- About magnesium hydroxide
- Before taking magnesium hydroxide
- How to take magnesium hydroxide
- Getting the most from your treatment
- Can magnesium hydroxide cause problems?
- How to store magnesium hydroxide
- Important information about all medicines
- Fast Acting Laxative: Phillips Milk Of Magnesia Review
- Don’t bomb the bowel with laxatives
- First choice: bulk-forming laxatives
- For stuck stools…
- Common laxatives and brands
- Stimulant laxatives
- When to talk to a doctor
- Review by Joanie
- Review by Becky
- Review by Debi
- Review by Viqui
- Review by Catherine
- Review by Carol
- Review by Anna
- Review by Tom
- Review by Chris
- Review by Julie
- What Is It?
- Expected Duration
- When To Call A Professional
- Additional Info
- Related posts:
About magnesium hydroxide
|Type of medicine||A laxative|
|Also called||Phillips’® Milk of Magnesia|
Constipation is a common problem. It can mean either going to the toilet less often than usual to empty your bowels, or passing hard or painful stools. Constipation can be caused by a number of things. Not eating enough fibre or not drinking enough fluid can cause constipation. Some conditions (such as pregnancy) can cause constipation, as can a lack of exercise or movement (such as being ill in bed), and some medicines. Often, increasing the amount of fibre in your diet (such as by eating more fruit, vegetables, cereals and wholemeal bread) and drinking plenty of water each day can effectively prevent or relieve constipation. A laxative such as magnesium hydroxide can also be helpful, if used occasionally.
Magnesium hydroxide works by drawing fluid into your bowel, which makes your stools softer and easier to pass. It can be bought without a prescription at pharmacies and other retail outlets.
Before taking magnesium hydroxide
To make sure that this is the right treatment for you, ask a pharmacist or doctor for advice before you start taking magnesium hydroxide if:
- You are pregnant. This is because if you are expecting a baby, medicines should only be taken on the advice of a doctor.
- You have problems with the way your kidneys work, or problems with the way your liver works.
- You have severe tummy (abdominal) pain, cramping, or sickness.
- You are taking any prescription medicines. This is because magnesium hydroxide can reduce the absorption of many medicines.
- You have ever had an allergic reaction to a medicine.
How to take magnesium hydroxide
- Before you start taking the mixture, read the manufacturer’s printed information attached to the pack. It will give you more information about magnesium hydroxide and how to take it.
- Shake the bottle well to make sure the medicine is evenly mixed before pouring out a dose. The dose for an adult is 30-45 ml (six to nine 5 ml spoonfuls). The dose for a child aged 3-12 years is 5-10 ml (one or two 5 ml spoonfuls), although magnesium hydroxide should only be given to a child on the advice of a healthcare professional. Swallow the dose with a glass of water or milk at bedtime. The water/milk helps the magnesium hydroxide to work so it is important that you drink a glassful. It is also especially important if you are elderly, or at risk of becoming lacking in fluid in the body (dehydrated) for any reason.
- Magnesium hydroxide is a laxative for occasional use only – do not take it for more than three consecutive days. It must not be taken to prevent constipation or to ‘keep you regular’. If you are concerned about your bowel habit, please speak with your doctor for advice.
- Do not take magnesium hydroxide at the same time as any other medicines. This is because it can interfere with the way your body absorbs other medicines and may stop them from working properly. Try to leave at least two hours both before and after a dose of magnesium hydroxide before you take any other medicines.
Getting the most from your treatment
- It is important for you to drink plenty while you are constipated. Adults should aim to drink at least two litres (about 8-10 cups) of fluid per day. Most sorts of drink will do but as a start, try just drinking a glass of water 3-4 times a day in addition to what you normally drink.
- Try to eat a balanced diet containing high-fibre foods such as wholemeal and wholegrain breads and cereals, fruit and vegetables, brown rice and wholemeal pasta. If you are not used to a high-fibre diet, it may be best to increase the amount of fibre you eat gradually.
- Keeping your body active will help you to keep your digestive system moving, so try to take some regular daily exercise.
- You may wish to include some foods in your diet that contain sorbitol. Sorbitol is a naturally occurring sugar. It is not digested very well and draws water into your bowel which has an effect of softening stools. Fruits (and their juices) that have a high sorbitol content include apples, apricots, gooseberries, grapes (and raisins), peaches, pears, plums, prunes, raspberries and strawberries.
