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Home Care for Constipation: Demystifying Choices at the Drug Store
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ROCHESTER, Minn. — The array of drug store products to address constipation can be daunting. The September issue of Mayo Clinic Health Letter sorts out the choices and offers advice on when to see a physician.
Constipation is common among older adults. Signs and symptoms include straining, passing lumpy or hard stools, a sensation of incomplete evacuation or sensation of blockage. Frequency of bowel movements isn't a reliable indicator of constipation. Healthy adults can have anywhere from three bowel movements a week to three a day.
In most cases, constipation symptoms can be reduced by gradually increasing fiber in the diet, drinking plenty of non-caffeinated fluids and taking 1 to 2 tablespoons of fiber supplement containing psyllium (Metamucil, others) or methylcellulose (Citrucel).
Short-term, occasional use of osmotic laxatives may help things get moving. This category includes:
- Saline laxatives, such as magnesium hydroxide (Phillips' Milk of Magnesia) and Epsom salts. They often work within hours but shouldn't be used by people with kidney problems.
- Lactulose (Enulose) and sorbitol. They may taste better than other laxatives, but they can be costly, take a day or two to work and often cause gas and bloating.
- Polyethylene glycol (Miralax). This product is very safe at recommended doses and causes less gas and bloating than lactulose and sorbitol. It offers a mild-to-moderate effect. Prolonged use can cause electrolyte imbalances.
Another option is stool softeners (emollients) such as docusate calcium (Surfak) and docusate sodium (Colace). They add lubrication to the stool but don't cause a bowel movement.
If symptoms don't improve after three weeks of home care, seeing a physician is recommended. A doctor will evaluate and address any underlying conditions that may be contributing to chronic constipation. The care provider may recommend a stimulant laxative. They are available in pill form or as suppositories. They are effective but should be used under a physician's supervision.
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Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.
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