The Dos and Don’ts of Treating Constipation

Many of us are all too familiar with the physical and mental discomfort that comes with constipation. General constipation symptoms include straining to go to the bathroom; hard, dry and/or small stools; incomplete bowel movements (BMs); or decreased frequency of BMs, particularly less than three times per week. Feeling bloated and struggling with painful stools can be a cause for worry, but it is a common gastrointestinal (GI) complaint often easily fixed through lifestyle changes and help from a pharmacist.

Causes include:

• Medical/psychological conditions: irritable bowel syndrome, bowel obstructions, stress, and depression
• Diet: insufficient fiber or fluid intake
• Medications: opioid pain relievers (morphine, codeine), NSAIDs (aspirin, Motrin/Advil), antihistamines (Benadryl, Zyrtec), iron supplements (Ferrosol, ferric sulfate/citrate), and blood pressure medications (amlodipine, diltiazem, metoprolol, atenolol)

How can I treat constipation?
Occasional episodes of constipation can be treated with over-the-counter (OTC) medications and/or changes in diet. Keep in mind the following if you choose to treat it yourself:

• DO ensure you are drinking enough water (generally, eight 8-ounce glasses of water per day) and eating foods high in dietary fiber such as beans, broccoli, berries, and whole grains. If you have certain health conditions such as heart failure, follow your doctor’s fluid intake recommendations.
• DO talk to your pharmacist about your symptoms and current medications. There are many OTC medications available that work in different ways.
• DO NOT stop taking medications that you believe they may be causing your constipation. Always talk to your doctor first.
• DO NOT start taking multiple OTC medications at once, unless directed by a medical professional. These medications may cause further GI issues when taken together.

Available OTC medications include:

• Bulk-forming laxatives – methylcellulose (Citrucel) and psyllium fiber (Metamucil), which add weight and consistency to your stool, making it easier to expel.
• Stool softeners – docusate (Colace), which increase the water and fat content in your stool to prevent straining and painful BMs.
• Hyperosmotic laxatives – polyethylene glycol (Miralax) and glycerin suppositories (Fleet), which pulls in water from your colon to stimulate a BM.
• Stimulant laxatives – bisacodyl (Dulcolax) and senna (Senokot), which increase movement in your intestines to cause a BM.
• Saline laxatives – magnesium hydroxide (Milk of Magnesia) and magnesium citrate solution, which increase water in the intestines to move stool through the GI system.

Summary
Constipation is very common and is often easily treated with changes to your diet and a conversation with your local pharmacist. To make an appropriate recommendation, the pharmacist will ask about your condition including, but not limited to, when your symptoms began, if they have changed, and other medications you are taking. It is important to be honest and upfront to ensure you receive the best treatment. We are always here to help!

Visit your doctor if you experience fever, severe abdominal pain, black or tarry stools, unexplained weight loss, or no relief after two weeks.