Seunga (Jasmine) Han, PharmD Student
In our last article, we talked about constipation – what it is, what some common causes are and how to prevent it. In today’s article, we’ll discuss some treatment options for constipation to help you navigate the confusing and overwhelming the stomach care aisle.
When should I seek a healthcare provider?
Even though we’ve mentioned it previously, let’s go over some signs that could mean you or your loved one is experiencing something more serious. If any of these apply, it’s important to seek a healthcare provider as soon as possible:
- Less than 2 years old
- Constipated for more than 2 weeks despite using laxatives
- Blood or mucus in stool
- Fever
- Fatigue
- Older than 50 years old, with a family history of colon cancer
- Constant stomach ache, or pain when passing stool
- Vomiting
- Alternating between diarrhoea and constipation
- Recent stomach surgery
What can I use to get rid of my constipation?
#1 PEG 3350 (PegaLAX®, Lax-A-Day®, RestoraLAX®)
Polyethylene glycol (PEG) works by bringing water into the gut to help stool move through the body more easily. This is one of the safest, most effective, and best-tolerated agents available. This product is ideal for all ages, young and old, as well as in pregnant women. It’s used by mixing 17g into a cup of water or juice (250ml) and drinking it within 15 minutes. Most products come with a measuring cup or are divided into sachets for easy measuring. The only downside to PEG is it takes about 2 to 3 days before it starts working. PEG can be safely used for up to six months if needed, but users should consult a healthcare provider if they need it for more than seven days.
#2 Glycerin suppository
If you’re simply looking for the fastest-working option, the glycerin suppository takes only about 15 to 30 minutes to work. Using a suppository can be something new for many individuals; if that includes you, make sure to follow the following steps:
- Wash your hands with soap and water.
- Remove the wrapper if present and moisten the suppository briefly in lukewarm water.
- Lay on your side with your lower leg straight, and your upper leg bent towards your stomach.
- Insert the suppository with your finger, pointed end first.
- Make sure it enters fully (1 inch in adults and ½ to 1 inch in infants), to avoid it falling out
- Retain the suppository as long as you can in the same position, for up to five minutes if possible.
- Make sure to wash your hands after and discard used materials.
#3 Senna (Senokot®), Bisacodyl (Ducolax®)
If you don’t prefer suppositories, but also don’t want to wait longer than a day to see an effect, stimulant laxatives may work in your favour. This class of laxatives works by stimulating muscle movement in your gut to pass stool along faster. It’s best to take these medications at bedtime since they take about 6 to 12 hours to work, and ideally cause a bowel movement the following morning. However, daily use of stimulant laxatives is not recommended as your body could develop a tolerance to them.
#4 Bulk-forming laxative (Metamucil®)
Bulk-forming laxatives, as the name suggests, work by increasing the bulk or volume of your stool to stimulate a bowel movement. It’s the safest class of medications you can use for long-term use but isn’t the ideal option if your goal is to relieve constipation immediately. It’s recommended that you take each dose with a full cup of water or juice (250ml) to prevent blockage. One important thing to note is individuals who are dehydrated or fluid restricted should avoid this class of medications.
Other options
Stool softeners (Colace®, Senokot-S®) are commonly seen in pharmacies but don’t actually have enough evidence to support their benefits for constipation. But, there are minimal side effects associated with them, so they can be useful for some patients who can’t use the other options above.
Along with stool softeners, there is insufficient evidence to support the use of probiotics, natural health products, homoeopathic therapies, and heavy mineral oil for constipation.
Constipation can be an embarrassing topic to bring up, but remember your healthcare providers are always there to provide you with the best recommendation possible. Feel free to reach out to us at ask@orbishealth.ca if you have any concerns or questions. We would be more than happy to hear from you.
RESOURCES
- RxTx
- Safe Medication. How to Use Rectal Suppositories Properly [Internet]. ASHP; [cited 2017 Feb 20]. Available from: http://www.safemedication.com/safemed/MedicationTipsTools/HowtoAdminister/HowtoUseRectalSuppositoriesProperly
