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    Mayo Clinic Q and A: Dealing with chronic constipation

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DEAR MAYO CLINIC: Is it safe to take a stool softener daily to prevent constipation? What are the side effects of doing so long-term?

ANSWER: There currently isn't any research that has examined the specific long-term side effects of taking a stool softener every day. While the risks associated with taking this kind of over-the-counter medication daily are not likely to be significant, it would be a good idea to talk with your health care provider about your symptoms. Although uncommon, an underlying health condition could be part of the problem.

Constipation typically is defined as having fewer than three bowel movements a week or other symptoms (e.g., hard stools, excessive straining, or a sense of incomplete evacuation after defecation). Chronic constipation refers to these symptoms when they last for several weeks or longer.

Constipation is a common problem, and there are many types of laxatives available to help treat it. Stool softeners, also called emollients, work by drawing fluids into stools, which is supposed to make them softer. This may make it easier to have a bowel movement without straining.

Over-the-counter stool softeners are effective for some people. However, in controlled clinical trials, there is no evidence that they improve symptoms. While they only are intended for short-term relief of constipation, using a daily stool softener long-term probably is not harmful. But there are other ways to help relieve constipation that often are successful.

Your diet often is one of the main drivers behind constipation. For many people, dietary changes can be an effective way to relieve constipation. One example is adding fiber to your diet, which may increase the weight of your stool and speed its passage through your intestines. Good sources of fiber include fresh fruits and green, leafy vegetables, as well as whole-grain breads and cereals. That said, do not add a significant amount of fiber to your diet quickly. A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly.

When constipation is a problem, limit foods that can make it worse. In particular, try to avoid foods such as pastries, puddings, sugar, candy, cake and cheese.

Fluid intake can have an effect on your bowel function, too. A good goal is to drink 8 ounces of fluid six to eight times a day. Water is the best choice, but other liquids also can help you get the fluid you need each day.

A lack of physical activity may contribute to constipation. If you do not exercise regularly, consider adding some type of physical activity to your daily routine. This can help relieve constipation.

Depending on your medical history and your symptoms, your health care provider may want to evaluate you for an underlying medical condition that could lead to chronic constipation. For example, a blockage in the colon or rectum or impaired relaxation of the pelvic floor muscles may result in constipation. Nerve and muscle problems can affect the muscles in the colon and rectum, making it difficult for stool to move through the intestines. Conditions such as diabetes and thyroid disorders may change the balance of hormones in your body, and that can result in chronic constipation as well.

If you do not have a medical issue causing constipation, discuss with your health care provider the best way to manage your condition. Depending on your individual circumstances, a daily stool softener or another simple laxative may be an appropriate remedy. Changing your diet and making other lifestyle changes also are likely to have a positive effect. — Dr. Adil E. Bharucha, Gastroenterology, Mayo Clinic, Rochester, Minnesota


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