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Near death by milk of magnesia

A 73-year old man with end-stage kidney disease (ESKD) developed severely reduced heart rate followed by cardiac arrest in the ambulance on the way to the hospital, according to the report published in BMJ Case Reports.

The man had been prescribed daily doses of milk of magnesia (magnesium hydroxide) to relieve constipation and had reported persistent nausea and vomiting.

Medical staff initially diagnosed a heart attack combined with either cardiogenic shock (the inability to pump sufficient blood) and/or sepsis. Symptoms of hypermagnesaemia (excessively high blood magnesium levels) can mimic those of cardiac arrest with these complications.

Hospital personnel initiated advanced cardiac life support. However, they later discovered that the patient had a blood magnesium level of over four times the normal levels.

Doctors were able to normalise the patient’s magnesium levels, blood pressure and low heart rate over a period of three days.

“The patient underwent emergency dialysis with reduction in magnesium to 2.59 millimoles/ litre (mmol/l). After three consecutive days of dialysis, his serum magnesium concentration was 1.15 mmol/l,” ​wrote senior author Dr. Elizabeth Sage Colombo from Veterans Health Administration, Albuquerque, New Mexico.   

“In summary, two mechanisms, decreased elimination as a consequence of ESKD and the ingestion of laxatives resulted in nearly fatal hypermagnesaemia in our patient. He responded remarkably well to haemodialysis,“ ​she continued.

Magnesium contraindicated in renal disease

Thepatient’s initial serum magnesium measurement of 4.1 mmol/l was at first thought to be an error as he had been tested 4 days previously at 1.15 mmol/l – marginally above the upper normal range limit of 1.0 mmol/l. However, repeat measurement verified the abnormally high result, suggesting that the patient had ingested large quantities of the milk of magnesia in the intervening period.

However, even normal doses of over-the-counter and prescribed magnesium-containing products can be dangerous for patients with kidney disease, suggested the authors.

“This case illustrates that clinicians should avoid prescribing magnesium-based laxatives to patients with renal dysfunction,​” advised Colombo.

“Patients should be educated regarding the safe use of magnesium containing over-the-counter products, such as milk of magnesia,” ​she recommended.

Finally, the importance of quick diagnosis and treatment was emphasised by Colombo.

“Recognition of the constellation of symptoms and signs of severe hypermagnesaemia is imperative. Timely treatment with diuresis, intravenous calcium and haemodialysis is highly effective in preventing significant morbidity and mortality associated with hypermagnesaemia,”​ she concluded.

Source:  BMJ Case Reports

Published online.   DOI :10.1136/ bcr-2016-218260​

“Near death by milk of magnesia”

Authors: Ahmed Alaini, Carlos A Roldan, Karen Servilla, Elizabeth Sage Colombo

Magnesium hydroxide.

Milk magnesium at Patient

About magnesium hydroxide

Type of medicine A laxative
Used for Constipation
Also called Phillips’® Milk of Magnesia
Available as Mixture

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.
  • You can read more about how to prevent or treat constipation in the separate condition leaflets called Constipation (for 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.

Cancer: Home Treatment for Constipation

Things you can do

Home treatment may be all that is needed to treat constipation caused by cancer, pain medicine, inactivity, or the side effects of chemotherapy or radiation therapy. If your doctor has given you instructions or medicines to treat constipation, be sure to follow them. Check with your doctor before using any nonprescription medicines for your constipation.

First:

  • Make sure you drink enough fluids.
    • Reduce your intake of alcoholic beverages. They can increase dehydration.
    • If you have heart failure or kidney failure, talk to your doctor about what amount of fluid is right for you.
  • Be more physically active. But check with your doctor before increasing your physical activity, especially if you are getting cancer treatments. Talk with your doctor about what kind of exercise and how much exercise will help you.
  • Include fruits, vegetables, and fiber in your diet each day. Have a bran muffin or some bran cereal for breakfast. And try eating a piece of fruit for a mid-afternoon snack.
  • Schedule time each day for a bowel movement. Setting a daily routine, such as after breakfast, may help. Take your time. Don’t be in a hurry.

If you are still constipated:

  • Add some processed or synthetic fiber, such as Benefiber, Citrucel, FiberCon, Metamucil, or Perdiem, to your diet each day.
  • Try a stool softener, such as Colace, if your stools are very hard.

If constipation persists, your doctor may suggest a laxative, such as Phillip’s Milk of Magnesia.

  • Do not use a laxative without consulting your doctor.
  • Do not take a laxative if you are on a sodium-restricted diet or have kidney problems.

You may sometimes need to try a stimulant laxative, such as Miralax.

  • Do not use laxatives without talking with your doctor.
  • Use these preparations sparingly. Regular use may interfere with your body’s ability to absorb vitamin D and calcium. This can weaken your bones.
  • Overuse of stimulant laxatives reduces the tone and sensation in the large intestine, causing physical dependence on laxatives.

