• Weekend Wellness: Talk to doctor before taking stool softener for chronic constipation

DEAR MAYO CLINIC: What are the long-term side effects of taking a stool softener daily? It is the only thing that keeps me regular, and when I have tried taking it every-other-day, it’s not effective.Woman's universal bathroom symbol - incontinence

ANSWER: At this time, no research 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 doctor 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, are laxatives that work by drawing fluids into the intestines. This prevents dry, hard stool masses and makes it easier to have a bowel movement without straining.

Stool softeners you can buy over-the-counter are effective for most people. While they are only intended for short-term relief of constipation, using a daily stool softener long-term probably is not harmful. However, there are other ways to help relieve constipation that are often successful.

Diet often is one of the main drivers behind constipation. For many people, dietary changes can be an effective way to relieve constipation. For example, adding fiber to your diet 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. 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, it is best to limit foods that can make it worse. In particular, try to avoid foods such as pastries, puddings, sugar, candy, cake and cheese.

Your fluid intake can have an effect on your bowel function, too. A good goal is to drink eight 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 it to your daily routine. Regular physical activity can help relieve constipation.

Depending on your medical history and your symptoms, your doctor 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 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 doctor 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 are likely to have a positive effect, too. Adil E. Bharucha, MBBS, M.D., Gastroenterology, Mayo Clinic, Rochester, Minn.


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