Thursday, 20 June 2013

Over-the-counter laxatives for constipation

Laxatives can help relieve and prevent constipation. But not all laxatives are safe for long-term use. Overuse of certain laxatives can lead to dependency and decreased bowel function.

If you've ever experienced the discomfort of constipation, perhaps while traveling or after a change in your diet you may have considered over-the-counter laxatives. Over-the-counter laxatives come in many different forms viz liquids, tablets, wafers, gums, or powders that you dissolve in water. You take rectal laxatives in the form of suppositories or enemas.

How often you have a bowel movement varies, but a "normal" frequency ranges from as many as three bowel movements a day to about three a week. Your body ordinarily needs no help to have bowel movements. But a poor diet, physical inactivity, pregnancy, illness or some medications can disrupt normal bowel function and cause constipation.

Before trying laxatives

Before turning to laxatives for relief, try these lifestyle changes to help manage occasional irregularity:

Eat fiber-rich foods, such as wheat bran, fresh fruits and vegetables, and oats.
Drink plenty of fluids daily.
Exercise regularly.
Lifestyle and dietary improvements relieve constipation for many people, but if problems continue despite these changes, your next choice may be a mild laxative.

How laxatives relieve constipation

Laxatives work in different ways, and the effectiveness of each laxative type varies from person to person. In general, bulk-forming laxatives, which are also referred to as fiber supplements, are the gentlest on your body and safe to use long term. Metamucil and Citrucel fall into this category. Stimulant laxatives, such as Ex-Lax and Senokot, are the harshest and shouldn't be used long term.

Following are some examples of common types of laxatives. Other types also exist. Even though many laxatives are available over-the-counter, it's best to talk to your doctor about laxative use and which kind may be best for you.

Type of laxative, How they work & their Side effects

Oral osmotics (Phillips' Milk of Magnesia, Miralax): Draw water into colon from surrounding body tissues to allow easier passage of stool.

Side Effect: Bloating, cramping, diarrhea, nausea, gas, increased thirst

Oral bulk formers (Benefiber, Citrucel, Fiber Choice, Metamucil): Absorb water to form soft, bulky stool, prompting normal contraction of intestinal muscles.

Side Effect: Bloating, gas, cramping, choking or increased constipation if not taken with enough water

Oral stool softeners (Colace, Kaopectate): Add moisture to stool to allow strain-free bowel movements.

Side Effect: Throat irritation, cramping

Oral stimulants (Ex-lax, Senokot): Trigger rhythmic contractions of intestinal muscles to eliminate stool.

Side Effect: Belching, cramping, diarrhea, nausea, urine discoloration

Rectal stimulants (Bisacodyl, Pedia-Lax, Dulcolax): Trigger rhythmic contractions of intestinal muscles to eliminate stool.

Side effect: Rectal irritation, stomach discomfort, cramping

Oral laxatives may interfere with your body's absorption of some medications and food nutrients. Rectal laxatives do not have this effect. Also, some oral and rectal laxatives can lead to an electrolyte imbalance, especially after prolonged use. Electrolytes, which include calcium, chloride, potassium, magnesium and sodium, regulate muscle contraction, heart rhythm, nerve function, fluid balance and other body functions. An electrolyte imbalance can cause abnormal heart rhythms, weakness, confusion and seizures.

Combination laxatives: Check labels carefully

Some products combine different types of laxatives, such as a stimulant and a stool softener. Combination products may not be any more effective than are single-ingredient products. But they may be more likely to cause side effects because of their multiple ingredients. Read labels carefully to see how many types of laxatives a product contains.

Risks of laxative use

Interaction with medications
Your medical history and other medications you're taking may limit your laxative options. Laxatives can interact with blood thinners such as warfarin (Coumadin), antibiotics such as tetracycline, and certain heart and bone medications. Before using any laxative, read the label carefully. If you're not sure whether a particular laxative is right for you, ask your pharmacist or doctor. Don't exceed recommended dosages unless your doctor tells you otherwise.