Symptoms to watch for during home treatment

If one or more of the following symptoms occur during home treatment, contact your doctor:

  • New constipation occurs or other bowel habit changes continue after 1 week of home treatment.
  • Ongoing (chronic) constipation:
    • Is causing new problems.
    • Has gotten worse.
    • Occurs along with other bowel habit changes, such as changes in the size, shape, or consistency of your stools.
  • Rectal pain develops or increases.
  • Blood in the stool develops or increases.
  • Belly pain or fever develops.
  • Uncontrolled leakage of stool occurs.
  • Your symptoms become more severe or more frequent.

Credits

Current as of: December 17, 2020

Author: Healthwise Staff
Medical Review: E. Gregory Thompson MD – Internal Medicine
Kathleen Romito MD – Family Medicine
Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

Current as of: December 17, 2020

Author:
Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

Over The Counter Medications and Chronic Kidney Disease

Pain Medications 

Acetaminophen (Tylenol®) is safe to use. If you have liver problems you should check with your pharmacist or physician first. Do not take more than 12 regular strength tablets or 8 extra strength tablets per day. Acetaminophen will relieve pain and fever but NOT inflammation. 

Medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®), or acetylsalicylic acid (Aspirin®) are unsafe for your kidneys.  They can also increase blood pressure, increase risk of heart attack and stroke and cause stomach ulcers and bleeding.  These agents should be avoided with the exception of low-dose daily Aspirin 81 mg, which is safe for regular use if prescribed by your doctor.  

Heartburn 

Most over the counter medications for heartburn are safe to use occasionally. If your heartburn occurs daily, speak with your family physician.  Magnesium-containing products should be avoided as they accumulate in patients with kidney disease.

For occasional use Avoid
Amphojel®  Maalox® 
Gaviscon® – containing alginic acid  
Tums®  

Constipation 

Constipation is a common problem for people with chronic kidney disease as both iron tablets and calcium tablets can cause this side effect. You may be on other medications, such as pain medications, which can cause constipation. 

If you are taking a medicine on a daily basis which can cause constipation you should also take a medication to prevent constipation. Ask your doctor or pharmacist which medication is best for you.  You do not need to take this with lots of additional fluid which is often recommended.  

Laxatives that are Safe Stool Softener Avoid 
PEG3350 (Restoralax®, Miralax®,), PEG3350 with Lytes (PEGLyte®, GoLytely®), Bisacodyl (Dulcolax®), Senna (Senokot®), Lactulose Docusate (Colace®) is safe but not very effective Milk of Magnesia®, Magnesium citrate solution, Fleet Phospho-Soda® 

To improve fibre in diet and regulate bowels, use Benefibre® powder rather than Metamucil®, as Metamucil® contains potassium. This can help with constipation or diarrhea.

Diarrhea 

You can take Loperamide (Imodium®) tablets for diarrhea in the usual dose. Do not take more than 8 tablets per day. 

Cough & Cold Medicine 

It is safe to take most cough and cold medications. Please consider the following if you have diabetes or high blood pressure:

Diabetes 

Many cough syrups and lozenges contain sugar. If your diabetes is well-controlled, using these medications short-term for a cold is usually not a problem. Ask your pharmacist for help if your diabetes is not well-controlled and you would like help choosing a sugar-free formulation.  

High Blood Pressure 

Avoid using products that contain decongestants such as pseudoephedrine and phenylephrine. Decongestants can cause your blood pressure to go dangerously high. If you have a stuffy nose, nasal saline spray (e.g. HydraSense®) or nasal decongestant spray (e. g. Otrivin®) are safer options. Nasal decongestant spray should not be used for more than 3 days. 

Allergy Medications (also called Antihistamines) 

Most over the counter allergy medications are safe to take at lower doses. If you have liver problems check with your pharmacist or doctor first before using an antihistamine. Products containing diphenhydramine (Benadryl®) are more sedating than other antihistamines.
 

Generic name 
(Brand Name)

 
Usual Dosing Renal dosing
Cetirizine (Reactine) 5-10mg once daily 5mg once daily
Desloratadine (Aerius) 5mg once daily 5mg every other day
Fexofenadine (Allegra) 60mg twice daily or 180mg once daily 60 mg once daily
Loratadine (Claritin) 10mg once daily 10mg every other day

Herbal Products

Herbal products may interact with the other medications you are taking. You should check with your pharmacist or physician before using herbal products. 

Vitamins

Replavite® is a safe vitamin that is prescribed for all patients on dialysis. It contains water soluble vitamins (i.e. vitamin C, and B vitamins such as folic acid) which are lost during dialysis.

Other over the counter multivitamins should be avoided, unless prescribed by your kidney doctor. They contain fat soluble vitamins (A, D, E and K) which are more likely to build up in your body. Vitamin A is especially a concern, as toxic levels may occur with daily supplements.

Vitamin C supplements are recommended in a 60 to 100 mg dose. There is concern that if you have CKD, taking very high doses of vitamin C can cause a buildup of oxalate, which can be deposited in the bones and soft tissues.

How to Evaluate, Prevent & Manage Constipation in Aging

Constipation is not a glamorous topic, but it’s certainly important, especially in older adults.

As anyone who has experienced occasional — or even chronic — constipation can tell you, it can really put a damper on quality of life and well-being.

