What are the common side effects of laxatives. How do different types of laxatives work. When should you consult a doctor about laxative use. What are the potential risks of using laxatives. How can you prevent constipation naturally.

Understanding Laxatives: Types and Their Functions

Laxatives are medicines designed to stimulate or facilitate bowel movements. They are commonly used to treat constipation, a condition characterized by difficulty emptying the bowels and having fewer than three bowel movements per week. While over-the-counter (OTC) laxatives are readily available, it’s crucial to consult with a healthcare professional before use.

There are five primary types of OTC laxatives:

1. Oral osmotics
2. Oral bulk formers
3. Oral stool softeners
4. Oral stimulants
5. Rectal suppositories

How do oral osmotics work?

Oral osmotics draw water into the colon, making stool passage easier. Popular brands include MiraLAX and Phillips’ Milk of Magnesia.

What is the mechanism of action for bulk formers?

Bulk formers absorb water to form a soft, bulky stool, prompting normal intestinal muscle contraction. Common brands are Benefiber, Citrucel, FiberCon, and Metamucil.

How do stool softeners function?

As the name suggests, stool softeners make hard stools softer and easier to pass with less strain. Colace and Surfak are popular brands in this category.

Common Side Effects of Different Laxative Types

While laxatives can provide relief from constipation, they may also cause various side effects. Understanding these potential issues can help users make informed decisions about their use.

What are the side effects of oral osmotics?

Oral osmotics may cause:

• Bloating
• Gas
• Cramping
• Diarrhea
• Thirst
• Nausea

Can bulk formers cause side effects?

Yes, bulk formers may lead to:

• Bloating
• Gas
• Cramping
• Increased constipation (if not taken with enough water)

Are there side effects associated with stool softeners?

Stool softeners generally have fewer side effects, but may cause loose stools.

What side effects can oral stimulants produce?

Oral stimulants may result in:

• Burping
• Cramping
• Urine discoloration
• Nausea
• Diarrhea

Do rectal suppositories have side effects?

Rectal suppositories can cause:

• Cramping
• Diarrhea
• Rectal irritation

Potential Risks and Complications of Laxative Use

Despite their availability over the counter, laxatives are not without risks. Users should be aware of potential complications and interactions with other medications.

Can laxatives interact with other medications?

Yes, laxatives can interact with certain heart medications, antibiotics, and bone medications. Always consult with a healthcare professional about potential interactions with your current medications.

Is there a risk of developing laxative dependency?

Overuse of laxatives (except for bulk formers) can lead to dependency. The intestines may lose muscle and nerve response, making it difficult to have bowel movements without laxatives. If you suspect dependency, consult your doctor for guidance on restoring normal colon function.

Can laxatives cause dehydration?

If laxative use results in diarrhea, it can lead to dehydration and electrolyte imbalance. Ensure adequate fluid intake when using laxatives.

Are there any special considerations for breastfeeding mothers?

Some laxative ingredients can pass through breast milk, potentially causing diarrhea or other issues for the baby. Breastfeeding mothers should consult their doctor before using any laxative.

When to Seek Medical Attention

While laxatives can be helpful for occasional constipation, certain symptoms warrant immediate medical attention.

When should you contact your doctor while using laxatives?

Contact your doctor immediately if you experience:

• Rectal bleeding
• Bloody stools
• Severe cramps or pain
• Weakness or unusual tiredness
• Dizziness
• Confusion
• Skin rash or itching
• Swallowing difficulty (feeling of lump in throat)
• Irregular heartbeat

Additionally, make an appointment if you experience unexplained changes in bowel patterns or constipation lasting longer than seven days, even with laxative use.

Natural Ways to Prevent Constipation

The best approach to managing constipation is prevention. By making certain lifestyle and dietary changes, you can reduce the need for laxatives.

How can diet help prevent constipation?

Adjust your diet to include more high-fiber foods such as:

• Fresh fruits and vegetables
• Whole-grain cereals
• Bran

Simultaneously, reduce consumption of low-fiber foods like processed foods and dairy products.