- Food such as pastries, puddings, sweets, cheese and cake can make constipation worse and are probably best avoided.
- You can read more about how to prevent or treat constipation in the separate condition leaflets called Constipation in Adults and Constipation in Children.
Can magnesium hydroxide cause problems?
Occasionally, people who have taken magnesium hydroxide have experienced digestive symptoms such as mild diarrhoea and stomach cramps. If either of these happens to you, stop taking it. Other side-effects are unlikely but if you do experience any other symptoms, speak with a doctor or pharmacist for further advice.
How to store magnesium hydroxide
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Check the label on the bottle for an expiry date. Once a bottle of mixture has been opened, it may need to be used within a period of time, or discarded.
Important information about all medicines
If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Fast Acting Laxative: Phillips Milk Of Magnesia Review
Hey guys, today I’m gonna review a fast-acting laxative which actually works. Yes, Phillips’ milk of magnesia is actually helping people getting regularity and immediate relief from constipation. This review is not about whether this fast acting laxative works or not but is about whether you should consider it for long or not.
Milk of Magnesia works the first time you take it and it may take 6 hours to have a bowel movement. It may also take just half an hour for milk of magnesia to kick in, it truly depends upon the cause of constipation. Results may vary from person to person.
That this fast acting laxative is cramp-free and stimulant-free (which any pharmaceutical company would). Phillips’ laxative work with your body’s natural process to gently relieve occasional constipation.
Magnesium Oxide – Magnesium Oxide is the only active ingredient in this medication. It is generally used to treat heartburn, indigestion, and constipation. Magnesium oxide is a saline laxative that works by increasing fluid in the small intestine. It is also used by the doctors to clean your intestines before a surgery.
Croscarmellose sodium is a commonly used matrix to deliver drugs to the intestines. Large doses of croscarmellose sodium may have the ability to create an intestinal blockage.
Pregelatinized starches (dried, cooked starches) are highly digestible. Its consumption on daily basis has resulted in obesity and iron-deficiency anemia in humans. However, no hazard has been suspected to the public when they are used at levels that are now current.
Stearic acid is a long-chain saturated fat that is abundant in beef, cocoa butter, coconut oil, and other natural foods. It doesn’t raise the cholesterol level or risk of heart diseases. Magnesium ion when bonds with two stearate molecules, it forms Magnesium Stearate. Which works as a laxative.
Microcrystalline Cellulose in large quantities provides dietary bulk that may lead to providing regularity.
For Adults and Children age 12: 2-4 Tablespoon.
Younger Children ages 6-11: 1-2 Tablespoon.
(Dose should be followed by 8 ounces of water)
- The most common side effect of this medication or any product containing magnesium is diarrhea. You may need to keep the washroom doors open for a good number of hours.
- Nausea and thick black stools are also seen in some users, this generally occurs in the case of an overdose. If it gets worse, consider consulting a doctor immediately. Although not many such cases have been noticed still it is a point to be taken care.
- The few negative reviews centered on experiencing cramps, rectal bleeding, and urgency to use the bathroom while taking this treatment have been noticed.
Anything artificial can never be considered as a permanent solution for your digestive problems. Anything related to indigestion is either because of your poor eating habits or unhealthy lifestyle. A reason may be junk food, low fiber diet or drinking less water. This medicine is to work as a fast-acting laxative but not a permanent solution to your constipation.
If it’s more than 2-3 days and you still can’t get regularity, you can go for Phillips Milk Of Magnesia. But, if you’re looking for a long-term solution and a permanent treatment, you really need some lifestyle changes and also some natural remedies.
Don’t bomb the bowel with laxatives
Image: ©Wavebreakmedia | Getty Images
Updated: September 25, 2019Published: April, 2014
If constipation becomes chronic, don’t keep playing laxative roulette. See your doctor for an exam.
Occasional irregularity is a fact of life, but you can minimize it with some basic steps. “You should be sure you are eating a fiber-rich diet, drinking adequate fluids, and staying physically active,” says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center. But when you do have constipation, start with the gentlest and safest option, like a bulk-forming laxative. If laxatives don’t work, ask for help. “You should see your doctor and discuss it if you are constantly needing to take laxatives,” Dr. Wolf says. “People shouldn’t have to take laxatives every day.”
