Laxatives For Constipation (cont.)
What over-the-counter preparations can be used for constipation?
Laxatives are medicines that increase the frequency
and ease
of passing bowel movements. Many types of laxatives are
available
over-the-counter (OTC) for the relief of mild, occasional
constipation. If the constipation becomes moderate to
severe or does
not respond to OTC products, a doctor should be consulted.
Most OTC laxatives are safe, effective, and well
tolerated. There
are distinct classes of laxatives, which function
differently and
have varying degrees of effectiveness and potential side
effects.
Bulk-Forming Laxatives
Bulk-forming laxatives are the most commonly
recommended
initial treatments for constipation. Bulk-forming laxatives
may work
as quickly as 12 hours or take as long as three days to
be
effective. Some bulk-forming laxatives are derived from
natural
sources such as agar, psyllium, kelp (alginates), and plant
gum.
Others are synthetic cellulose compounds such as
methylcellulose and
carboxymethylcellulose. Natural and synthetic bulk-forming
laxatives
act similarly. They dissolve or swell in the intestines,
lubricate
and soften the stool, and make the passage of bowel
movements easier
and more frequent.
Examples of bulk-forming laxatives are methylcellulose (Citrucel) psyllium hydrophilic mucilloid (Metamucil), polycarbophil (FiberCon), guar gum (Benefiber) and malt soup extract (Maltsupex). Many of these agents are available as powders and are mixed with fluids. Fruit drinks, fruit juice, and soft drinks mask the gritty taste of these laxatives better than water. Some are available as wafers, which are designed to be eaten with a separate beverage.
The benefits of bulk-forming laxatives are:
- Bulk-forming laxatives are not absorbed from the
intestines into
the body and are safe for long-term use. They are also safe
for
elderly patients with constipation.
- They are helpful in patients with
irritable bowel
syndrome,
diverticulosis, and colostomies.
- Some bulk-forming laxatives (such as guar gum) are
used as fiber
supplements in patients whose diets contain insufficient
fiber. High
fiber consumption can help control
weight gain and
sometimes modestly
lower the level of cholesterol in the blood.
Precautions for using bulk-forming laxatives.
- Each dose of a bulk-forming laxative should be taken
with at
least a full glass (8 ounces) of fluid to be safe and
effective.
Therefore, bulk-forming laxatives may not be appropriate
for patients
who must restrict oral fluid intake (such as patients with
kidney
failure).
- Patients with narrowing of the digestive tract
(including
esophageal stricture, intestinal stricture, or severe
adhesions)
should not use bulk-forming agents without their doctors'
approval
due to the risk of blockage of the intestine or the
esophagus.
- Some patients may be allergic to the laxative or other
substances
contained in the product, such as coloring or artificial
sweeteners.
- Abdominal bloating, discomfort, and
flatulence (gas) can be
bothersome
to some patients using bulk-forming laxatives.
- Some of these products contain sugar.
Diabetes mellitus
patients
may need to select sugar-free bulk-forming laxatives. By
trying
different types of bulk-forming laxatives, it usually is
possible to
find one that does not cause discomfort.
- They can decrease the absorption of certain medications (aspirin, warfarin (Coumadin), and
carbamazepine (Tegretol) and can also reduce blood sugar levels.
Next: Stool Softeners (emollient laxatives) »
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