What lifestyle changes can help prevent constipation?

Consider implementing these lifestyle changes:

• Drink plenty of fluids
• Get regular exercise
• Manage stress
• Don’t ignore the urge to pass stool

Understanding Constipation: Causes and Diagnosis

Constipation is a common digestive issue that can significantly impact quality of life. Understanding its causes and how it’s diagnosed can help in prevention and treatment.

How is constipation defined medically?

While the parameters for constipation vary from person to person, it’s generally defined as having fewer than three bowel movements per week, accompanied by difficulty emptying the bowels. If this condition persists for several weeks or longer, it’s considered chronic constipation.

What are common causes of constipation?

Constipation can be caused by various factors, including:

• Low-fiber diet
• Dehydration
• Lack of physical activity
• Certain medications
• Ignoring the urge to have a bowel movement
• Changes in routine or travel
• Certain medical conditions (e.g., hypothyroidism, irritable bowel syndrome)

How do doctors diagnose chronic constipation?

Diagnosis typically involves:

1. Medical history review
2. Physical examination
3. Discussion of symptoms and lifestyle factors
4. Possible diagnostic tests (e.g., blood tests, colonoscopy) if an underlying condition is suspected

The Role of Fiber in Digestive Health

Fiber plays a crucial role in maintaining digestive health and preventing constipation. Understanding its importance can help in making informed dietary choices.

How does dietary fiber help prevent constipation?

Dietary fiber adds bulk to the stool, making it easier to pass through the intestines. It also helps retain water in the stool, preventing it from becoming too hard and difficult to pass.

What are good sources of dietary fiber?

Excellent sources of dietary fiber include:

• Whole grains (e.g., oats, quinoa, brown rice)
• Legumes (e.g., lentils, beans, chickpeas)
• Fruits (e.g., apples, pears, berries)
• Vegetables (e.g., broccoli, carrots, sweet potatoes)
• Nuts and seeds

How much fiber should you consume daily?

The recommended daily intake of fiber is:

• 25-30 grams for adults
• 21-25 grams for women
• 30-38 grams for men

It’s important to increase fiber intake gradually and drink plenty of water to avoid digestive discomfort.

The Importance of Hydration in Preventing Constipation

Adequate hydration is crucial for maintaining regular bowel movements and preventing constipation. Understanding the role of fluids in digestive health can help in developing better hydration habits.

How does water intake affect bowel movements?

Water helps soften stools and promotes regular bowel movements. When the body is dehydrated, it absorbs more water from the colon, leading to harder, more difficult-to-pass stools.

How much water should you drink daily?

While individual needs vary, a general guideline is:

• About 11.5 cups (2.7 liters) a day for women
• About 15.5 cups (3.7 liters) a day for men

These amounts include fluids from all sources, including food.

What other fluids can help prevent constipation?

In addition to water, these fluids can help prevent constipation:

• Herbal teas
• Fresh fruit juices
• Clear soups
• Prune juice (known for its natural laxative effect)

Remember to limit caffeine and alcohol intake, as these can contribute to dehydration.

Exercise and Its Impact on Digestive Health

Regular physical activity plays a significant role in maintaining digestive health and preventing constipation. Understanding how exercise affects bowel movements can motivate individuals to incorporate more activity into their daily routines.

How does exercise help prevent constipation?

Physical activity helps stimulate the natural contraction of intestinal muscles, moving stools through the colon more efficiently. It also helps reduce the time it takes food to move through the large intestine, limiting the amount of water absorbed from the stool into the body.

What types of exercises are most beneficial for digestive health?

While any form of physical activity can be beneficial, these exercises are particularly helpful for digestive health:

• Brisk walking
• Jogging
• Swimming
• Cycling
• Yoga (especially poses that target the abdominal area)

How much exercise is recommended for digestive health?

Aim for at least 30 minutes of moderate-intensity exercise most days of the week. This can be broken up into shorter sessions throughout the day if needed.

Stress Management and Its Role in Digestive Health

Stress can have a significant impact on digestive health, including contributing to constipation. Understanding the connection between stress and digestion can help in developing effective stress management strategies.

