Classical medicine does not consider it necessary for health to pass bowel movements on a daily basis. The frequency of bowel movement depends on each person, but it is generally referred to as constipation if there are fewer than 3 bowel movements per week and the bowel movements are hard or difficult to pass.
The doctor will first determine if it is a secondary constipation (consecutive to another disease) or primary. In the first case, he will treat the cause or order additional examinations, such as a colonoscopy . Treat your hemorrhoids if necessary. They are often the cause of constipation. If your constipation is recent and you are taking a new medication , talk to your doctor. Your medication may be the cause of your problem.
The doctor will first recommend modifying the diet so as to increase the fiber intake : raw vegetables, cooked vegetables, legumes, fruits rich in pectin (apple, pear, peach, berries), but especially whole grains.
One can add wheat bran, rich in fiber, or other grains to muffin recipes, etc. To treat constipation, it is recommended to consume about 1/4 cup of wheat bran per day. Whole prunes and prune juice are also very effective in relieving constipation because they contain sorbitol, a natural laxative. A daily dose of 8 ounces is generally sufficient . However, it can sometimes take several weeks before you feel the benefits of a fiber-enriched diet in transit.
In parallel, the doctor will also recommend drinking enough , while avoiding alcohol and caffeinated drinks, which dehydrate and can irritate the colon. However, if constipation is chronic and is accompanied by intestinal irritation, avoid suddenly changing your diet.
If constipation persists, he will recommend a laxative . There are 6 categories:
- The laxatives ballast or weight are generally mucilages or prepared dietary fiber psyllium hydrophilic mucilloid or methylcellulose. This type of laxative is the mildest for the intestines. By binding to water, the fibers swell, which helps form loose, bulky stools. Their volume triggers peristalsis of the intestines, which causes the stool to move towards the rectum. It may take a few days for the laxative effect to appear. It is recommended to drink the equivalent of 5 to 10 times the volume of the amount of ballast laxative ingested. Metamucil®, Prodiem® and the Kellogs Bran Buds® are examples.
Possible side effects:bloating, flatulence and cramps. Incorporating them gradually in the diet limits these inconveniences.
- The stool softeners , which soften the stool. For example, docusate sodium (Colace®, Ex-Lax®, Soflax®).
Possible side effects: diarrhea and mild stomach cramps.
- The osmotic laxatives help retain more water in the intestine, thus softening the stool. They include salts (sodium sulfate, magnesium sulfate or Epsom salt), magnesium hydroxide (milk of magnesia), sugars that cannot be assimilated by the intestine (lactulose, mannose, mannitol, sorbitol, etc. ) or glycerin (as a suppository). Polyethylene glycol laxatives (Miralax®, Lax-A-Day®) are osmotic laxatives available for adults complaining of occasional constipation.
Possible side effect: diarrhea, flatulence, cramps, and dehydration in large doses.
- The laxative lubricants , which lubricate the stool and facilitate their evacuation. Most often it is mineral oil (paraffin oil or petrolatum). They can be used orally or rectally.
Possible side effects: diarrhea and mild stomach cramps. Please note that inflammation of the lungs can occur if the oil is accidentally drawn into the lungs.
- The stimulant laxatives act directly on the intestinal mucosa and all peristalsis (bisacodyl, anthracene, castor oil emulsified). They decrease the reabsorption of water and electrolytes in the colon. Stimulating laxatives, which are very irritating to the lining of the colon, are used as a last resort. They are not recommended in case of chronic constipation . They should not be taken for more than 1 or 2 weeks without medical supervision.
Possible side effects: abdominal cramps, diarrhea, and burning sensation in the rectum.
Caution.Overdose can cause addictive lazy bowel syndrome, as well as lowering sodium and potassium levels in the blood, dehydration, and possibly more serious conditions.
Warning. They are contraindicated for pregnant and breastfeeding women.
Some preparations are made up of drugs from 2 or 3 of these groups of laxatives.
- Lubiprostone (Amitiza®). This new class of drug is indicated for the treatment of chronic constipation in adults, if other treatments fail 19 . It works by increasing the secretion of water by the intestine.
Possible side effects: nausea, diarrhea, abdominal pain and flatulence.
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In case of terminal constipation, the doctor may recommend micro – enemas or suppositories to restore the evacuation reflex. In addition, by biological feedback (biofeedback), it will be possible to re-educate anorectal motor skills after an episode of chronic constipation, if necessary.