Treating Constipation with Laxatives

Before heading to the laxative alley at your local pharmacy to self-treat constipation, it'southward important to exist informed. With the many varieties and types of laxatives and therapies available, choosing the best one for your torso's needs, while avoiding those that are likewise aggressive, requires knowledge and understanding. Also, every bit with all treatments, proper use will aid to avert unwanted side effects.

Normally, if you lot're eating a diet high in insoluble fibre, drinking at least 6-8 cups (250mL or 8oz) of liquids a mean solar day, and exercising daily, this is plenty to maintain a salubrious, constipation-costless digestive organisation. Of form, many of the states sometimes deviate from this and find that constipation is a problem. Some people with conditions such every bit diabetes or Parkinson's illness are more likely to experience constipation. Additionally, some drugs cause constipation, for instance, the codeine contained in many combination-type pain medications (e.g., Tylenol® #1, 2, or iii). Nevertheless, when chronic constipation occurs, it's possible that diet and lifestyle regimes may not be enough to remain symptom free without the assistance of over-the-counter or prescription laxatives.

Whether you need a short-term solution for constipation in an otherwise normal digestive tract, or you need relief on a regular basis, every bit prescribed past a healthcare professional for a specific situation, the following is a list of the different types of laxatives and treatments bachelor. It's best if your determination is guided by your healthcare provider so yous can make an informed choice that is nigh suitable for you.

Majority-Forming

Your body does not digest bulk-forming laxatives; instead, the fibre they incorporate absorbs and retains a large quantity of fluid, thereby forming a soft, bulky stool (formed feces). The bulky size stimulates the intestinal muscles to naturally contract (peristalsis), causing digestive contents to move along, leading to an easier bowel movement. It can take anywhere from about 12 hours to three days for bulk-forming laxatives to show results, depending on private digestive system transit times, so this laxative blazon will not provide firsthand relief of constipation. They are all-time to use for ongoing digestive regularity and are helpful for conditions such equally diverticular disease, irritable bowel syndrome, and hemorrhoids. Although bulk-forming laxatives are safe for long-term use and are unremarkably well tolerated, sometimes these products tin can cause bloating, intestinal gas, cramping, and/or increased constipation, especially if you don't consume plenty water. To help prevent side furnishings, first consuming these products slowly, gradually increasing each dose while making certain to potable enough of extra water. Examples of bulk-forming laxatives are psyllium (Metamucil®), inulin (Metamucil® Simply Clear), wheat dextrin (Benefibre®), methylcellulose (Citrucel®), and polycarbophil (FiberCon®, Prodiem®).

Stool Softeners

Stool softeners enable easier incorporation of water into the stool to continue it soft and easier to pass. Past making the stool softer, it reduces or eliminates the need to strain, so stool softeners may be recommended after childbirth or surgery, or during a tour of hemorrhoids. Some individuals may form a tolerance to softeners and may require college doses over time. Stool softeners do not direct affect the digestive tract muscles and are safe to use in pregnant women and elderly people. Some experts practice not classify stool softeners as laxatives. An instance of a stool softener is docusate sodium (Colace®). Long-term use, if bowel movements remain comfortable, is acceptable.

Lubricants

Lubricant laxatives simply coat the colon and stool in a waterproof film allowing it to remain soft and easier to slip through the intestine while retaining its moisture, unremarkably within six-8 hours. Don't use these products for longer than a week, as some take been shown to cause vitamin deficiencies and they might likewise interact with some medications by affecting how the body absorbs them. Pregnant women and persons who have difficulty swallowing should avert lubricant laxatives. An example of a lubricant laxative is mineral oil.

Stimulants

Stimulants increase muscle contractions of the digestive system (peristalsis) to move contents along, facilitating a shorter colonic transit time. Although individuals often apply this type of laxative as a class of self-treatment, they should be reserved for utilise in extreme weather and only under the recommendation or supervision of a pharmacist or physician. A risky side issue is that they may cause the colon to terminate functioning correctly (cathartic colon), which oftentimes occurs with daily utilize after which the body becomes dependent on the stimulant laxative for normal peristaltic activeness. Stimulants taken orally ofttimes accept 6-10 hours to accept an consequence. For patients who have chronic constipation caused by irritable bowel syndrome, stimulants may be the simply solution but, even so, should only be used for a short term. This form of laxative is not recommended for significant women. Examples of stimulants are bisacodyl (Ex-lax®, Dulcolax®), brush oil, and senna (Senokot®).

Hyperosmotics

Osmotic laxatives encourage bowel movements by drawing water into the bowel from the nearby tissue (abdominal lumen) thereby softening the stool. Some of these laxatives can cause electrolyte imbalances as they draw out nutrients and other contents with the water, which increases thirst and dehydration. There are four primary types of hyperosmotics: saline, lactulose, polymer, and glycerine.