How does stress affect digestion?

Stress can slow down digestion, leading to constipation. It can also cause muscle tension in the abdomen, making it harder to pass stools. Additionally, stress may lead to unhealthy eating habits or neglect of regular exercise, further contributing to digestive issues.

What are effective stress management techniques?

Consider incorporating these stress-reduction techniques into your daily routine:

• Meditation
• Deep breathing exercises
• Progressive muscle relaxation
• Regular physical exercise
• Adequate sleep
• Engaging in hobbies or enjoyable activities
• Seeking support from friends, family, or a mental health professional

Can mindfulness practices improve digestive health?

Yes, mindfulness practices can help improve digestive health by:

• Reducing stress and anxiety
• Promoting awareness of bodily sensations, including digestive processes
• Encouraging mindful eating, which can support better digestion
• Helping maintain a regular bathroom routine

Incorporating mindfulness into daily life can contribute to overall digestive wellness and potentially reduce the need for laxatives.

Common Side Effects of Laxatives

Constipation and laxatives

The parameters for constipation vary from person to person.

Generally, if you have difficulty emptying your bowels and have fewer than three bowel movements a week, you likely have constipation.

If these infrequent bowel movements and difficulty passing stools continues for several weeks or longer, you’re considered to have chronic constipation.

A laxative is a medicine that stimulates or facilitates bowel movements. There are different types of laxatives available that don’t require a prescription.

Even though these laxatives are readily available at your drug store or online, you should talk to your doctor or pharmacist about your needs and which type may be the best one for you.

There are five primary types of over-the-counter (OTC) laxatives:

Oral osmotics

Taken orally, osmotics help make the passage of stool easier by drawing water into the colon. Popular brands of osmotics include:

• MiraLAX
• Phillips’ Milk of Magnesia

Oral bulk formers

Taken orally, bulk formers prompt normal intestinal muscle contraction by absorbing water to form a soft, bulky stool. Popular brands of bulk formers include:

• Benefiber
• Citrucel
• FiberCon
• Metamucil

Oral stool softeners

Taken orally, stool softeners work like the name implies — they make hard stools softer and easier to pass with less strain. Popular brands of stool softeners include:

• Colace
• Surfak

Oral stimulants

Taken orally, stimulants encourage bowel movements by triggering rhythmic contractions of the intestinal muscles. Popular brands of stimulants include:

• Dulcolax
• Senokot

Rectal suppositories

Taken rectally, these suppositories soften stool and trigger rhythmic contractions of the intestinal muscles. Popular brands of suppositories include:

• Dulcolax
• Pedia-Lax

Following are the common potential side effects of the five primary types of OTC laxatives.

Oral osmotics

Possible side effects include:

• bloating
• gas
• cramping
• diarrhea
• thirst
• nausea

Oral bulk-formers

Possible side effects include:

• bloating
• gas
• cramping
• increased constipation (if not taken with enough water)

Oral stool softeners

Possible side effects include:

• loose stools

Oral stimulants

Possible side effects include:

• burping
• cramping
• urine discoloration
• nausea
• diarrhea

Rectal suppositories

Possible side effects include:

• cramping
• diarrhea
• rectal irritation

As with any OTC medication, read the laxative label carefully and talk with your doctor or pharmacist to see if it’s a viable choice for you and your current state of health.

Just because laxatives are available OTC doesn’t mean that they’re without risks. If you’re considering using laxatives, understand that risks can include:

Interaction with other medications

Among other medications, laxatives can interact with certain heart medications, antibiotics, and bone medications.

This information is often on the label. But to be safe, ask your doctor or pharmacist about the laxative you’re considering and how it might interact with the other medications you’ve been prescribed.

Complications

If your constipation is caused by another condition — such as diverticulosis — frequent or long-term laxative use can worsen constipation by decreasing your colon’s ability to contract.

The exception is bulk-forming laxatives. These are safe to take every day.

Dehydration

If laxative use results in diarrhea, your body can become dehydrated. Diarrhea can also lead to electrolyte imbalance.