First choice: bulk-forming laxatives
Bulk-forming laxatives draw water into stool, making it softer and easier to pass. But don’t expect instant gratification: these can take a half-day to several days to provide relief. They are safe to use daily. They contain various ingredients, and you may have to try more than one to find the product that helps you with minimal side effects, such as flatulence and bloating. They may be marketed as laxatives or as fiber supplements.
For stuck stools…
Stool softeners add moisture to stools to make them softer and easier to pass. Mineral oil, a lubricant, helps stools “slide on by” if the stools feel stuck low in your bowels, if you have an internal tear or “fissure,” or if you have pain from hemorrhoids during bowel movements. Don’t take mineral oil at the same time as stool softeners. Take 1 tablespoon at breakfast or lunch. But don’t use it for more than a few days, because mineral oil interferes with absorption of some vitamins and if inhaled it can cause pneumonia. Consider wearing a protective pad in your undergarments to absorb any leakage.
Other laxative options
If the conservative route doesn’t work, Dr. Wolf recommends the osmotic laxative MiraLAX or a generic version. These hold water in stool to soften it and increase bowel movements. Common side effects are gas, bloating, and nausea. Another option that works for some people is diet candies containing the sweetener sorbitol. These essentially trigger a mild case of the runs. You may experience bloating and gas along with the laxative effect, however.
Another option would be a magnesium-based laxative, such as milk of magnesia or magnesium citrate. These are members of a larger class of laxatives called saline osmotics, which draw water into the bowels and trigger bowel movements. The active ingredients include magnesium, sulfate, citrate, and phosphate. But don’t take more than the recommended amounts of these laxatives, or use them long-term, because they can throw off your chemistry. Combined with an underperforming kidney or heart failure, saline osmotic laxatives can be dangerous.
Common laxatives and brands
cereals and other foods
Colace, Correctol, Peri-Colac e, Surfak
Various branded and generic products
magnesium citrate, milk of magnesia
MiraLAX or generic versions
sorbitol or lactulose
ingredients in various products
Correctol, Dulcolax, Ex-Lax Ultra
Dialose Plus, Peri-Colace
various brand and generic products
Ex-Lax, Fletcher’s Castoria, Senokot
Stimulant laxatives such as bisacodyl and cascara trigger contractions in the bowels that push the stool along. “When bowel movements are slow, some people really do need stimulant laxatives,” Dr. Wolf says. The first choice she recommends is a senna-based stimulant laxative. But if you take stimulant laxatives too often, you could become dependent on them to have a bowel movement at all—possibly because the bowel is not functioning normally.
When to talk to a doctor
If you find yourself trying one laxative after another for long periods, see your doctor for an evaluation. Additional testing can lead to better therapy and rule out any possible serious malfunctions. “And if it is just constipation, your doctor can offer other medications to you that may be more helpful than over-the-counter laxatives,” Dr. Wolf says.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Review by Joanie
I was given milk of magnesia when I was four years old. I have been taking it ever since and I am now 75. I have definitely become dependent and cannot have a bowel movement without it. I have tried many other laxatives and milk of magnesia is the only one that works. I am trying to cut down on it, but at this time in my life I am taking a tablespoon every night with great success. I feel great.
Review by Becky
I have had years of IBS. I am 57 years old. I also have taken everything to help. The doctor has told me to increase my fiber so I used fiber pills and at first they worked wonders. Then I noticed I was getting constipated again…I increased my water because fiber has to have water to bulk, and that didn’t work.
After a miserable week I decided to take milk of magnesia and I feel extremely relieved. There have been many times before of not being able to go at all because I was so constipated. That is the worst feeling in the world, but now I am so relieved to have started this and the movements are so easy.
I too am concerned about whether I will become dependent, but at this point it is better than suffering. And I feel if we have to take fiber that is a dependency also. I will stick with Phillips milk of magnesia. I took one dose and the next morning I was relieved. I now take it two times weekly, only one tablespoon to stay normal, if needed. I am grateful!
