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Constipation: Treatments & Complications

istock_000008408710xsmallMost people who are mildly constipated do not need laxatives. However, for those who have made diet and lifestyle changes and are still onstipated, they can take laxatives for a limited period.

A doctor should determine when a patient needs a laxative and which form is best.  Different laxative groups are:

• Bulk-forming laxatives generally are considered the safest but can  interfere with absorption of some medicines. These laxatives are to be taken with water. They absorb water and make the stool soft.
• Stimulants increase muscle contractions of the colon.
• Stool softeners provide moisture to the stool. These laxatives are often recommended after childbirth or surgery.
• Lubricants grease the stool enabling it to move through the intestine more easily.  Liquid paraffin is the most common example.
• Saline laxatives draw water into the colon. Milk of Magnesia is an example of this group.

The treatment measures can be summarized as:

• Eat a diet high in roughage (fiber).
• Eat regular meals; it is especially important to have breakfast.
• Take bulking agent with meals and follow with a full glass of water.
• Do not take harsh (stimulant) laxatives except as directed.
• Establish regular daily bowel habits; Do not ignore the urge to have a bowel movement.
• Sit in the toilet for sufficient time and do not strain.
• If there has been no bowel movement after 48 hours, take 1 or 2 tablespoons Milk of Magnesia at bedtime. If unsuccessful, the dose may be increased the next evening.
• If no bowel movement occurs after 3 days, use a glycerin suppository.
• Exercise daily.
• Whenever possible, avoid medications that contribute to constipation. Do not stop taking any prescribed medications unless approved to do so by the physician.

Complications

Sometimes constipation can lead to complications. These complications include hemorrhoids/piles caused by straining to have a bowel movement or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle.

Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition is known as rectal prolapse.

Hard stool can block the intestine and rectum so that the normal action of the colon is not enough to expel the stool. This condition is called fecal impaction and occurs most often in children and older adults.

An impaction can be softened with mineral oil taken by mouth or by glycerin suppository. If stools are not passed then, the hardened stool is removed by inserting one or two fingers into the anus.

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