Breastfeeding

If you’re breastfeeding, some ingredients can pass to your baby through your breast milk, possibly causing diarrhea or other problems. Talk with your doctor before using any laxative.

Dependency

Overuse of laxatives (other than bulk formers) can result in the intestines losing muscle and nerve response, which can lead to dependency on laxatives to have a bowel movement.

If you find yourself in this situation, your doctor should have suggestions on how to remedy laxative dependency and restore your colon’s ability to contract.

When you have constipation and are using laxatives, make an appointment to see your doctor if you experience unexplained changes in bowel pattern or constipation lasting longer than seven days (even with using a laxative).

Contact your doctor immediately if you experience:

• rectal bleeding
• bloody stools
• severe cramps or pain
• weakness or unusual tiredness
• dizziness
• confusion
• skin rash or itching
• swallowing difficulty (feeling of lump in throat)
• irregular heartbeat

If you don’t get constipated, you won’t need laxatives.

To help treat constipation and avoid it in the future, consider making these dietary and lifestyle changes:

• Adjust your diet so you’re eating more high-fiber food, such as fresh fruits and vegetables, whole-grain cereals, and bran.
• Reduce your consumption of low-fiber foods, such as processed foods and dairy products.
• Drink plenty of fluids.
• Get regular exercise.
• Manage stress.
• When you feel the urge to pass stool, don’t ignore it.
• Create a regular schedule for bowel movements, such as after meals.

For the treatment of occasional constipation, you have a choice of a number of safe, effective OTC laxatives. If you decide to use one, read the label directions carefully and only use it as directed.

Talk with your doctor or pharmacist to help choose a laxative that won’t interact with other medications you’re taking or otherwise put you at risk.

If you have chronic constipation, see your doctor. They can tailor a plan of medication, diet, and lifestyle changes to help you treat and avoid future problems with bowel movements.

Common Side Effects of Laxatives

Constipation and laxatives

The parameters for constipation vary from person to person.

Generally, if you have difficulty emptying your bowels and have fewer than three bowel movements a week, you likely have constipation.

If these infrequent bowel movements and difficulty passing stools continues for several weeks or longer, you’re considered to have chronic constipation.

A laxative is a medicine that stimulates or facilitates bowel movements. There are different types of laxatives available that don’t require a prescription.

Even though these laxatives are readily available at your drug store or online, you should talk to your doctor or pharmacist about your needs and which type may be the best one for you.

There are five primary types of over-the-counter (OTC) laxatives:

Oral osmotics

Taken orally, osmotics help make the passage of stool easier by drawing water into the colon. Popular brands of osmotics include:

• MiraLAX
• Phillips’ Milk of Magnesia

Oral bulk formers

Taken orally, bulk formers prompt normal intestinal muscle contraction by absorbing water to form a soft, bulky stool. Popular brands of bulk formers include:

• Benefiber
• Citrucel
• FiberCon
• Metamucil

Oral stool softeners

Taken orally, stool softeners work like the name implies — they make hard stools softer and easier to pass with less strain. Popular brands of stool softeners include:

• Colace
• Surfak

Oral stimulants

Taken orally, stimulants encourage bowel movements by triggering rhythmic contractions of the intestinal muscles. Popular brands of stimulants include:

• Dulcolax
• Senokot

Rectal suppositories

Taken rectally, these suppositories soften stool and trigger rhythmic contractions of the intestinal muscles. Popular brands of suppositories include:

• Dulcolax
• Pedia-Lax

Following are the common potential side effects of the five primary types of OTC laxatives.

Oral osmotics

Possible side effects include:

• bloating
• gas
• cramping
• diarrhea
• thirst
• nausea

Oral bulk-formers

Possible side effects include:

• bloating
• gas
• cramping
• increased constipation (if not taken with enough water)

Oral stool softeners

Possible side effects include:

• loose stools

Oral stimulants

Possible side effects include:

• burping
• cramping
• urine discoloration
• nausea
• diarrhea

Rectal suppositories

Possible side effects include:

• cramping
• diarrhea
• rectal irritation

As with any OTC medication, read the laxative label carefully and talk with your doctor or pharmacist to see if it’s a viable choice for you and your current state of health.