Review by Debi
I am 51 and I have suffered with IBS (with constipation) for 11 years. The doctors all told me to eat more fiber, 20-30 grams per day. I did and with no results, only lots of gas. I tried 10-15 glasses of water (thinking that would help) per day, also no results. I bought laxatives which cramped me so much that I had to plan on staying home on those days!
Then my mom told me about milk of magnesia. Wow! No cramping, only results. I take one tablespoon every other night. Now my life is back on track! The only drawback is the taste.
Review by Viqui
I have had IBS for about seven years now and I am 55 years young. I suspect it may have begun from being exposed to a parasite from impure water, but I am not positive. I was using a senna herbal laxative in pill form and having OK results, but those things all warn you that they are habit forming and could make my body dependent. I was afraid to use it more than twice a week.
I had terrible gas after flying around the world – not sure if it was the food I ate or the stress and anger of the unfairness of losing a lawsuit I should have won. Regardless, two days after arriving home I thought I was dying. Then I guessed it might be gas. I massaged my stomach, took charcoal to get rid of gas, tried fiber drinks, then after 24 hours of being in bed doubled over in pain, my husband offered to get some milk of magnesia.
I had never taken it before for the gas or stomach problems. I was willing to try anything because my husband had already offered to take me to the emergency room. Wow. Fabulous results. Where had milk of magnesia been all my life? The flavor was cherry and it tasted great, like a milkshake. I had to control myself not to take more than I was supposed to.
I will try to take it twice a week at most as I fear becoming dependent upon it. I must say, the results were better than anything I have ever tried. I sure hope it won’t harm me with a side effect. It’s definitely the best thing for IBS I have ever, ever tried.
Review by Catherine
Milk of magnesia works pretty good for me. After I take one dose I am pretty regular for several days, and then I have to try another dose. I would recommend it for anyone with constipation.
Review by Carol
I am from England and have suffered from IBS-related constipation for years. I am now aged 56. Recently on a holiday to Florida I had not had a bowel movement for eight days and was feeling really low. I was bloated, and I didn’t want to eat as I felt full all the time. No matter how long I sat on the loo nothing happened. These symptoms are pretty symptomatic of my condition and I have resorted to all types of laxatives, high fiber foods, etc but to no avail.
In desperation I consulted an in-store pharmacist who recommended Phillips milk of magnesia (strawberry flavored). Obviously I was rather skeptical but willing to try anything. After just one dose I had a gentle bowel movement the next morning and daily for the rest of the holiday, with none of the accompanying cramps I usually get with using laxatives.
I found the dosage of one tablespoon sufficient, and the product also tasted OK to take. There was an aftertaste but I had a sweet handy to disguise the aftertaste. I have been back home now for two months and all my old symptoms have returned. The only problem is I have finished my bottle of Phillips milk of magnesia and am desperately trying to find a supplier in England. I have just purchased a bottle of M of M by another manufacturer and hope that will work just as well as the Phillips. I hope this review is of help to anyone suffering from IBS.
Review by Anna
I have known that I have IBS for four years. I think maybe I had slight symptoms before that, but while working a very stressful customer service job I found myself experiencing the symptoms more often. It became unbearable. I was having bouts of diarrhea combined with awful stomach pain.
At some point in an episode I would usually have sharp stabbing pain in my left side so that it would double me over. I had to abruptly leave stores and make mad dashes for home or the nearest public restroom. I feared going on trips or visiting parks due to not knowing where the nearest restroom was. One time, the pain was so bad I almost passed out.
Well, with my doctor’s help I eventually tried a fiber product put out by Novartis under the Perdiem brand name. It worked fairly well but I would have occasional flare-ups. Then, the company stopped making this product so I had to search for another alternative. For a while I took enteric-coated peppermint capsules with meals and at bedtime. This helped somewhat but also left me with a burning/cooling sensation in my stomach and throat area. I also used Symax and Librax for a while, and still have Librax for pain if I experience an episode – but I cannot remember the last time I took one of the pills.
Finally I stumbled upon two products that have changed my life. The first was Intestinal Soothe and Build capsules put out by Nature’s Sunshine. They are a herbal blend including things like chamomile, rosehips, etc. I took these with meals and anytime I experienced problems. I found them hard to swallow on occasion but it was worth the relief. I cannot remember but I may have had occasional flare-ups using this treatment as well.
