How to Cure Constipation the Natural Way -- Without Drugs, Laxatives, or Harsh Stimulants
Although many of these conservative measures have probably previously been recommended to the patient, it is important to reiterate their importance so that the patient can take an active role in improving their bowel health and function. The quality of evidence supporting different treatment modalities in the management of chronic constipation is summarized in Table 3. The choice of osmotic laxatives is largely dependent on patient tolerance, financial situation and drug coverage. Lactulose is reimbursed by all provincial and private drug programs.
Electrolyte-enriched formulas of PEG are covered by some plans. PEG electrolyte free is an over-the-counter medication and is generally not covered.
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PEG tends to cause less abdominal bloating and flatulence. In my practice, I find osmotic laxatives to be more effective if they are initiated after the colon has been cleansed by colonoscopy-type bowel preparations, particularly in patients with significant fecal loading. Glycerine suppositories frequently help to stimulate bowel movement and are considered to be safe for long-term use 6. They can be used every two to three days as necessary. Stimulant laxative and enema are generally recommended for occasional use as rescue therapy 6.
The quality of evidence was assessed according to the Grading of Recommendations, Assessment, Development and Evaluation GRADE system 64 , which defines study quality as high further research is very unlikely to change our confidence in the estimate of effect; moderate further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate ; low further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate ; or very low any estimate of effect is very uncertain.
The dosages of senna and probiotics depends on the preparation. In view of the limitations of existing data and clinical experience in using probiotics in the management of chronic constipation, they cannot be recommended as a standard therapy in the management pyramid Figure 1. However, probiotics appear to improve functional complaints and may be helpful in patients with mild symptoms. Additional studies to evaluate probiotic strains, dosage and the patient population that will ultimately benefit are required to recommend its use. In the cisapride and tegaserod era, clinical experience demonstrated that these prokinetic agents are effective in the management of chronic constipation.
Unfortunately, these agents are no longer available in Canada, although cisapride can be accessed by the limited-assessed program through Heath Canada. Prucalopride is a new, highly selective 5HT 4 agonist and is currently under review by Health Canada. When it is approved, prucalopride will offer an effective and safe option for patients who are not satisfied with the other medical treatments in the management pyramid.
Although surgery is the final treatment option in the management pyramid of chronic constipation Figure 1 , it should be recommended with extreme caution because of the poor long-term functional outcomes. Surgical interventions should only be considered in highly selected, medically refractory patients after a thorough expert assessment. National Center for Biotechnology Information , U. Journal List Can J Gastroenterol v. Can J Gastroenterol. Author information Article notes Copyright and License information Disclaimer.
Telephone , fax , e-mail ac. Received Jun 13; Accepted Jun All rights reserved. This article has been cited by other articles in PMC. Abstract Chronic constipation is a common functional gastrointestinal disorder that affects patients of all ages. Constipation and immobility Studies supporting physical activity in the management of constipation are sparse and inconsistent.
Bulking agents: Fibre supplementation Bulking agents are organic polysaccharides that increase stool weight and improve stool consistency by retaining fluid in the stool. Stimulant laxatives The commonly available stimulant laxatives in Canada are bisacodyl, senna, cascara and sodium picosulfate SPS. Prucalopride The cardiovascular toxicity of cisapride and tegaserod is related to their nonspecific effect on the delay rectifying potassium HERG-K channel that leads to prolong QT interval, precipitating torsade de pointes.
Open in a separate window. Figure 1. Long-term safety and efficacy of chronic use are unclear;. Dose reduction is likely required in patients with severe renal insufficiency or hepatic impairment. PEG Polyethylene glycol. Epidemiology of constipation in North America: A systematic review. Am J Gastroenterol. A multinational survey of prevalence and patterns of laxative use among adults with self-defined constipation. Aliment Pharmacol Ther.
Tack J, Muller-Lissner S. Treatment of chronic constipation: Current pharmacologic approaches and future directions. Clin Gastroenterol Hepatol. Health-related quality of life in functional GI disorders: Focus on constipation and resource utilization.
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Functional bowel disorders. Recommendations on chronic constipation including constipation associated with irritable bowel syndrome treatment. Singh S, Rao SS. Pharmacologic management of chronic constipation. Gastroenterol Clin North Am. Camilleri M, Bharucha AE. Behavioural and new pharmacological treatments for constipation: Getting the balance right.
Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. Functional anorectal disorders. Digital rectal examination is a useful tool for identifying patients with dyssynergia. Pharmacological management of constipation. Neurogastroenterol Motil. Effect of aerobic exercise on mouth-to-cecum transit time. Effect of exercise on intestinal motility and transit in trained athletes. Am J Physiol. Does physical exercise influence bowel transit time in healthy young men? Effects of resistance and functional-skills training on habitual activity and constipation among older adults living in long-term care facilities: A randomized controlled trial.
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Chronic constipation: Current treatment options
Is constipation associated with decreased physical activity in normally active subjects? The effects of conservative treatment for constipation on symptom severity and quality of life in community-dwelling adults. J Wound Ostomy Continence Nurs. The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: A randomised controlled trial. Int J Sports Med. Physical activity improves symptoms in irritable bowel syndrome: A randomized controlled trial. Mechanisms of constipation in older persons and effects of fiber compared with placebo.
J Am Geriatr Soc. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. An open, randomised, parallel group study of lactulose versus ispaghula in the treatment of chronic constipation in adults. Br J Clin Pract.
Dettmar PW, Sykes J. A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation. Curr Med Res Opin. Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep. Bruckert E, Rosenbaum D. Lowering LDL-cholesterol through diet: Potential role in the statin era. Curr Opin Lipidol. Dioctyl sodium sulphosuccinate as a laxative in the elderly. Constipation prevention: Empiric use of stool softeners questioned. Psyllium is superior to docusate sodium for treatment of chronic constipation.
Treatment of chronic constipation with lactulose syrup: Results of a double-blind study. Sanders JF. Lactulose syrup assessed in a double-blind study of elderly constipated patients. J Clin Pharmacol. Small volume isosmotic polyethylene glycol electrolyte balanced solution PMF in treatment of chronic nonorganic constipation. Dig Dis Sci. Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution PMF in the treatment of functional chronic constipation. A randomized, multicenter, placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation.
A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Cost-effectiveness of macrogol compared to lactulose in the treatment of chronic functional constipation in the UK. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: Systematic review and meta-analysis.
Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Myths and misconceptions about chronic constipation. Ault A. Zelnorm pulled off the shelf due to possible cardiovascular risk signal. Family Practice News. Tegaserod and the risk of cardiovascular ischemic events: An observational cohort study. J Cardiovasc Pharmacol Ther.
Chapman H, Pasternack M. Eur J Pharmacol. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med. Clinical trial: The efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation — a week, randomized, double-blind, placebo-controlled study. Prucalopride Resolor in the treatment of severe chronic constipation in patients dissatisfied with laxatives.
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You may wonder whether they are safe or if you can use them on a long-term basis. In order to make an informed decision for yourself, it's important to learn a few facts.
1. Drink more water
A visit to your local drugstore will show you that there are many different brands of stimulant laxatives available. These products come in a variety of forms, including tablets, liquids, and suppositories. The active ingredient in these products differ and here are the more common options:.
They decline to recommend any other types due to lack of sufficient research. The ingredients in stimulant laxatives induce a bowel movement by acting to speed up colonic muscle movement motility. Stimulant laxatives differ in their action from stool softeners , which work by reducing absorption of fluids in the intestines thereby increasing the amount of water in the stool. This results in a softer, easier-to-pass stool. When using stimulant laxatives, make sure to read and follow package directions carefully.
Determine if the product is a pill or liquid that should be taken orally or a suppository that is used rectally. Many of these products recommend that you use them at bedtime. This helps them work with your body's natural biorhythms to produce a bowel movement in the morning. As with all medications, check with your physician prior to use.
Stimulant laxatives are designed to be used on a short-term basis only, meaning no longer than one week. Some people experience abdominal pain and cramps or temporary symptoms of fecal incontinence after using a stimulant laxative. There have been some reports of more serious side effects, including allergic reactions, electrolyte imbalances, and liver damage.
List of Laxatives + Uses, Types & Side Effests - ihosaxupoxyd.tk
Traditionally, there have been some concerns about the safety of stimulant laxatives. There is also a fear that chronic use of stimulant laxatives could increase one's risk for colon cancer. Stimulant laxatives appear to be a safe short-term treatment for constipation. Just be sure to follow dosing instructions carefully. If you are uncomfortable with the idea of using a stimulant laxative due to the safety considerations discussed above, you might want to consider using a stool softener as an alternative.
If your constipation is a chronic problem, it is best that you work with your doctor to develop a long-term management plan.
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