Complicating conditions 

Just because laxatives are available without a prescription doesn't mean that they're without risk. Laxative use can be dangerous if constipation is caused by a serious condition, such as appendicitis or a bowel obstruction. If you frequently use certain laxatives over a period of weeks or months, they can decrease your colon's natural ability to contract and actually worsen constipation.

Precautions for pregnant women and children 

Don't give children under age 6 laxatives without a doctor's recommendation. If you're pregnant, get your doctor's advice before using laxatives. Bulk-forming laxatives and stool softeners are generally safe to use during pregnancy, but stronger laxatives can harm you or your baby. The stimulant laxative castor oil, for example, can cause uterine contractions. If you've recently given birth, consult your doctor before using laxatives. Although they're usually safe to use during breast-feeding, some ingredients may pass into breast milk and cause diarrhea in nursing infants.

Don't be lax about laxatives

Call your doctor immediately if you have bloody stools, severe cramps, pain, weakness, dizziness, unusual tiredness or rectal bleeding. You should also see a doctor if you have unexplained changes in bowel patterns or habits or if constipation lasts longer than seven days despite laxative use. If you're dependent on laxatives to have a bowel movement, ask your doctor for suggestions on how to gradually withdraw from them and restore your colon's natural ability to contract.

10 Tips To Relieve Constipation

Drink Plenty of Fluids

Drinking extra fluids may not relieve your constipation, but it can make stools softer and easier to pass. Getting enough fluids can also help prevent dehydration, which can cause constipation. Carry a water bottle with you and keep it filled. If you can’t get clean tap water, drink plenty of bottled spring water, fruit juice, or other non-caffeinated drinks.

Limit Low-Fiber Foods

Many of the foods you might love on vacation -- like snack foods and dessert -- can actually make constipation worse. Common culprits include cheese, sweets, meats, pizza, processed foods, chips, and ice cream. If constipation becomes a problem, limit these foods to occasional treats.

Don't Forget Fiber

Trading in your whole grain cereal for chocolate croissants while on vacation? Then make sure to get fiber somewhere else in your diet. Not eating enough fiber is a common cause of constipation, whether you’re on vacation or not. Try eating 2 1/2 cups of vegetables and 2 cups of fruit every day. Beans and whole grain breads also help add bulk.

Limit Caffeine and Alcohol

Drinking a margarita by the poolside may sound heavenly, but it could add to your constipation problems. Alcohol and caffeine can cause dehydration. If you’re prone to constipation while traveling, try to limit alcohol and drinks with caffeine. Or, drink plenty of water when you enjoy these beverages to make sure you stay hydrated.

Stay Active

Traveling often means sitting -- in a car, train, boat, or plane. Unfortunately, when you stop moving, so may your bowels. If you’re sitting for long periods of time, take frequent breaks to move around. And once you reach your destination, schedule physical activities -- like long walks or bike rides -- to get your body moving.

Don't Ignore Your Body

There are many reasons why you might ignore the urge to have a bowel movement while on vacation. You might feel uncomfortable using a public restroom or be too busy sightseeing to find a place to go. But ignoring the urge can sometimes lead to constipation. Instead of putting it off, use the restroom when you feel the need to.

Plan for Bathroom Breaks

If you usually use the restroom at a certain time of day, try to plan for this during your vacation. Give yourself time to relax. You may find reading a magazine or newspaper helps. If you don’t have a bowel movement in 10 minutes, try again later when you have the urge.

Prepare for Travel

If you often have constipation when you travel, prepare ahead of time. One way is to start taking a stool softener or a bulk-forming laxative a few days to a week before you leave. Then continue taking it while you’re on vacation. This will help soften your stool and make it easier to pass.

Use Laxatives Wisely

If diet and exercise don't help, you may want to try a laxative. Using laxatives too often can make your body dependent on them. So you should only use them for a short time. Many types of laxatives are available over the counter. In some cases, you may need a prescription laxative. Ask your doctor what's best for you.

When to Get Help

In some cases, constipation can cause hemorrhoids or tears in the skin around the anus. This can lead to bleeding from the rectum or blood in your stool. In more severe cases, constipation can lead to impaction, where stool becomes stuck in the rectum. If you have blood in your stool, or if your constipation is so severe that you cannot pass any stool, call your doctor.