Monday, November 5, 2007

Treatment of Constipation


People who tend to ignore their body signals over time have lost the ability to recognize when it's time to move their bowels. This is common in constipation. In this situation, it may help to go to the bathroom at the same time every day when a bowel movement is most likely to occur, usually about thirty minutes after breakfast or after a cup of caffeinated coffee (caffeine is a stimulant of the gastrointestinal tract). Remember, however, that caffeine is a Flag Food for heartburn - again what helps an gastrointestinal problem may exacerbate another. Nicotine, while a recognized stimulant of the intestines, is not recommended as a treatment for constipation.

When you attempt to "retrain" your bowel, remember to take your time. Your mother may have told you to "do your business" quickly and get off the toilet, possibly to avoid hemorrhoids but probably because most of us grew up in a house with one bathroom. Today, even small houses usually have at least two bathrooms, so take your time. If breakfast time finds you at work, any large meal will do for bowel retraining. When food enters your stomach, it encourages the colon to contract. This impulse is transmitted by nerves that innervate the colon; certain hormones may also be involved. Some people, especially those with inflammatory bowel disease, have an exaggerated gastrocolic reflex - soon after they eat, they have to run to the bathroom. In bowel retraining for constipation, the gastrocolic reflex works in your favor in moving your bowels.

Drugs may also be used to treat constipation. Scores of laxatives on the market can provide a quick fix to relieve constipation. They fall into several different categories according to their mechanism of action. Bulk laxatives add volume and fluid to the stool. Metamucil, Efferyllium and Perdiem are psyllium seed laxatives that add non-irritating bulk and promote normal elimination. FiberCon, which has a similar bulking action, contains the fiber calcium polycarbophil. You may notice an increase in wind (flatulence) and stomach bloating when you are taking fiber supplements. This is normal and tends to settle down after a few months after the gut becomes used to the increase in fiber. Stool softeners are not laxatives but contain surface-active ingredients that keep soft for easy, natural passage. Magnesium salts like Milk of Magnesia work by increasing the fluid of the gastrointestinal tract. Dolculax is a stimulant laxative that acts directly on the colon to make it contract. Miralax is a prescription drug that works very well for some constipated individuals. Zelnorm can be used to treat garden variety constipation not related to irritable bowel disease. Lactulose is another prescription drug to treat constipation.

In general, it is always best to try the gentlest agents first. Over time, harsh laxatives can damage the bowel and ultimately make you dependent on laxatives to move your bowel. For most people, it is recommended to start with a bulk laxative or stool softener and, if necessary, adding Milk of Magnesia. Only in very difficult cases would a stimulant laxative or prescription drug be the treatment of choice for constipation.

Michael Russell

Your Independent guide to Constipation


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