Constipation can also cause more substantial problems, such as:

  • Severe abdominal pain, which can lead to emergency room visits
  • Hemorrhoids, which can bleed or be painful
  • Increased irritability, agitation, or even aggression, in people with Alzheimer’s disease or other forms of dementia
  • Stress and/or pain that can contribute to delirium (a state of new or worse confusion that often happens when older adults are hospitalized)
  • Fecal incontinence, which can be caused or worsened by having a hard lump of stool lodged in the lower bowel
  • Avoidance of needed pain medication, due to fear of constipation

Fortunately, it’s usually possible to help older adults effectively manage and prevent constipation. This helps maintain well-being and quality of life, and can also improve difficult behaviors related to dementia.

The trouble is that constipation is often either overlooked or sub-optimally managed by busy healthcare providers who aren’t trained in geriatrics. They are often focused on more “serious” health issues. Also, since many laxatives are available over-the-counter, some providers may assume that people will treat themselves if necessary.

Personally, I don’t like this hands-off approach to constipation. Although several useful laxatives are indeed available over-the-counter (OTC), I’ve found that the average person doesn’t know enough to correctly choose among them.

Also, although in geriatrics we often do end up recommending or prescribing laxatives, it’s vital to start by figuring out what is likely to be causing — or worsening — an older person’s constipation.

For instance, many medications can make constipation worse, so we usually make an attempt to identify and perhaps deprescribe those.

In short, if you’re an older adult, or if you’re helping an older loved one with health issues, it’s worthwhile to learn the basics of how constipation should be evaluated and managed. This way, you’ll be better equipped to get help from your health providers, and if it seems advisable, choose among OTC laxative options.

Here’s what I’ll cover in this article:

  • Common signs and symptoms of constipation
  • Common causes of constipation in older adults
  • Medications that can cause or worsen constipation
  • How constipation should be evaluated, and treated
  • The laxative myth you shouldn’t believe
  • 3 types of over-the-counter laxative that work (and one type that doesn’t)
  • My approach to constipation in my older patients

I’ll end with a summary of key take-home points, to summarize what you should know if you’re concerned about constipation for yourself or another older person.

Common signs and symptoms

Constipation can generally be diagnosed when people experience two or more of the following signs, related to at least 25% of their bowel movements:

  • straining

  • hard or lumpy stools

  • a sense of incomplete evacuation

  • the need for “manual maneuvers” (some people find they need to help their stools come out)

  • fewer than 3 bowel movements per week

People often want to know what is considered “normal” or “ideal,” when it comes to bowel movements. Although it’s probably ideal to have a bowel movement every day, it’s generally considered acceptable to have them every 2-3 days, provided they aren’t hard, painful, or difficult to pass.

The handy Bristol Stool Scale can be used to describe the consistency of a bowel movement, with Type 4 stool often being considered the “ideal” (formed but soft).

Constipation is pretty common in the general population and becomes even more so as people get older.  Experts estimate that over 65% of people over age 65 experience constipation, with straining being an especially common symptom.

Other symptoms that may be caused by constipation in older adults

Constipation may be associated with a feeling of fullness, bloating, or even pain in the belly. In some people, this may interfere with appetite.

Although most older adults will admit to symptoms of constipation when asked, a person with Alzheimer’s or a related dementia may be unable to remember or relay these symptoms. Instead, they might just act out or become more irritable when they are constipated.

Prolonged constipation can also lead to a more urgent problem called “fecal impaction.” This means having a hard mass of stool stuck in the rectum or colon. It happens because the longer stool remains in the colon, the dryer it tends to get (which makes it harder to pass).

Impaction tends to be very uncomfortable, and can even provoke a full-on crisis of belly pain. It can also be associated with diarrhea and fecal incontinence.

Clearing out impacted stool can be hard to do with oral laxatives; these can even make things worse by creating more pressure and movement upstream from the blockage.

Fecal impactions are usually dislodged using treatments “from below” to soften and break up the lump, such as suppositories and/or enemas. (I address what type of enema is safest below.) They sometimes require help from clinicians in urgent care or even the emergency room.

Common causes of constipation in older adults

Like many problems that affect older adults, constipation is often “multifactorial,” or due to multiple causes and risk factors.

To have a normal bowel movement, the body needs to do the following:

  • Move fecal material through the colon without excess delay (stool gets dryer and harder, the longer it stays in the colon).
  • Coordinate a defecation response when stool moves down to the rectum, which requires properly working nerves and pelvic muscles.

As people get older, it becomes increasingly common to develop difficulties with one or both of these physical processes. Such problems can be caused or worsened by:

  • Medication side-effects (more on those below)
  • Insufficient dietary fiber
  • Insufficient water intake
  • Electrolyte imbalances, including abnormal levels of blood calcium, potassium, or magnesium
  • Endocrine disorders, including hypothyroidism
  • Slow transit due to chronic nerve dysfunction, which can be due to neurological conditions (including Parkinson’s disease) or can be caused by long-standing conditions that eventually damage nerves, such as diabetes
  • Irritable bowel syndrome
  • Pelvic floor dysfunction
  • Psychological factors, such as anxiety, depression, or even fear of pain during the bowel movement
  • Very low levels of physical activity
  • “Mechanical obstruction,” which means that the colon or rectum — or their proper function — is impaired by some kind of mass, lump, narrowing, or another physical factor
    • A tumor can cause this problem, but there are also non-cancerous reasons that a person can develop a mechanical obstruction affecting the bowels.

