known to modify the gut microbiota and to alter nerve action in the intestines .
Psychological stress influences the gut both directly and indirectly. Availability of coping mechanisms and social support helps determine severity of symptoms and impact on quality of life. Click to enlarge. Image source.
Its important to manage stress, both for overall health and to ease digestive symptoms.
Mindfulness meditation has shown particular promise in reducing IBS symptoms .
In one high-quality study, IBS patients who received online mindfulness training reported a 42% reduction in symptoms at 3 months. By contrast, IBS patients who had access to an online discussion forum reported a 12% increase in symptoms .
The study also showed that the benefits of mindfulness training appear to be long-lasting. Participants who completed all mindfulness training sessions reported sustained benefits 1518 months after the study ended, even without seeking additional treatment .
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Treatment For Constipation In Elderly People
Managing constipation in the elderly is crucial. To begin treating chronic constipation, your doctor should first diagnose all underlying conditions that cause it and treat them properly. They should also revise all medications to identify and find substitutes for those causing constipation, if possible. Then, you can implement other lifestyle changes, drugs, procedures, and home remedies for constipation in elderly people.
Physical Or Functional Causes:
Physical or functional issues may cause constipation. This includes slow-transit time constipation related to issues with the nervous system of the gastrointestinal system . Another example is ano-rectal dysfunction which is when the muscles of the pelvic floor are not functioning optimally, impairing complete evacuation. Adhesions , strictures , and fissures are other examples of physical disrupters of healthy bowel movements.
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When Chronic Constipation Is A Warning Sign
Changes in your bowel habits may be a warning sign of a viral or bacterial infection, obstruction, inflammatory bowel disease , or colon cancer. If you have one or more of the following symptoms, call your health care provider:
- Constipation that lasts for more than two weeks
- Severe diarrhea lasting more than two days
- Mild diarrhea lasting a week
- Unexplained urges to have a bowel movement
- Bloody diarrhea
- Black or tarry-colored stools
SOURCES: Mayo Clinic: “10 Symptoms Not to Ignore.” Mayo Clinic: “Dehydration.” McIlwain H. A Diet for a Pain-Free Life, Marlowe, 2007. Harris McIlwain, MD, Tampa Medical Group, PA. Satish SC Rao, MD, PhD, FRCP, professor of medicine and director, neurogastroenterology & GI motility, University of Iowa. Medicinenet.com: “Constipation.” Harvard School of Public Health: “Fiber: Start Roughing It!”
Go When You Have To And Prop Up Your Feet
Certain practices before and during bowel movements can help reduce chronic constipation symptoms.
Bowel withholding is one common habit that may increase risk.
Occasionally resisting the urge to move the bowels is probably not harmful. Frequent withholding of stool, on the other hand, may cause the stool to dry out and become more difficult to pass.
Chronic stool withholding may lead to nerve damage and cause the bowel wall to become stretched. These issues could, in turn, worsen constipation .
Its best to move the bowels when you have the urge.
Certain body positions may make it easier to fully evacuate stool. Studies have shown that a semi-squatting position, with the feet slightly elevated , results in significantly less retained stool in the colon .
Squatting is believed to help by widening the anorectal angle and lengthening the pelvic floor muscles, which allows for easier passage of stool .
Summary: Moving the bowels when the urge first strikes and slightly elevating the feet when defecating may reduce risk of constipation and minimize straining during bowel movements.
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Treating And Preventing Constipation
There are several things you can do at home to prevent constipation and treat it if it does occur. These include:
- eating more high fibre foods
- drinking plenty of water and other fluids
- exercising regularly
- going to the toilet when you need to, without delaying
If these measures dont work, ask your doctor for advice. They might need to check any medications you take, or prescribe a laxative to get your bowel moving.
Chronic Constipation: Why Are Baby Boomers At Risk
If you’re a baby boomer born between 1946 and 1964, you may wonder if chronic constipation tends to increase with age. McIlwain tells WebMD that there are several different causes that trigger constipation in aging adults.
“As adults age, we tend to become more sedentary, eat and drink less, and take in much less fiber in our daily diet,” says McIlwain, “all of which are habits that aggravate chronic constipation.”
Then, according to McIlwain, more problems occur when you are constipated and start depending on laxatives. “Within days, this laxative habit can aggravate the cycle of chronic constipation and the need to take another laxative and then another.”
Not only do lifestyle habits put boomers at risk for chronic constipation, but McIlwain says that many over-the-counter and prescription medications commonly taken to treat arthritis, back pain, hypertension, allergies, and even depression can result in chronic constipation.
For people of all ages, certain medications do result in chronic constipation, including some analgesics for pain, antidepressants, and medications to treat hypertension, among others. Iron supplements that many women of childbearing age take in their daily multivitamin increases the chance of chronic constipation, as can pregnancy.
McIlwain also recommends low-dose magnesium hydroxide to his patients for relieving chronic constipation.
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Does Biofeedback Exercise And Surgery Help Relieve Symptoms Of Constipation
Most of the muscles of the pelvis surrounding the anus and rectum are under some degree of voluntary control. Thus, biofeedback training can teach patients with pelvic floor dysfunction how to make their muscles work more normally and improve their ability to defecate. During anorectal biofeedback training, 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 by the catheter and recorded on a screen. By watching the pressures on the screen and attempting to modify them, patients learn how to relax and contract the muscles more normally.
People who lead sedentary lives are more frequently constipated than people who are active. Nevertheless, limited studies of exercise on bowel habits have shown that exercise has minimal or no effect on the frequency of how often you go to the bathroom. Thus, exercise can be recommended mostly for its many other health benefits, but not for its effect on constipation.
Does Not Having Regular Bowel Movements Cause Toxins To Build Up In My Body And Make Me Sick
Dont worry, this usually isnt the case. Although your colon holds on to stool longer when you are constipated and you may feel uncomfortable, the colon is an expandable container for your waste. There is possibly a slight risk of a bacterial infection if waste gets into an existing wound in the colon or rectum.
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Treatment Of Chronic Constipation
Constipation in children can be treated in many different ways. In the end, most treatments revolve around three basic principals:
Early on, constipation can often be treated by changing a childs diet. But once the constipation becomes chronic, laxatives are usually needed to re-establish regular bowel movements and eliminate the pain associated with passing bowel movements.
Treat Ibs Or Fodmap Sensitivities
Irritable bowel syndrome affects an estimated 11% of the worlds population .
It causes chronic constipation , chronic diarrhea or alternating symptoms .
Theres no known cure for IBS, but certain diets including a low-FODMAP diet can help prevent constipation.
FODMAPs are short-chain carbohydrates that are found in many fruits, vegetables, grains, legumes and sweeteners. Theyre not digested well in the small intestine and ferment when they reach the bowel, causing constipation and other digestive problems.
Removing high-FODMAP foods from the diet for several weeks and then systematically reintroducing them helps to identify food intolerances. This method has been shown to relieve IBS-C symptoms for those with food sensitivities .
More information about a low-FODMAP diet for IBS can be found here.
Summary: Low-FODMAP diets have been shown to help with constipation and other digestive issues. These diets are temporary and are meant to identify food sensitivities.
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Stop Taking Certain Medicines Or Dietary Supplements
If you think certain medicines or dietary supplements are causing your constipation, talk with your doctor. He or she may change the dose or suggest a different medicine that does not cause constipation. Dont change or stop any medicine or supplement without talking with a health care professional.