Just because laxatives are available OTC doesn’t mean that they’re without risks. If you’re considering using laxatives, understand that risks can include:

Interaction with other medications

Among other medications, laxatives can interact with certain heart medications, antibiotics, and bone medications.

This information is often on the label. But to be safe, ask your doctor or pharmacist about the laxative you’re considering and how it might interact with the other medications you’ve been prescribed.

Complications

If your constipation is caused by another condition — such as diverticulosis — frequent or long-term laxative use can worsen constipation by decreasing your colon’s ability to contract.

The exception is bulk-forming laxatives. These are safe to take every day.

Dehydration

If laxative use results in diarrhea, your body can become dehydrated. Diarrhea can also lead to electrolyte imbalance.

Breastfeeding

If you’re breastfeeding, some ingredients can pass to your baby through your breast milk, possibly causing diarrhea or other problems. Talk with your doctor before using any laxative.

Dependency

Overuse of laxatives (other than bulk formers) can result in the intestines losing muscle and nerve response, which can lead to dependency on laxatives to have a bowel movement.

If you find yourself in this situation, your doctor should have suggestions on how to remedy laxative dependency and restore your colon’s ability to contract.

When you have constipation and are using laxatives, make an appointment to see your doctor if you experience unexplained changes in bowel pattern or constipation lasting longer than seven days (even with using a laxative).

Contact your doctor immediately if you experience:

• rectal bleeding
• bloody stools
• severe cramps or pain
• weakness or unusual tiredness
• dizziness
• confusion
• skin rash or itching
• swallowing difficulty (feeling of lump in throat)
• irregular heartbeat

If you don’t get constipated, you won’t need laxatives.

To help treat constipation and avoid it in the future, consider making these dietary and lifestyle changes:

• Adjust your diet so you’re eating more high-fiber food, such as fresh fruits and vegetables, whole-grain cereals, and bran.
• Reduce your consumption of low-fiber foods, such as processed foods and dairy products.
• Drink plenty of fluids.
• Get regular exercise.
• Manage stress.
• When you feel the urge to pass stool, don’t ignore it.
• Create a regular schedule for bowel movements, such as after meals.

For the treatment of occasional constipation, you have a choice of a number of safe, effective OTC laxatives. If you decide to use one, read the label directions carefully and only use it as directed.

Talk with your doctor or pharmacist to help choose a laxative that won’t interact with other medications you’re taking or otherwise put you at risk.

If you have chronic constipation, see your doctor. They can tailor a plan of medication, diet, and lifestyle changes to help you treat and avoid future problems with bowel movements.

Constipation – from mild upset to wake-up call

• home
• Interviews with doctors
• Constipation – from a mild disorder to a wake-up call

Arabova R.D.
Gastroenterology

What are constipation related to? They can be a sign of a disease or dangerous condition of the organs of the gastrointestinal tract is broken. And also – a symptom of a violation of the diet or a manifestation of side effects from taking medications. It is important to determine what problem constipation is associated with. Robiya Damirovna Arabova, a practicing gastroenterologist at the Class Clinic Kaliningrad medical center, spoke about its most common causes and what needs to be done.

How often do you have to deal with chronic constipation, what causes it?
Patients with chronic constipation occur in almost all age groups. Naturally, with age, the frequency of constipation increases. This is due to a sedentary lifestyle, the presence of concomitant diseases, especially in old age: for example, diabetes, hypothyroidism, heart failure, etc. Sometimes constipation occurs due to the intake of various drugs that slow down intestinal motility.

However, it cannot be said that constipation is not typical for young people. In young people, they are also quite common, and, as a rule, this is a manifestation of irritable bowel syndrome.

What is irritable bowel syndrome (IBS)?
In this disease, there are no organic lesions of the intestinal mucosa (inflammatory, erosive-ulcerative, tumor), but functional disorders occur, manifested by abdominal pain, changes in the frequency and shape of the stool, and bloating. In patients with IBS, there is an increase in the level of pain sensitivity to stretching and impaired motor activity (motility) of the large intestine. As a result, with an increase in intracavitary pressure in the intestine, pain occurs, and intestinal motility disorders lead to stool disorder (constipation or diarrhea).

