Written by Mita Majumdar |Updated : July 3, 2015 1:31 PM IST
Constipation is painful; it is frustrating and you would not like to talk about it.
Constipation problems are mostly related to our diet and sometimes medicines we take. Of course constipation can be relieved by eating a balanced diet that includes lots of fibre, drinking lots of water and exercise, but sometimes we need to resort to laxatives as a short-term measure.
Here are some of the commonly used over-the-counter laxatives, their dosage and their side effects.
Isabgol
Isabgol, or psyllium husk, is perhaps the first thing that you would reach out for if you chronically suffer from constipation. Isabgol available as an over-the-counter remedy for constipation is a mix of soluble and insoluble fibre, with 70 percent as soluble fibre. It adds bulk to the stools and also facilitates smooth passage of stool because of its water-holding properties.
Stir in 3 to 4 teaspoons of the husk in a cup of warm water or warm milk at bedtime. Drink it up immediately as it tends to swell in the cup itself. Use it daily for better effects. Continue till you find your bowel movement improves.
A study shows that the superior stool softening effect of psyllium increases over a 2-week treatment period, suggesting that the stool softening effect may be greater with continued use.[1] Another study found isabgol to be not effective in people with slow colonic-transit (time taken for food to travel through your digestive system), but it is effective for 85 percent of people with normal physiology.
It is one of the safest OTC laxatives. If at all, side effects include abdominal fullness and minor bloating in some people. However, you may be allergic to psyllium, so check with your doctor immediately if you get rash, hives, difficulty breathing, difficulty swallowing, or you start vomiting.
Milk of magnesia
Milk of magnesia, or magnesium hydroxide, is an oral osmotic laxative available over-the-counter. It works by drawing water into the colon from the tissues surrounding it and making the stool softer and easier to pass.
Take 2 to 4 tablespoons of the laxative preferably at bedtime. Drink a full glass of water after taking the laxative. You will be good to go next morning. Laxatives can be habit forming; don t use it for more than a week at a stretch unless your doctor asks you to.
Side effects include minor cramping, bloating, or diarrhoea. There are no serious side effects of milk of magnesia unless you are allergic to the chemical. Call your doctor immediately if you get rash, hives, difficulty breathing or difficulty swallowing. Consult your doctor if you are using prescription medicines since the laxative may interfere with some drugs. Also, do not use this laxative if you have kidney disease. If you are pregnant or breast feeding, do not take any laxatives without consulting your doctor.
Glycerine suppositories
Glycerine suppositories work by increasing the volume of water in the intestine and softening the stool making it easier to pass.
How to use a suppository: For ease of insertion, refrigerate the glycerine suppository for about half an hour. Take it out of the fridge and remove the wrapper carefully. Lie down on your left side. Keep the lower leg straight and the upper leg bent at the knees toward your stomach. Lift the upper leg, and slowly insert the tip of the suppository (either with your hand or the applicator given) into the rectum. Do not force the applicator into the rectum or you could injure yourself. Slowly squeeze the bottle until is nearly empty. Stay lying down for 15 minutes or until you feel the urge for bowel movement. You may experience bowel movement within 15 minutes to one hour of using the suppository.
Glycerine suppositories are a better alternative than oral laxatives because
These are used as occasional relief from constipation. Not for long-term use. Do not use it more than once in a 24-hour period.
Common side effects are rectal burning or pain, stomach discomfort or loose stools. Call your doctor immediately if you have rectal bleeding or severe stomach pain or you don t have a bowel movement even after one hour of glycerine use. Again do not use glycerine suppository if you are allergic to glycerine.
Stimulant laxatives
Stimulant laxatives work by increasing the muscle contractions in the intestines and inducing bowel movements. It is a wonderful remedy for constipation but it is effective only when used on short term basis.
1. Aloe vera juice: Aloe juice available as OTC aids digestion and improves bowel movement. Drink 2 ounces of aloe vera juice daily when constipated. You may see results in 8 to 10 hours. Remember not to overdo it. The laxative action of aloe vera juice is because of its ingredient called anthroquinone and anthrones. Prolonged use of aloe juice, say more than 3 times a week for a year, can cause black pigmentation of the colon wall and can make constipation symptoms worse.
Side effects Long term use can cause bloating and fullness, abdominal pain and faecal evacuation. Worse, it can lead to gastroenteropathy, osteomalacia, and vitamin and mineral deficiencies.
2. Senna (liquid or powder): Senna is another stimulant laxative that is derived from the leaves of the senna plant. The bacteria in the colon converts the laxative into active compounds which then stimulate the contraction of intestine muscles. Use it orally as directed on the package. Preferably take it before going to bed. It starts to produce bowel movement in 6 to 12 hours.
Side effects Diarrhoea, nausea, upper stomach pain, loss of appetite, joint pain. Over use of the laxative tends to lower the potassium levels in the body. You will then have symptoms such as extreme thirst, muscle weakness, leg discomfort, uneven heart rate, and confusion.
3. Castor oil: Castor oil acts by irritating the intestinal wall and causing a peristaltic movement thus promotingevacuation of bowels. It also helps by accumulating fluid in the intestinal and ensures a sort of diarrhoeal evacuation. So try to have an easy access to the toilet because it might be difficult to control the urge. Avoid taking castor oil at bedtime because for most people it works within 4 to 6 hours. One tablespoon for adults and one teaspoon for children is the dose. Do not take it daily. Leave it for the worst days.
Castor oil is safe and the toxic ingredient ricin in the castor seed is not transferred to the oil. So don t worry about the oil being not safe. It is absolutely safe. It has its share of side effects though. Nausea, digestive discomfort, diarrhoea are common side effects. If you have haemorrhoids, or suffer from cramps, ulcers or irritable bowel, avoid using castor oil.
Castor oil can be an Ayurvedic treatment for constipation as well. Apply 3 - 4 drops of lukewarm castor oil over your belly button before going to bed. You might have the same effect as taking castor oil internally.
Mineral oil (Lubricant laxative)
Mineral oil is a lubricant laxative that works by slowing the absorption of water from the bowel, which softens the stool. Mix the measured dose in 3-4 tablespoons of water, milk, or fruit juice and drink it. Take it at least one hour before the meal or two hours after the meal. It stimulates bowel movement in 6 to 8 hours.
Do not use this laxative for more than a week. Also do not use any additional laxatives with mineral oil.
It is not recommended for children below six years of age, pregnant women, and nursing women.
Seek medical attention if you do not get a bowel movement within 8 hours of taking the mineral oil, or if you show severe allergic reaction such as rash, hives, difficulty breathing, or swelling of mouth, lips and tongue.
Mineral oil taken as oral OTC laxative is normally well tolerated with rare uncommon side effects, it should not be used in people with swallowing dysfunction.
Avoid prolonged use of laxatives. Continued use can cause, what is called, lazy bowel syndrome, which means, the colon becomes weak and is unable to work without the use of more laxative. Try natural remedies to treat constipation exercise regularly or do yoga, eat lots of fresh fruits and vegetables to give you enough fibre, avoid processed foods, consume lots of fluids preferably water, and have meals on time.
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