At the advice of my mother’s hairdresser I tried milk of magnesia and the result has been incredible. I have resumed a normal lifestyle. I can travel and go to parks, and I do not even think about whether there is a restroom or not. When I occasionally have diarrhea due to a virus or whatever, the stomach cramps (which are mild compared to what I had before) are foreign to me and remind me to be thankful for my present condition because I have forgotten what they felt like.
I use about one tablespoon or less per night. My PCP told me this was safe since I was taking such a small dose, but another doctor once told me that it could cause cancer used long term. I ran that idea by my PCP and he said it was not an abrasive, stimulant laxative and should not cause cancer. But I try to use as little as necessary just in case and still would like a confirmation from another medical professional that this is OK long term.
Due to the changes it has brought about in my life, it would be difficult for me to give it up. My quality of life is so much better. The milk of magnesia has been such a huge help that it is worth getting past the nasty taste. I use the cherry flavor, which is slightly better than the original.
Review by Tom
I tried milk of magnesia this past spring on my doctor’s advice, two tablespoons at night before bed as needed only. The result was excellent, with large daily bowel movements every morning at the same time for two months and I would only take it every Thursday night.
Then I fell out of that pattern and it seemed not to help and I struggle very much now. I had a stressful, miserable 10-hour a day job plus a long commute that did not help, but this option is worth trying again in my case now that I have a pleasant, less stressful schedule.
I am completely disgusted by the taste of milk of magnesia, as well as the fact according to what I read that the ph level of 10.5 is well above the slightly acidic levels the bowels are supposed to have, making it an unfriendly substance to the healthy bacteria of the intestines. I therefore consider this a temporary relief measure.
I wish and try to return to the two-foot long snake-like bowel movements I had plus a small bowel movement each day for much of last year, despite my IBS with constipation diagnosis.
Review by Chris
I have had chronic constipation all of my life, and I am 54 years old. I went to the doctor because of lower back pain, seemingly from intestinal problems. He suggested I flush out my system using a saline product, which didn’t work. I then tried milk of magnesia and it worked without cramping or any other symptoms. It felt like what I always thought a normal bowel movement would feel like, that I had never experienced.
I now take a swig out of the bottle every night before I go to bed and it also helps with stomach acid. That small swig keeps my bowels working perfectly, for the first time in my entire life!
Review by Julie
I never really thought much about my bowel movements until about a month or two ago. I had heard of IBS and seen Zelnorm commercials and almost poked fun of the idea that bowel movements could not be a normal occurrence, but I guess I jinxed myself, in the fact that I now have IBS with constipation. I can try as hard as I want to and can’t go!
I don’t have a lot of money, so prescriptions aren’t an option – the only thing that has worked for me is milk of magnesia. I ran out and tried taking three 5mg Dulcolax pills, but I honestly thought about going to the emergency room, as my stomach hurt worse than anything I have ever felt in my life.
I did some research and those particular pills are what’s called a stimulant laxative, which means it stimulates all of your muscles in the stomach and bowel areas, which in turn can create some awful cramping and pain. I spent the entire night on the toilet with a bucket in my lap, throwing up and, well, you know the rest.
I am now going on two hours of sleep, and 24 hours later, my stomach is still in knots and cramping. I did, however, manage to lose 7lbs in nine hours last night! But that’s not the way to lose weight at all. I now hope that I am not going to become dehydrated and that the cramping will stop here anytime.
If you are suffering from IBS with constipation, my remedy of milk of magnesia is a lot cheaper than prescription meds, and even though the taste and chalky feel is bad, it’s worth it.
Do you suffer from IBS? Have you tried milk of magnesia? Please contact Sophie to send in your review.
What Is It?
Normally, people have bowel movements at fairly regular intervals, and stool passes out of the body easily without much straining or discomfort. Although the normal frequency of bowel movements varies from person to person, about 95% of healthy adults have a pattern that ranges from three times a day to three times a week.
In constipation, bowel movements either occur less often than expected or the stool is hard, dry and difficult to pass. Most of the time, constipation is not related to an illness or digestive disorder. Instead, the problem is caused by diet, lifestyle, medications or some other factor that hardens the stool or interferes with the stool’s ability to pass comfortably. Some common triggers of constipation in adults include:
- A diet low in fiber —You need about 25 grams to 30 grams of fiber every day to soften the stool and encourage proper bowel function. Most American diets contain less than half that amount.