Medications associated with constipation

Several commonly used medications can cause or worsen constipation in older adults. They include:

  • Anticholinergics, a broad class which includes sedating antihistamines, medications for overactive bladder, muscle relaxants, anti-nausea medications, and more. (This group of medications is also associated with worse brain function; they block acetylcholine, which is used by brain cells and by the nerves in the gut.)
  • Opiate painkillers, such as codeine, morphine, oxycodone
  • Diuretics
  • Some forms of calcium supplementation
  • Some forms of iron supplementation (often prescribed for anemia)

It’s not always possible or desirable to stop every medication associated with constipation. If a medication is otherwise providing an important health benefit and there’s no less constipating alternative, we can continue the medication and look for other ways to improve bowel function.

Still, it’s important to consider whether any current medications can be deprescribed, before deciding to use laxatives and other management approaches.

If opioids are absolutely necessary to manage pain (such as in someone with cancer, for instance), a special type of medication can be used, to counter the constipating effect of opioids in the bowel. This is generally better than depriving a person of much-needed pain medication.

How to evaluate constipation

How to treat constipation basically depends on what appears to be the main causes and contributors to a person’s symptoms.

An evaluation should start with the health provider asking for more information regarding the symptoms, including how long they’ve been going on, as well as the frequency and consistency of stools.

It’s also important for the clinician to ask about “red flags” that might indicate something more serious, such as colon cancer. These include:

  • Blood in the stool (which can be red, or black and “tarry” in appearance)
  • Weight loss
  • New or rapidly worsening symptoms

The next steps of the evaluation will depend on a person’s medical history and symptoms. It’s generally reasonable for a healthcare provider to check for these common causes of constipation:

  • Medication side-effects
  • Low intake of dietary fiber
  • Low fluid intake
  • Common causes of painful defecation, such as hemorrhoids or anal fissures

Evaluation for possible mechanical obstruction will depend on what the clinician sees on physical examination, the presence of potential red flags, and other factors. Generally, a rectal exam is a good idea.

In a 2013 review, the American Society for Gastroenterology recommends that clinicians evaluate for possible pelvic floor dysfunction mainly in those people whose constipation doesn’t improve with lifestyle changes and over-the-counter (OTC) laxatives.

They also recommend diagnostic colonoscopy only for people with alarm symptoms, or who are overdue for colorectal cancer screening.

How to treat constipation

In most older adults with constipation, there are no red flags or signs of mechanical obstruction.

To treat these cases of “garden-variety” constipation, geriatricians usually use a step-wise approach:

  • Identify and reduce constipating medications if possible.
  • Increase dietary fiber intake and fluid intake, if indicated.
  • Encourage a regular toilet routine, with time on the toilet after meals and/or physical activity.
  • If necessary — which it often is — use over-the-counter laxatives to establish and maintain regular bowel movements.

The American Society of Gastroenterology recommends more in-depth constipation evaluation for older adults who fail to improve from this type of first-round treatment. Some older adults do have pelvic floor disorders, which can be effectively treated through biofeedback.

The laxative myth you shouldn’t believe

People often have concerns about using laxatives more than occasionally, because they’ve heard this can be dangerous, or risky.

This is a myth that really should be dispelled. Although medical experts used to worry that chronic use of laxatives would result in a “lazy” bowel, there is no scientific evidence to support this concern.

In fact, in their technical review covering constipation, the American Society of Gastroenterology notes that “Contrary to earlier studies, stimulant laxatives (senna, bisacodyl) do not appear to damage the enteric nervous system.”

(FYI: the “enteric nervous system” means the system of nerves controlling the digestive tract.)

Lifestyle changes and over-the-counter oral laxatives are the approaches endorsed as the first-line of constipation therapy, by the American Gastroenterology Society and others. There are no evidence-based guidelines that caution clinicians to only use laxatives for a limited time period.

The four types of OTC laxatives that I’ll cover in the next section have been used by clinicians and older adults for decades, and when used correctly, are considered safe and do not seem to cause any long-term problems.

That’s not to say that they should be used willy-nilly, or in any which way. You absolutely should understand the basics of how each type works, so let’s cover that now.

Three types of laxative that work (and one that doesn’t)

There are basically four categories of oral over-the-counter (OTC) laxative available. Three of them are proven to work. A fourth type is commonly used but actually does not appear to be very effective. Each has a different main mechanism of action.

