What treatments for constipation are available?
There are many treatments for constipation, and the best approach relies on aclear understanding of the underlying cause.Home remedies and OTC medications to treat for constipationDietary fiber (bulk-forming laxatives)The best way of adding fiber to thediet is increasing the quantity of fruits and vegetables that are eaten. Thismeans a minimum of five servings of fruits or vegetables every day. For manypeople, however, the amount of fruits and vegetables that are necessary may beinconveniently large or may not provide adequate relief from constipation. Inthis case, fiber supplements can be useful.Fiber is defined as material made by plants that is not digested by the humangastrointestinal tract. Fiber is one of the mainstays in the treatment ofconstipation. Many types of fiber within the intestine bind to water and keepthe water within the intestine. The fiber adds bulk (volume) to the stool andthe water softens the stool.There are different sources of fiber and the type of fiber varies from sourceto source. Types of fiber can be categorized in several ways, for example, bytheir source. The most common sources of fiber include:fruits and vegetables,wheat or oat bran, psyllium seed (for example, Metamucil, Konsyl), synthetic methylcellulose (for example, Citrucel), and polycarbophil (for example, Equilactin, Konsyl Fiber).Polycarbophil often is combined with calcium (for example, Fibercon). However, in somestudies, the calcium-containing polycarbophil was not as effective as thepolycarbophil without calcium. A lesser known source of fiber is an extract ofmalt (for example, Maltsupex); however, this extract may soften stools in ways otherthan increasing fiber.Increased gas (flatulence) is a common side effect of high-fiber diets. The gas occurs because the bacteria normally presentwithin the colon are capable of digesting fiber to a small extent. Thebacteria produce gas as a byproduct of their digestion of fiber. All fibers, no matterwhat their source, can cause flatulence. However, since bacteria vary in theirability to digest the various types of fiber, the different sources of fiber mayproduce different amounts of gas. To complicate the situation, the ability ofbacteria to digest one type of fiber can vary from individual to individual. This variabilitymakes the selection of the best type of fiber for each person (for example, afiber that improves the quality of the stool without causing flatulence) more difficult.Thus, finding the proper fiber for an individual becomes a matter oftrial and error.The different sources of fiber should be tried one by one. The fiber shouldbe started at a low dose and increased every one to two weeks until either thedesired effect on the stool is achieved or troublesome flatulence interferes.(Fiber does not work overnight.) If flatulence occurs, the dose of fiber can bereduced for a few weeks and the higher dose can then be tried again. If flatulence remains a problem and prevents the dose of fiber frombeing raised to a level that affects the stool satisfactorily, it is time tomove on to a different source of fiber.When increasing amounts of fiber are used, it is recommended that greater amountsof water be consumed . In theory, thewater prevents "hardening" of the fiber and blockage (obstruction) of theintestine. This seems like simple and reasonable advice. However, ingestinglarger amounts of water has never been shown to have a beneficial effect on constipation, with or without the addition of fiber. (There is already a lot ofwater in the intestine and extra water that is digested is absorbed and excreted in the urine.)It is reasonable to drink enough fluids to prevent dehydration because withdehydration there may be reduced intestinal water.Because of concern about obstruction, persons with narrowings (strictures) or adhesions of their intestines should not use fiber unless it has been discussedwith their physician. Some fiber laxatives contain sugar, and patients with diabetesmay need to select sugar-free products.Lubricant laxativesLubricant laxatives contain mineral oil as either the plain oil or an emulsion of the oil. The oilstays within the intestine, coats the particles of stool, and presumably prevents the removal ofwater from the stool. This retention of water in the stool results insofter stool. Mineral oil generally is used only for the short-term treatment of constipation since its long-term use has several potential disadvantages.