- Inadequate fluid intake — To help prevent stools from becoming dry and hard, your daily diet should include at least six to eight “servings” of water. “Servings” can include full glasses of milk, juice and other beverages, but you also can count the water content in fruits, soups, stews and solid foods.
- A sedentary lifestyle — Because regular exercise is necessary to promote normal muscle contractions in the bowel wall, having a sedentary job or rarely exercising puts you at high risk of constipation.
- Ignoring the urge to defecate — If you have your bowel movements right after you feel an urge to defecate, this reinforces a normal nerve reflex that helps you to pass stool easily. Sometimes, because of a busy schedule or limited access to restrooms, a person ignores the urge to defecate. If you repeatedly postpone bathroom trips until a more convenient time, this can lead to constipation problems.
- Travel and scheduling factors — Travel can promote constipation by changing your diet, interfering with the normal timing of your meals, and limiting your access to restrooms.
- Laxative overuse — Long-term, regular use of laxatives can teach your bowel to rely on these medicines for help with bowel movements. Eventually, a laxative habit can contribute to your constipation, making you dependent upon continued laxative use.
- A side effect of medications — Constipation is a side effect of many prescription and nonprescription medications. Common problem medicines include iron supplements and vitamins that contain iron; calcium supplements; antacids that contain aluminum; antidepressants; drugs to treat schizophrenia or hallucinations; narcotic pain killers; general anesthesia; diuretics; muscle relaxants; and certain prescription drugs used to treat seizure disorders, Parkinson’s disease, overactive bladder, and hypertension.
- Local pain or discomfort around the anus — An anal fissure or hemorrhoids can make bowel movements painful or uncomfortable. (An anal fissure is a small tear in the skin around the anus, and a hemorrhoid is a bulge from a vein in the anus.) To avoid pain, a person with one of these problems sometimes resists the urge to defecate. This can cause symptoms of constipation.
Less often, constipation may be a symptom of an illness or condition that affects the digestive tract, the brain or the spinal cord. Some examples include irritable bowel syndrome, intestinal obstruction, diverticulitis, colorectal cancer, hypothyroidism, abnormally high blood calcium levels (hypercalcemia), multiple sclerosis, Parkinson’s disease and spinal cord injury.
Constipation is a very common problem that affects at least 80% of people at some time during their lives. In the United States, treatment for constipation accounts for more than 2.5 million visits to doctors’ offices each year, with at least $800 million spent annually for laxatives. Although adults of all ages can suffer from constipation, the risk of this problem increases dramatically after age 65 in both men and women.
Occasionally, long-term constipation develops into fecal impaction, which is a blocked colon from a mass of stool that can’t be moved by colon contractions. Fecal impaction can cause pain and vomiting, and a person with fecal impaction may require emergency treatment or hospitalization. Fecal impaction is a fairly common complication of long-term constipation in the elderly and bedridden, occurring in about 30% of all nursing home residents.
Symptoms of constipation include:
- Fewer than three bowel movements per week
- Small, hard, dry stools that are difficult or painful to pass
- The need to strain excessively to have a bowel movement
- A feeling that your rectum is not empty after a bowel movement
- Frequent use of enemas, laxatives or suppositories
Symptoms of fecal impaction include:
- Liquid stool (the stool is leaking around the impacted mass of feces and can be mistaken for diarrhea)
- Abdominal pain, especially after meals
- A persistent urge to move the bowels
- Nausea and vomiting
- Poor appetite, weight loss
- Malaise (a generally sick feeling)
- If the problem is not treated, dehydration, rapid pulse, rapid breathing, fever, agitation, confusion and urinary incontinence
Most people with simple constipation can diagnose and treat themselves. If you have constipation, begin by examining your lifestyle. Review your current diet, your level of daily exercise, and your bowel habits. In particular, do you often ignore the urge to have a bowel movement because it is inconvenient? Then take preventive measures, such as adding fiber to your diet, drinking plenty of fluid, and getting regular exercise. If this does not relieve your problem, contact your doctor.
If you have constipation together with rectal bleeding, abdominal pain or abdominal distention (bloating), contact your doctor immediately. It is best in this case for your doctor to evaluate you, including a physical exam and digital rectal examination.