The three types of OTC laxative that work are:

  • Osmotic agents: These include polyethylene glycol (brand name Miralax), sorbitol, and lactulose. Magnesium-based laxatives also mostly work through this mechanism.
    • These work by drawing extra water into the stool, which keeps it softer and easier to move through the bowel.
    • Studies have shown osmotic agents to be effective, even for 6-24 months. Research suggests that polyethylene glycol tends to be better tolerated than the other agents.
    • Magnesium-based agents should be used with caution in older adults, mainly because it’s possible to build up risky levels of magnesium if one has decreased kidney function, and mild-to-moderately decreased kidney function is quite common in older adults.
  • Stimulant agents: These include senna (brand name Senakot) and bisacodyl (brand name Dulcolax).
    • These work by stimulating the colon to squeeze and move things along more quickly.
    • Studies have shown stimulant laxatives to be effective. They can be used as “rescue agents” (e.g. to prompt a bowel movement if there has been none for two days) or daily, if needed.
    • Bisacodyl is also available in suppository form, and can be used this way as a “rescue agent.”
  • Bulking agents: These include soluble fiber supplements such as psyllium (brand name Metamucil) and methylcellulose (brand name Citrucel).
    • These work by making the stool bigger. Provided the stool doesn’t get too dried out and stiff, a bulkier stool is easier for the colon to move along.
    • Bulking agents have been shown to improve constipation symptoms, but they must be taken with lots of water. Older adults who take bulking agents without enough hydration — or who otherwise have very slow bowels — can become impacted by the extra fiber.
    • People with drug-induced constipation or slow transit are not likely to benefit from bulking agents.

(For more details regarding the scientific evidence on these laxatives, see this 2013 technical review.)

And now, let’s address the type of OTC laxative that is least likely to work.

The type of OTC laxative that isn’t really effective is a “stool softener”, such as docusate sodium (brand name Colace).

These create some extra lubrication and slipperiness around the stool. They actually have often been prescribed by doctors; when I was a medical student, almost all of our hospitalized patients were put on some Colace.

But, the scientific evidence just isn’t there! Because this type of laxative is so commonly prescribed, despite a weak evidence base, the Canadian Agency for Drugs and Technologies in Health completed a comprehensive review in 2014. Their conclusion was:

Docusate appears to be no more effective than placebo for increasing stool frequency or softening stool consistency.”

So, save your money and your time. Don’t bother buying docusate or taking it. And if a clinician suggests it or prescribes it, politely speak up and say you’ve heard that the scientific evidence indicates this type of laxative is less effective than other types.

Laxatives do work and are often appropriate to use, but you need to use one of the ones that has been shown to work.

About prescription laxatives

Newer prescription laxatives are also available, and may be an option for those who remain constipated despite implementing lifestyle changes and correctly used over-the-counter laxatives. These include lubiprostone (brand name Amitiza) and linaclotide (brand name Linzess).

But, it’s not clear, from the scientific research, that they are more effective than older over-the-counter laxatives. In its technical review, the American Society of Gastroenterology noted that “meta-analyses, systematic reviews, and the only head-to-head comparative study suggested that some traditional approaches are as effective as newer agents for treating patients with chronic constipation.”

Since these newer medications have a more limited safety record and are also expensive, they probably should only be used after an older person has undergone careful evaluation, including evaluation for possible pelvic floor disorders.

About enemas

Enemas are another form of “constipation treatment” available over-the-counter in the U.S.

The main thing to know is that the most commonly available form, saline enemas (Fleet is a common brand name), have been associated with serious electrolyte disturbances and even kidney damage. Because of this, the FDA issued a warning in 2014, urging caution when saline enemas are used in older adults.

Enemas certainly can be helpful as “rescue therapy,” to prevent a painful fecal impaction if an older person hasn’t had a bowel movement for a few days. But they should not be used every day.

Frequent use of enemas is really a sign that a person needs a better bowel maintenance regimen. This often means some form of regular laxative use, plus a plan to use a little extra oral laxative as needed, before things reach the point of requiring an enema.

If an enema appears necessary, experts recommend that older adults avoid saline enemas, and instead use a warm tap water enema, or a mineral oil enema.

My approach to constipation in my older patients

Generally, to help my older patients with garden-variety constipation, I start by checking for medications that are constipating, and then recommending prunes and encouraging more fiber-rich foods. As noted above, a randomized trial found that 50 grams of prunes twice daily (about 12 prunes) was more effective in treating constipation than psyllium (brand name Metamucil).

Then we usually add a daily osmotic laxative, such as polyethylene glycol (Miralax). If needed, we might then add a stimulant agent, such as senna.

We do sometimes try a bulking agent, but I find that many frailer older adults tend to get stoppered up by the extra bulk. Again, if you use a supplement (such as Metamucil) to put extra fiber in the colon but can’t keep things moving along fast enough, that extra fiber might dry out and become very difficult to pass as a bowel movement.

It usually takes a little trial and error to figure out the right approach for each person, so it’s essential for an older person — or their family — to keep a log of the bowel movements and the laxatives that are taken. If a person has loose stools or too many bowel movements, in response to a given laxative regimen, we dial back the laxatives a bit.

It’s also important to have a plan for “rescue,” which means adding some extra “as-needed” laxative (usually either senna or a suppository), if a person hasn’t had a bowel movement for 2-3 days. The goal of rescue is to avoid the beginnings of fecal impaction.

