By Stacey Snyder
Beth Israel Deaconess Medical Center Staff
Constipation is an uncomfortable thing to talk about (never mind experience). But following some simple guidelines and treatment recommendations can make constipation much easier to stomach.
Symptoms of constipation include: infrequent bowel movements, abdominal pain, fecal straining, bloating, nausea, sluggishness, painful bowel movements, and difficult bowel movements.
Dr. Kenneth R. Falchuk, Co-Director of the Inflammatory Bowel Disease Center at Beth Israel Deaconess Medical Center and Associate Clinical Professor of Medicine at Harvard Medical School, suggests making an appointment with a physician if symptoms include weight loss, bleeding, abdominal pain or recent onset of constipation, as these symptoms may indicate a more serious medical disorder.
As Dr. Falchuk explains, constipation can be experienced as a symptom of other conditions such as: irritable bowel syndrome, tumors that can obstruct the lumen of the colon, metabolic or endocrine disorders such as hypothyroidism or diabetes, and also with the use of medications that decrease bowel motility such as pain killers, antidepressants, and even drugs that treat hypertension.
However, frequently constipation is caused by lifestyle choices. Many individuals do not have enough fiber in their diet, do not consume enough liquid and do not exercise regularly; all factors that can contribute to chronic constipation.
Tier 1: Dr. Falchuk notes that simple changes, such as adding fiber into one's diet, consuming different types of grains, monitoring and increasing daily fluid intake, and making exercise part of your daily routine can alleviate constipation fairly quickly. If these changes are not effective, adding a fiber supplement such as Metamucil, Citrucel or Benefiber will stimulate the bowels and ease constipation.
Tier 2: Stool softeners and fiber powders such as Miralax are effective choices for moderate to severe constipation that is not relived using tier one therapies.
However, laxatives such as Exlax and home remedies including mineral oil are not recommended for constipation relief. Individuals can become dependent on these products and may damage their digestive system with prolonged use.
Tier 3: A medication fairly recently put on the market, Amtiza (lubiprostone), delivers more fluid into the inside of the intestine, stimulating bowel activity and relieving constipation. Another treatment, Chronulac Syrup (lactulose), is also often prescribed but it can cause excessive diarrhea and eliminate essential minerals from the body in some patients.
As Dr. Falchuk cautions, "any medication for constipation only available via prescription should be used after other standard forms of treatment fail."
Why some treatments are better than others
In recent years, several medications commonly used to alleviate constipation have been pulled from the market due to side effects leading to kidney damage, electrolyte disturbances and cardiovascular complications.
There are currently new medications being investigated for their effectiveness in alleviating constipation, but any medication, both over the counter and prescribed, should be taken with caution and discussed with a physician to ensure safety and effectiveness.
Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted March 2009