If your symptoms indicate you might have fecal impaction, your doctor can confirm the diagnosis by examining your abdomen and by checking for a mass of impacted feces during the digital rectal exam. You may need other tests, including blood tests, plain abdominal X-rays, a barium enema or sigmoidoscopy (in which a special instrument is used to view the lower colon).
People 50 years and older are more likely to develop colon polyps or colon cancer. Constipation can be a symptom of colon polyps or cancer, and you should make sure that your screening for colon cancer (by colonoscopy or another test) is up-to-date.
How long constipation lasts depends on its cause. In most otherwise healthy adults, constipation improves gradually within a few weeks after they increase their intake of dietary fiber and fluid and begin exercising regularly. However, constipation in bedridden people with neurological problems can be persistent and is a risk factor for fecal impaction.
In many cases, you can prevent constipation by taking the following steps:
- Add more fiber to your diet — Set a dietary goal of 25 grams to 30 grams of fiber daily. Choose from a variety of high-fiber foods such as beans, broccoli, carrots, bran, whole grains and fresh fruits. To avoid bloating and gas, add these foods gradually over a period of several days.
- Drink adequate amounts of fluid — For most healthy adults, this is the equivalent of six to eight glasses of water daily.
- Begin a program of regular exercise — As little as 20 minutes of brisk walking daily can stimulate your bowels.
- Help train your digestive tract to have regular bowel movements — Schedule a 10-minute period to sit on the toilet at approximately the same time each day. The best time to do this is usually right after the morning meal.
- Do not postpone having a bowel movement until the time is more convenient — Respond to the urge without a delay.
- Use an over-the-counter stool softener or fiber supplement — This may prevent occasional constipation. Always follow the dosage instructions exactly as written on the labels of these medications.
If you have uncomfortable symptoms of constipation, the first step is ensure you are drinking enough fluids, and to increase your fiber intake. The fiber content of your diet by adding cereal grains, fruits and vegetables, or daily doses of a fiber supplement (for example, Metamucil or Citrucel). If constipation persists, it is reasonable to use a laxative treatment to help your bowel expel the stool. There are many laxatives available without a prescription, and they are safe for occasional use.
Salt-based or carbohydrate-based (“osmotic”) laxatives use natural salts, magnesium salts or undigested sugars to help loosen stool by drawing water through the bowel wall into the bowel. Examples are milk of magnesia, lactulose, and polyethylene glycol (Miralax)
Stimulant laxatives, such as laxatives that contain senna, cascara or bisacodyl, are less gentle. Stimulant laxatives cause the colon muscles to contract more frequently or more aggressively.
Laxatives are available in forms that can be swallowed or inserted into the rectum as a suppository.
Enemas also can relieve constipation and are available at pharmacies without a prescription. An enema is a bag of liquid (usually a mixture of salt and water) attached to a plastic tube with a tapered tip. The enema fluid can be emptied into the rectum after the tip is inserted into the anus. The fluid is emptied when you lift the bag several inches and allow the fluid to move with gravity. An enema loosens stool in the rectum and triggers the rectal muscles to squeeze as a reaction to their being stretched.
If you have fecal impaction, your doctor may remove part of the fecal mass by hand, by using a lubricated, gloved finger inserted in the rectum. The rest of the mass usually can be removed with an enema. Rarely water irrigation through a sigmoidoscope is needed to clear a fecal impaction. Once the impacted stool is removed, your doctor will have you follow a high-fiber diet and may recommend a stool-softening medication or laxative to promote regular bowel movements.
When To Call A Professional
Call your doctor immediately if your bowel movements stop and you develop abdominal pain or distention. Also contact your doctor immediately if you have any bleeding from your rectum.
Call your doctor for milder symptoms if you want advice, or if constipation continues for longer than a couple of weeks, or if you need laxatives more than two or three times per week to help you move your bowels.
Most people with constipation can achieve normal bowel function through diet and lifestyle changes.
The outlook for most people with fecal impaction is good. However, it is common for fecal impaction to return if constipation is not improved with additional treatment. A long-term program of mild laxatives, periodic enemas or both may be necessary.
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American College of Gastroenterology (ACG)P.O. Box 3099
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