Hospitals Offer Laxatives, Enemas For Constipation Relief

Constipation is a common condition that can usually be treated at home by making changes to diet and lifestyle. However, in some cases, it may require medical attention, especially if it is chronic or accompanied by other symptoms such as abdominal pain, vomiting, or rectal bleeding. Treatment for constipation typically involves increasing fluid and fibre intake, getting regular physical activity, and addressing any underlying conditions or medications that may be causing the issue. In some cases, laxatives or other medications may be recommended by a doctor.

Laxatives

Types of Laxatives

Osmotic Laxatives

Osmotic laxatives, such as Milk of Magnesia and Miralax, increase the water content of the stool, making it softer and easier to pass. These types of laxatives can interfere with the absorption of water from the bowel or swell the stool with fluid. Polyethylene glycol (PEG) is another osmotic laxative that can be used for colonoscopy preparation and is considered safe for long-term use.

Stimulant Laxatives

Stimulant laxatives, like Correctol and Dulcolax, are often combined with stool softeners and are useful for patients with poor colonic motility. However, their long-term use is not recommended as they can cause side effects like cramping and electrolyte wasting. They may also lead to melanosis coli, tolerance, or cathartic colon, and there is limited evidence for their effectiveness.

Stool Softeners

Stool softeners, such as Colace and Docusate, facilitate the interaction between colonic water and stool, making it softer.

Lubricants

Lubricants, such as mineral oil, alter stool composition and make it slippery, aiding in its passage. However, prolonged use of lubricants like paraffin may cause malabsorption of fat-soluble vitamins.

Dosage and Precautions

It is important to follow the recommended dosage for laxatives and not to exceed it. In some cases, the dose of laxatives may need to be adjusted to balance their benefits with any adverse effects. If you have been taking laxatives for an extended period and find yourself dependent on them for bowel movements, consult your doctor about gradually stopping their use.

Additionally, it is worth noting that laxatives are not always the first line of treatment for constipation. Lifestyle changes, such as increasing dietary fibre and fluid intake, as well as regular physical activity, are often recommended first. If these measures do not provide relief, laxatives may be introduced for a short period before considering other medical interventions.

Dietary fibre

To relieve constipation, it is recommended to eat plenty of fresh fruits, vegetables, and legumes such as beans and lentils. The fibre found in these foods stimulates the growth of colonic flora, which increases stool weight and the amount of bacteria in the stool. It is important to note that increasing your fibre intake should be done gradually, as it can cause gastrointestinal symptoms such as gas, cramping, or bloating if done too quickly.

For those dealing with occasional constipation, increasing your fibre intake for a few days can be sufficient to get back to a more normal bowel movement schedule. For chronic constipation, consulting with a dietitian is advised to create a long-term, fibre-rich eating plan. The recommended daily fibre intake for adults is 25-30 grams for women and 30-38 grams for men. However, it is important to note that more than 90% of women and 97% of men do not meet these recommended intakes.

In addition to increasing fibre intake, staying properly hydrated is crucial when addressing constipation. Water helps to plump out the stool and aids in the digestive process. Therefore, increasing water intake is recommended when increasing fibre-rich foods in your diet.

Osmotic laxatives

There are several common osmotic laxatives available over the counter and by prescription. Polyethylene glycol (PEG) is an organic compound derived from petroleum that can be safely ingested to manage constipation. Available over the counter, PEG-containing laxatives include Miralax and GlycoLax. Lactulose is a type of sugar that is not absorbed by the intestine. Instead, the sugar sits and ferments in the intestines, producing fatty acids that draw water into the lumen. Available by prescription, lactulose-containing laxatives include Cephulac, Duphalac, Kristalose, and many others. Sorbitol is another non-absorbable sugar with an action similar to lactulose. Over-the-counter (OTC) and prescription versions are available, including Arlex and GeriCare. Magnesium citrate is magnesium in salt form combined with citric acid. The salts help draw water into the lumen. OTC versions include Citrate of Magnesia, Citroma, and LiquiPrep. Magnesium hydroxide is a milder form of magnesium sold under the brand name Milk of Magnesia. Available over the counter, Milk of Magnesia is also used as an antacid.

The overuse of osmotic laxatives can cause dehydration and the loss of electrolytes like sodium, calcium, and potassium. These are some of the minerals that the body needs to regulate heartbeats, muscle contractions, and other key functions. Common side effects of osmotic laxatives include nausea, bloating, cramping, flatulence, and diarrhea.

Stimulant laxatives

It is important to be aware of the potential side effects of stimulant laxatives, which include abdominal cramps, brownish-red urine, and allergic reactions. They are also not recommended for children under the age of 6 unless instructed by a pediatrician. As with any medication, it is essential to discuss the use of stimulant laxatives with a doctor and follow their recommendations.

Physical activity

Exercising decreases the time it takes for food to move through the large intestine, improving the efficiency of the digestive tract. Even light activity can help get things moving.

Yoga

Many yoga poses increase blood flow to the digestive tract and stimulate intestinal contractions.

• Cat-Cow: Begin on all fours with your knees under your hips and wrists under your shoulders. Inhale and arch your back, then exhale and round your spine towards the ceiling. Continue alternating between these poses for at least 10 rounds.
• Downward Facing Dog: Start on all fours and tuck your toes under, straightening your legs and pushing down through your palms. Keep your feet hips-width apart and your arms a bit wider, and hold this upside-down "V" pose for 10 deep breaths.

There are many other yoga poses that can help relieve constipation, so feel free to explore different options.

Aerobics

Aerobic exercises accelerate your breathing and heart rate, stimulating intestinal muscles to contract and helping move stools out quickly. Any form of cardio is beneficial for relieving constipation, including Zumba, jogging, water aerobics, running, or walking. Aim for 30 minutes of cardio daily, or break it up into mini cardio sessions throughout the day if that's more manageable.

Here's a 30-minute walking exercise to try:

• Warm-up: Walk at a normal pace for 5 minutes.
• Main exercise: Increase your pace to a brisk walk for 25 minutes.
• Cool-down: Slow down your pace and finish with some gentle stretching to relax your muscles.

In addition to these specific exercises, it's important to maintain a consistent exercise routine. Regular physical activity can improve defecation patterns and colonic transit time, which can help prevent constipation.

A study on middle-aged obese women with chronic constipation found that a 12-week program of physical activity and a low-calorie diet improved constipation symptoms and quality of life. The women in the study participated in a walking program on a treadmill, starting with 15 degrees of inclination and increasing to 40-60% of their target heart rate.

Another study found that regular physical activity improved constipation in middle-aged inactive individuals with chronic constipation.

It's worth noting that exercise may be more effective in relieving constipation for older individuals, who tend to be more sedentary. However, this doesn't mean that younger people shouldn't also incorporate physical activity into their constipation relief strategies.

Remember to always consult with your doctor before starting a new exercise regimen, especially if you're experiencing persistent constipation. Combining exercise with a high-fibre diet and adequate fluid intake is a great way to promote digestive health and relieve constipation.

Frequently asked questions