Saline laxatives are essentially salts in liquid; they apace empty all the contents of the bowel and are not intended for long-term utilise or for significant women. These by and large work within 30 minutes to iii hours. Examples of saline laxatives are citrate salts (Royvac®), magnesium preparations (Phillips'® Milk of Magnesia), sulfate salts, and sodium phosphate.

Lactulose laxatives are a sugar-similar agent that work similarly to the saline laxatives just at a much slower charge per unit and are sometimes used to care for chronic constipation. Often they will have an effect in 6 hours, only can take up to 2 days. Lactulose comes in a liquid form taken orally and several manufacturers make information technology.

Polymer laxatives consist of large molecules that cause the stool to concur and retain water. They are commonly not-gritty, tasteless and are well-tolerated for occasional constipation. Results tin can exist expected within 6 hours, but it can have longer depending on the dose. An example of a polymer laxative is polyethylene glycol (Lax-A-Day®, PegaLAX®, RestoraLax®).

Glycerine is available equally a suppository and mainly has a hyperosmotic result but information technology may as well accept a stimulant event from the sodium stearate used in the preparation. Glycerine is available equally a laxative through several manufacturers.

Enema

An enema may exist preferred occasionally to salve astringent constipation or to empty the bowel prior to surgery. This method involves insertion of liquid, usually water or hyperosmolar salt solution, described in a higher place, which acts as a mechanical stimulant and osmotic, into the rectum via the anus. You lot can buy prepared enemas, an enema seedling, or fountain syringe at your local chemist's to use for this sole purpose. Typically, after holding the liquid in place for a few minutes, there is an intense urgency to move the bowels. An enema may crusade uncomfortable bloating and cramping; however, it usually leads to urgent elimination of the contents of the rectum and colon, doing away with constipation.

Colonic Irrigation

Information technology is important to note that although many holistic ad campaigns recommend colonic irrigation to 're-program the bowel's motility and assist in the reduction of constipation', there is no medical evidence that colonic irrigation or colon cleansing is effective in either of those claims, or the myriad of other cure-alls promoted on tardily-night idiot box shows. Physicians and other healthcare providers associated with the GI Society do not recommend the use of colonic irrigation. In fact, these procedures could negatively affect the natural pH balance of the colon, crusade electrolyte imbalances, upset the natural bacterial and yeast milieu necessary for expert digestion, and could fifty-fifty crusade permanent physical damage to the bowel. This approach may worsen existing digestive atmospheric condition.

Pregnancy and Childbirth

A common complication of pregnancy is constipation. If making the appropriate dietary and lifestyle adjustments to reduce constipation for a pregnant or nursing woman exercise not work, then her main physician may recommend either stool softeners or bulk-forming laxatives, depending on the frequency and elapsing of constipation. Information technology is very important that she beverage plenty of h2o while taking a laxative, as some can exist high in common salt and might dehydrate the expectant or nursing mother. Others require sufficient fluid intake to work properly, as with majority-forming laxatives. Always consult a pharmacist or medico before taking medications while pregnant or nursing, as some formulas of over-the-counter or prescription laxatives tin can negatively touch the infant. By preventing straining during a bowel movement, dietary fibre and bulk-forming laxatives tin also help in the prevention of hemorrhoids, a common pregnancy and delivery concern.

Proper Use of Laxatives

It is important for individuals to follow the instructions given by a healthcare provider and those supplied by the product manufacturer when taking an over-the-counter laxative. Unless otherwise directed by a medical professional person, recall that over-the-counter and prescription laxatives are only intended for short-term employ and y'all should not exceed the dosage on the label.

With all types of laxatives, it is of import to eat at least 6-8 cups (250mL or 8oz) of liquids (preferably water) every day plus an additional glass with every laxative dose taken, unless otherwise advised past your healthcare provider. Every bit described in a higher place, laxatives ofttimes draw fluid into the digestive system to soften the stool and/or laissez passer it out with the bowel motility. Ensure plenty of fluid intake to foreclose dehydration.

Laxative abuse can pb to serious dysfunction of bowel motility such as intestinal paralysis, cathartic colon, lazy or laxative gut, irritable bowel syndrome, pancreatitis, and other problems. Using laxatives regularly, except for bulk-forming agents and stool softeners, tin can pb to these problems. Therefore, it is important to apply laxatives in moderation and nether the supervision of a physician or other regulated healthcare provider. If you have chronic constipation, where it is a daily effect or occurs more one time a calendar week, and then seek the care of a medical professional earlier self-treating with over-the-counter laxatives.

Alan Low, BSc. (Pharm.), Pharm. D., RPh, ACPR, FCSHP, CCD
Pharmacist and Clinical Acquaintance Professor,
Faculty of Pharmaceutical Sciences, UBC
Get-go published in the Inside Tract® newsletter issue 174 – 2022
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