Last but not least, we also try to make sure an older person is getting enough physical activity, and to establish a routine of having the person sit on the toilet after meals.

With a little time and effort, we usually find a way to help an older person have a comfortable bowel movement every 1-2 days.  This does often require taking a daily oral laxative indefinitely, but this is quite common in geriatrics. And as best we can tell, daily laxatives are unlikely to cause harm, provided one doesn’t use a magnesium laxative daily.

The most important take-home points on constipation in older adults

Here’s what I hope you’ll take away from this article:

1.Know that constipation is common but shouldn’t be considered a “normal” part of aging. It deserves to be evaluated and managed by your healthcare providers.

  • Be sure to ask for help, if you’ve noticed any difficulties having a comfortable bowel movement every 1-2 days.
  • A log of bowel movements and related symptoms will be very helpful to your health providers.

2. If an older person with Alzheimer’s or another dementia is acting out, consider the possibility of constipation.

3. Be sure to speak up if you’ve noticed any “alarm symptoms.”

  • The main ones to look for are red blood in the stool, black or tarry stools, unintended weight loss, and new or worsening symptoms.

4. An initial evaluation of constipation should include the following:

  • A review of concerning symptoms
  • A review of diet, fiber, and fluid intake
  • Checking for medications that cause or aggravate constipation (especially anticholinergics) and making sure that any prescribed iron is really necessary
  • A rectal exam

5. Most garden-variety constipation can be effectively managed through a combination of lifestyle changes, deprescribing constipating medications, and using over-the-counter (OTC) laxatives.

  • Lifestyle changes to consider include avoiding mild dehydration, eating fiber-rich foods, getting enough physical activity, and encouraging a regular toilet routine (e.g. sitting on the toilet after meals).
  • Anticholinergics and other constipating medications should be deprescribed whenever possible.
  • Daily prunes are especially effective as a “natural” laxative, since they contain soluble fiber and exert an “osmotic laxative” effect.

6. It is often ok to use OTC oral laxatives daily or regularly.

  • Many older adults will need to use OTC laxatives to maintain regular bowel movements.
  • There is no credible evidence that it’s harmful to use OTC oral laxatives long-term.

7. Three types of OTC laxative have proven efficacy: bulk-forming fiber supplements, osmotic laxatives, and stimulant laxatives. It often takes some trial and error to find the right regimen for a person.

  • Osmotic laxatives such as polyethylene glycol (brand name Miralax) are well-tolerated by most older adults, and can be used daily.
  • Fiber supplements such as psyllium (brand name Metamucil) are usually effective, provided an older adult drinks enough fluid and doesn’t suffer from a condition causing slow colonic transit. Fiber supplements that get dried out in a slow colon can worsen blockage.
  • Stimulant laxatives such as senna are often helpful, and can be used in combination with an osmotic laxative. They can be used daily or as needed, for “rescue therapy.”

8. “Stool softeners” such as docusate sodium (brand name Colace) do not appear to be effective. Don’t bother taking them.

9. It’s best to have a bowel maintenance plan and also a “rescue plan.”

  • Your health providers can help you determine which additional laxatives to use “as-needed,” if a person hasn’t had a bowel movement for a few days.
  • Frequent use of “rescue” laxatives usually means the regular regimen should be adjusted.

10. Be prepared to do some trial and error, to figure out the best way to manage chronic constipation in any particular person.

  • Be sure to keep track of bowel movements and what laxatives you — or your older relative — are taking.
  • Your clinicians will need this information in order to advise you on how to further adjust your laxative use.

I hope you now feel better equipped to address this important issue for yourself, or on behalf of an older loved one. Please post any questions or comments below!

Milk of Magnesia

IBS Tales Home > Treatment Reviews > IBS Medications > Milk of Magnesia

Overall rating 5/5

based on 37 reviews

Milk of magnesia (magnesium hydroxide) is most commonly found as a liquid. The magnesium in the liquid can both neutralize excess stomach acid to treat indigestion and, if taken in slightly larger doses, act as a saline laxative. This means that the magnesium works to pull salt or a saline solution from the blood into the intestines, therefore increasing the amount of water in the intestines and causing a laxative action. Milk of magnesia is generally considered to be one of the more gentle laxatives, as opposed to stimulant laxatives such as Dulcolax.

The best known form of milk of magnesia is the chalky-tasting liquid which comes in bottles, such as Phillips milk of magnesia. This liquid is available in the original, non-flavored form or with added flavors such as cherry. Milk of magnesia is also available in chewable tablet form.

Milk of magnesia side effects

The most common side effects of milk of magnesia are diarrhea, gas, stomach cramps and increased thirst.

REVIEWS OF MILK OF MAGNESIA

Review by Anon

I have now been taking milk of magnesia regularly for two and a half years. I had IBS for a long time before this but it didn’t completely stop my bowel function until two and a half years ago.

Although I still feel somewhat bad about being dependent on a laxative, I am totally satisfied with milk of magnesia. It is as natural, pain-free and cramp-free as a normal bowel movement without a laxative would be.