Basically, irritable bowel syndrome occurs under the influence of psychogenic factors: severe stress, prolonged psycho-emotional overstrain, anxiety and depressive disorders. People can be in this condition for years without significant improvement, which seriously impairs the quality of life.

Irritable bowel syndrome is a diagnosis of exclusion. That is, it is established only with the exclusion of other probable causes of intestinal pathology, including infections, parasitic invasion, inflammatory diseases, and tumors.

What are the most common complaints from patients? Is there any specific criterion that allows diagnosing constipation?
Each patient under the very term “constipation” understands something of his own, but in fact it is a complex of symptoms associated with impaired bowel movement.

We diagnose constipation when the patient has less than 3 empty stools per week. It also makes sense to talk about constipation if there is a feeling of incomplete emptying, there is difficulty in defecation, scanty stools, or hard, fragmented stools.

Another characteristic sign of constipation is excessive and ineffectual straining, discomfort during defecation, which makes the patient spend more than 3-5 minutes in the toilet without a satisfactory result.

What are the most worrisome symptoms associated with constipation?
Should be seriously alert for regular, intense, progressive pain and other symptoms that bother you at night. Signs of serious problems are the excretion of blood, mucus, pus in the feces, an increase in body temperature, a decrease in the level of hemoglobin and red blood cells, as well as an increase in ESR in the general blood test.

All of these signs, combined with constipation, may indicate the possibility of severe cancer and other diseases, such as ulcerative colitis, Crohn’s disease, and other life-threatening conditions.

In what cases of constipation should I urgently consult a specialist?
Urgently seek medical attention if constipation is accompanied by warning signs – these are intense pain, blood in the stool, nausea, vomiting, fever.

Unmotivated, sudden weight loss, especially after the age of 50, may be a sign of cancer and is also a reason for an urgent visit to the doctor.

What is the risk of self-treatment of constipation with laxatives?
Regular misuse of laxatives, especially irritants, causes bowel dysfunction that can be quite difficult to manage. I have seen patients under the age of 25 who have not had a single independent bowel movement without taking laxatives for a year.

A special term has now been introduced – laxative disease. This is a condition that occurs with the abuse of irritant laxatives. It manifests itself as chronic diarrhea, and as a result – a violation of metabolism and absorption in the intestine. Another of its manifestations is the “lazy gut” syndrome, when the intestines are not able to function normally without taking laxatives.

We treat laxative disease, but it is much easier to prevent it by using laxatives strictly according to the doctor’s prescription and following his recommendations. From the illiterate use of these drugs, constipation develops into more serious problems, and the patient falls into a vicious circle.

Make an appointment with Robiya Damirovna Arabova on the website or by phone (4012) 33-44-55.

Make an appointment

What to do with constipation after taking antibiotics: how to restore bowel function

How do antibiotics affect bowel function?

The main mechanism by which antibiotics cause disruption of the normal functioning of the intestine is not associated with the toxic effect of drugs, but with their effect on the intestinal microflora ² .

Antibacterial drugs significantly inhibit the growth of not only pathogenic microorganisms, but also the normal microflora in the large intestine, which is directly involved in the digestive process. As a result, quantitative and qualitative
changes in the composition of the intestinal microflora, which may be accompanied by a disorder of the gastrointestinal tract ³ .

Constipation is one of the possible manifestations of dysbacteriosis and microflora disorders associated with taking antibiotics. In this case, as shown by a number of studies, there is a death of normal intestinal
microflora, which includes bacteroids, bifidobacteria and lactobacilli, as well as other bacteria useful to us ⁴ .

With the participation of beneficial bacteria, ³ :

• normally stimulates the immune system;
• final digestion and metabolism of nutrients;
• neutralization and removal of toxic compounds;
• synthesis and supply of B vitamins, pantothenic acid to the body;
• energy supply of the intestinal epithelium, etc.

