Constipation in Adults

Fortunately, you don't have symptoms that would suggest a blocked pelvic outlet. Your symptoms can probably be safely treated with medicines by mouth. We will review laxatives now, and then we will offer you some additional advice after you complete our final questions.

Oral laxatives

If you still have constipation after increasing your dietary fiber, oral laxatives may be useful. Oral laxatives may be tried in the following order:

1. Bulk laxatives. (These have already been discussed in the soluble fiber section. They are over-the-counter fiber supplements.)

2. Salt-based laxative pills or liquid. The safest laxatives for frequent use function by drawing extra water into stool as it forms, and they are known as "osmotic" laxatives.

Over-the-counter osmotic laxatives include concentrated salt solutions containing magnesium hydroxide or magnesium citrate:

• Milk of Magnesia

• EvacQMag

Several others are available by prescription:

• Lactulose (Chronulac and others)

• Sorbitol

• Polyethylene glycol (Miralax, GoLytely electrolyte solution, and others)

• Lactulose and sorbitol commonly cause gas or bloating side effects but they are safe and effective

3. Stimulant laxatives

Laxatives that make your colon contractions more forceful are known as "stimulant" laxatives. Long term repeated use of oral stimulant laxatives should be avoided, and maximum use should be three times in a week. Stimulant laxatives are a danger because long-term use can be habit-forming, can cause nerve damage in the colon or can interrupt or damage your normal digestion, resulting in protein malnourishment or electrolyte abnormalities.

Stimulant laxatives that are found over-the-counter include:

• Bisacodyl (Correctol, Dulcolax, FeenAMint, BisacEvac, BiscoLax, Carter's Little Pills, Clysodrast, Dacodyl, Deficol)

• Cascara

• Casanthrol (PeriColace)

• Castor oil

• Senna (ExLax, Senokot, Fletcher's Castoria, SennaGen, Senexon, Black Draught)

One over-the-counter laxative, mineral oil, can cause lung irritation at the time it is swallowed. It should not be taken by mouth, particularly in people who are elderly or who have swallowing difficulties. Products with added aloe (also known as casanthrol) frequently cause cramps and are not preferred.

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