I take two tablespoons two or three times per week. Although the stools are loose (sometimes diarrhea) it is far better than constipation. The movements continue for a few hours in the morning and then stop. Then, I can go out. It can work within a few hours so I tend to stay up late on the days that I take it so that it doesn’t start working too early in the morning.

In conclusion, I just hope that it will always work and that it will never be withdrawn from the market. Nothing else works as good as this! It has been around for a long time.

Review by Denise

I have had IBS since I was eight. I had the constipation and diarrhea but as I got into my late teens to twenties it went all to constipation. I go maybe two times a week and it’s those round little poops! I have so many other health problems like interstitial cystitis, fibromyalgia, scoliosis, TMJ, nerve damage in both legs…I’m not going to list everything or I will be typing a novel!

I started taking milk of magnesia. I take the child dose. I cannot take anything but MOM as the others just cramp me so bad and give me diarrhea. MOM gives me a normal bowel movement! It’s so nice. It sometimes takes a day or two to work, plus I am on pain meds which doesn’t help with constipation, but I am happy that MOM works well and is so gentle.

When I tried the pills I took two and they cramped me but did not make me go. I’m not sure why the pills cramp me but the liquid doesn’t. I hate the taste, I always hold my nose! I do take Bentyl when my IBS is acting up as it really takes the cramping away. I hope everyone is having a good day.

Review by Kathy

I was diagnosed with IBS at least 20 years ago and gastritis due to an over-acidic stomach. I would throw up stomach acid. I had a gastric sleeve done in 2012 and I lost 110lbs. After one year my stomach eased up and the acid problem went away. After three years I broke three teeth in a month so I started having trouble eating because of the pain. I started eating pop tarts and Cheetos. I went into what I think was like malnutrition and within a three-month period my thyroid went out of whack and my iron level dropped to 20. I gained weight back every so often because my thyroid goes out of whack every so often.

I take three of the pill-form milk of magnesia every two days. It takes two days for the pills to work on me. I take them on Monday and bave a BM on Wed. It takes longer but the pills are easier to take than the nasty liquid.

Review by Rebecca

I’ve been diagnosed with IBS with redundant colon. I had been taking a fiber laxative for a year but it stopped working. I tried almost everything and forgot about MOM until I read about it online. I have a longer colon so I have to take the maximum dose every night, but then in the morning I have a number of loose watery stools (not diarrhea). I can hold it for a short time but I have to be near the bathroom for a couple of hours.

If I don’t take it or I take the minimum dose I get constipated. I would rather have watery stools daily then use an enema a few times a week, or prescription meds, so I have found it works well. I also lost seven or eight pounds of bloat and water weight.

Review by Christopher

I’ve been an IBS sufferer for 15 years. After two weeks of rabbit pellets or no bowel movement at all I was feeling really down as well as terribly uncomfortable. My sister mentioned milk of magnesia and I looked at her as if she had eight heads. Desperate, however, I Googled the product and found this site with its recommendations, so off I popped to the local supermarket and bought a bottle. I took 60ml (more than they recommend for constipation which is 45ml) followed by a pint of water…and waited.

Within an hour I felt ‘rumblings’ in my tummy and I started to fart and burp which, for me, is good because when I have ‘rumblings’ in my tummy and I fart and burp I actually feel relief! Even though I hadn’t had a bowel movement before bed I slept better knowing that things seemed to be working in my gut.

Within an hour of waking this morning I was on the toilet and delighted with my successful evacuation. It wasn’t as soft as I had expected and it wasn’t diarrhea which I also thought may occur, but it was a decent size and most importantly it was out! I’ve been back to the toilet three or four times since and each time my stool has been very soft.

I am now hoping that some normality returns to my bowel movements, but I feel much better having been today and also in knowing that if I get bothered again I can depend on dear old milk of magnesia!

Review by Adam

I did not have a BM for about a week, and it was very hard to go to the bathroom. I was afraid to eat because I didn’t want any more trouble. I tried everything. My sister got me some docusate stuff and not only did it taste like chemicals it did not usually do what it should have done and when it did it messed me up.

I tried a fiber drink and prune juice and nothing happened. I didn’t want to use a Fleet enema. Lo and behold my sister-in-law came through with some milk of magnesia and what a trick it did. The only thing about that was that it woke me up at three in the morning, but when I had to go I went and went well.

Review by Mike

I too have suffered from constipation and I have found that milk of magnesia has helped me. One problem I have is closing of my throat as I start falling asleep, and I also get hives. I have read that the side effects from MOM can be ‘closing of the throat’ and hives. I pass this info along to anyone who maybe has the same problems that I do.

Review by Kris

When I’m suffering from IBS and chronic constipation a high fiber diet usually works for me, but when I can’t eat normally I suffer from very hard stools and serious constipation. After seeing the reviews on this site I decided to try milk of magnesia instead of the usual stool softener, because I didn’t want to suffer for several days while waiting for the stool softener to take effect.