With the participation of beneficial bacteria normally occurs ³ :

• stimulation of the immune system;
• final digestion and metabolism of nutrients;
• neutralization and removal of toxic compounds;
• synthesis and supply to the body of vitamins of group B, pantothenic acid;
• energy supply of the intestinal epithelium, etc.

Various components and waste products of bacteria can affect intestinal motility. For example, under the influence of intestinal microflora, short-chain fatty acids are normally formed, which stimulate the motor activity of the intestine.
When the microbiome changes, the production of other compounds (such as methane) may increase, which can suppress intestinal motility and lead to unpleasant symptoms ^{4, 5} .

Symptoms of constipation due to medications, including antibiotics, may include ⁶ :

• abdominal pain, including cramping;
• pain in the rectum and anus;
• loss of appetite;
• bloating;
• nausea/vomiting;
• infrequent or infrequent, difficult or delayed defecation;
• the need to strain for a long time and often unsuccessfully;
• sensation of incomplete emptying of the bowels after a bowel movement;
• Pain when passing stools due to thickening, roughness, dryness of feces.

Symptoms of constipation due to medications, including antibiotics, may include ⁶ :

• abdominal pain, including cramping;
• pain in the rectum and anus;
• loss of appetite;
• bloating;
• nausea/vomiting;
• infrequent or infrequent, difficult or delayed defecation;
• the need to strain for a long time and often unsuccessfully;
• sensation of incomplete emptying of the bowels after a bowel movement;
• Pain when passing stools due to thickening, roughness, dryness of feces.

As a result of inhibition of the normal intestinal microflora, the multiplied opportunistic microbes begin to release toxic substances – toxins. Bacterial toxins have a number of negative effects. They can cause direct damage to the intestinal
epithelium, the intestinal mucosa may become thinner and more permeable to pathogens with subsequent development of inflammation ⁷ . Mucosal damage
Intestinal mucus can be aggravated by antibiotics themselves, which either have a direct toxic effect on its mucosa or cause significant changes in the physicochemical properties of intestinal mucus ⁸ .

How to restore intestinal health after taking antibiotics?

This question worries many patients who have undergone a course of antibiotic therapy. It is better to start treatment of dysbacteriosis as early as possible, as the course of chronic diseases of the digestive tract, if any, can be aggravated.

Therapy should be comprehensive, aimed at eliminating excessive bacterial colonization of the intestine with opportunistic microflora, restoring normal microflora and impaired motility of the large intestine, improving intestinal digestion and absorption,
stimulation of the body’s reactivity ⁹ .
To normalize the work of the intestine, disturbed during antibiotic therapy, it is recommended to follow a diet. For example, the Mediterranean diet includes an abundance of fruits, vegetables, olive oil and fatty
fish (rich in mono- and polyunsaturated fatty acids), whole grains and nuts ¹⁰ .

Activation of intestinal motility is facilitated by food rich in dietary fiber. Although dietary fiber is not digested by the gastrointestinal tract’s own enzymes, it plays an important role in maintaining
growth of beneficial microflora ¹¹ .

The benefits of dietary fiber ¹¹ :

• help to remove harmful substances from the body, including bacterial toxins;
• retain water, swell and increase the volume of feces, thereby contributing to better bowel emptying;
• contribute to the synthesis of hormones, B vitamins and other substances necessary for the functioning of the immune system;
• serve as food for beneficial gut bacteria.

With the participation of beneficial bacteria normally occurs ³ :

• help to remove harmful substances from the body, including bacterial toxins;
• retain water, swell and increase the volume of feces, thereby contributing to better bowel emptying;
• contribute to the synthesis of hormones, B vitamins and other substances necessary for the functioning of the immune system;
• serve as food for beneficial gut bacteria.

Dietary fiber is found only in plant foods; they are not found in animal products. Many dietary fibers contain ¹¹ :

• pomace (this is what remains after squeezing juices from vegetables and fruits, oils from oilseeds) and bran (in fact, waste from the production of high-grade flour), which contain coarse dietary fiber in a high
  concentration. It is necessary to use them in food in their pure form carefully and in small quantities;
• whole grains of legumes and cereals and whole grain products thereof;
• nuts and dried fruits – they have less fiber than beans and cereals, but contain a large amount of other biologically active substances necessary for health;
• fresh vegetables, fruits and herbs. You need to eat a serving of at least 400 grams per day ¹² .

Fermented milk products play a significant role in the prevention of intestinal dysbacteriosis. They are considered natural probiotics because they contain live microorganisms that have a positive effect on health.
with regular use. The menu can include yogurt, kefir, curdled milk, varenets, cottage cheese ³ .
To facilitate the excretion of feces, it is necessary to observe the drinking regimen: drink at least 2 liters of fluid per day ¹¹ .

Fermented milk products play a significant role in the prevention of intestinal dysbacteriosis. They are considered natural probiotics because they contain live microorganisms that have a positive effect on health.
with regular use. The menu can include yogurt, kefir, curdled milk, varenets, cottage cheese ³ .
To facilitate the excretion of feces, it is necessary to observe the drinking regimen: drink at least 2 liters of fluid per day ¹¹ .

Prevention of constipation after antibiotic therapy

To prevent constipation when taking antibiotics, children and adults must adhere to the following rules ^{9, 13} :

• use antibiotics only as prescribed by a doctor, but not as self-medication, since they themselves can have a detrimental effect on the normal microflora of the large intestine stimulating the growth of pathogenic
  and conditionally pathogenic microflora;
• keep a diet, maintain an optimal drinking regimen;
• reduce the content of simple carbohydrates in food, as they are a good breeding ground for opportunistic bacteria;
• Digestive enzymes may be used to improve digestion.

To improve intestinal motility, it is important to be in motion. Moderate physical activity, including abdominal exercises, improves intestinal motility. Hiking, skiing, riding are useful
cycling, swimming ¹¹ .
When the urge to defecate appears, they cannot be ignored and suppressed. It is important to try to develop a conditioned reflex to empty the bowels at a certain time of the day (the most physiological time of defecation is
15-30 minutes after a hearty breakfast) ¹¹ .

To improve intestinal motility, it is important to be on the move. Moderate physical activity, including abdominal exercises, improves intestinal motility. Hiking, skiing, riding are useful
cycling, swimming ¹¹ .

When the urge to defecate appears, they cannot be ignored and suppressed. It is important to try to develop a conditioned reflex to empty the bowels at a certain time of the day (the most physiological time of defecation is
15-30 minutes after a hearty breakfast) ¹¹ .

How to choose a laxative

If constipation due to antibiotics persists despite lifestyle changes, a prescription may be recommended to normalize the condition.
laxatives ⁶ .

For the treatment of constipation, drugs of various mechanisms of action are used. Laxatives,
e. g. sodium picosulfate (active ingredient of Guttalax®) ¹⁴ .

Sodium picosulfate is a local laxative, it is activated in the large intestine and has a stimulating effect on the colonic mucosa, promotes the accumulation of water and electrolytes in the intestinal lumen.
As a result, the intestinal contents move faster and soften. The laxative effect may occur 6-12 hours after ingestion, therefore, to obtain it in the morning, the medicine should be taken
the night before.

The drug is available in the form of drops for oral administration and tablets, so there is the possibility of individual dosage selection ¹⁴ .

More about the drug

If constipation due to antibiotics persists despite lifestyle changes, a prescription may be recommended to normalize the condition.
laxatives ⁶ .

For the treatment of constipation, drugs of various mechanisms of action are used. Laxatives,
e.g. sodium picosulfate (active ingredient of Guttalax®) ¹⁴ .

Sodium picosulfate is a local laxative, it is activated in the large intestine and has a stimulating effect on the colonic mucosa, promotes the accumulation of water and electrolytes in the intestinal lumen.
As a result, the intestinal contents move faster and soften. The laxative effect may occur 6-12 hours after ingestion, therefore, to obtain it in the morning, the medicine should be taken
the night before.