I was very happy with the results: within two hours of taking mint-flavored Phillips milk of magnesia I had very gentle relief with no after-effects. I can’t convey quite how relieved I am and I would encourage anyone who hasn’t to try milk of magnesia when suffering from hard stools. It will be my go-to for relief from now on and I can’t believe I’ve overlooked such an old school, yet effective medicine for so long.

Review by Brian

I’m a recent transplant to Florida. Since my arrival in the sunshine state 10 months ago I have suffered from IBS, anal sphincter spasms and constipation. Initially I thought my diet was to blame for my difficulties so I decided to change my eating habits. After several weeks of being on a liquid diet I made a slow transition back to solid foods only to experience the same problems. This continued for several more months and was getting progressively worse.

I tried everything from prune juice, Dulcolax, Metamucil and in extreme cases oral magnesium citrate liquid to alleviate constipation and soften the stool. These products only provided temporary relief.

Tired of suffering the same fate I began reading about my symptoms on the internet as this was all new to me. Lo and behold I ran across this site. Never in my wildest imagination did I consider milk of magnesia (MOM) the answer to my prayers. After all, MOM has been on store shelves for decades and the product never crossed my mind.

Excited about this revelation I immediately ran to the store and purchased a bottle of MOM. I waited until that evening and took a teaspoonful followed by a glass of water. The next morning I had a very soft stool. I have taken the product several times since and I have not experienced one problem. I truly believe my constipation and IBS issues are behind me. Pardon my pun!

Review by Lois

I have suffered from constipation all my life. I am now 49 years old. During my thirties I was diagnosed with IBS, a hiatus hernia and reflux oesophagitis. I have struggled for years trying to control symptoms from one end of my gut to the other. The constipation I suffered from during my two pregnancies was so severe the straining of trying to go caused my bladder to become overactive and I had to spend several weeks wearing a catheter 24/7 to try and rest it. I believe the straining of trying to pass a motion caused my hiatal hernia and chronic constipation contributed to indigestion and heartburn.

I was prescribed several different medications for my constipation-related IBS including Fybogel, Colofac, Dulcoease (stool softener) and Movicol. However the only thing I found effective was Senokot granules. Unfortunately these always caused severe cramping and diarrhea and I had to be prepared to sacrifice the morning dealing with this, so I couldn’t take them every day.

Over the past few months my constipation has become so bad I have not been able to go naturally at all and to my dismay Senokot granules have been removed from sale. I had also started to suffer symptoms of noisy rumbling and excessive flatulence. I don’t know why I had forgotten about milk of magnesia as I was sometimes given it as a child. After reading the reviews on this website a few weeks ago I decided to give it a try. The result was wonderful, a good night’s sleep and no cramping with a normal easy-to-pass bowel movement the very next morning.

I have continued to use MOM two to three times a week and have not looked back. I feel a different person and amazingly my digestion and upper gastric problems have improved. I was definitely suffering from depression up until recently but now that has lifted, and I’m sure I read somewhere that magnesium can help with depression and anxiety. MOM is sold in all major supermarkets at about half the price of a prescription. One capful is all I need to take and a bottle lasts me a couple of weeks. I only hope it will never be withdrawn from sale.

Review by Natalie

I was diagnosed with IBS seven years ago, switching between diarrhea and constipation. My stomach has been unsettled for such a long time that I had forgotten what it feels like to not be in pain or discomfort or in a panic about finding a bathroom. I recently was in a bout of constipation, not being able to go to the bathroom for four days and then not feeling as though it was a complete movement. The bloating and gas was unbearable. I tried a high fiber diet, lots of fruit, veggies, flax, whole grain and tons of water. Nothing helped.

After a month and a half I couldn’t take it anymore. I went to my doctor again, not knowing what he would say or suggest. I figured that it would be like my many other visits and he would tell me that there is no cure for it, and that I was a healthy 30 year-old woman. But this time he suggested milk of magnesia. I was definitely skeptical, thinking why didn’t he suggest this before if it would help? But I was desperate and was ready to try anything.

Well after two tablespoons and a good night’s sleep I finally was able to have a bowel movement, a few actually. But I have never felt so relieved as I did after using milk of magnesia. I am a little worried about what will happen after I stop taking it, but at least I know that this is something that works.

Review by Kelly

I have commented on this before, so this is just an update. MOM is a Godsend. I’ve been taking three tablespoons every week or so. The only problem with it is that it causes watery stools. I wonder if anyone else has had this problem? I may try one or two tablespoons every other night and see if that works better. Also, since I already drink six to eight glasses of water a day, I wonder if it’s necessary to drink 8oz with it? PS: Use the cherry flavored kind. Tastes fine.

Review by Kelly

I was diagnosed with IBS with alternating constipation and diarrhea three years ago and I’m a 31 year-old female. I had an episode where I was unable to move my bowels for two weeks. I looked nine months pregnant and the cramps were killing me. My gastro doctor had me on all different types of anti-spasmodic medication and nothing helped. When I first learned I had this condition I used everything from Miralax and fleet enemas to suppositories and again none of these would relieve the pressure and cleanse me like I needed to be.

My primary doctor was the one who told me to drink a large amount (I had to drink half a bottle) of milk of magnesia. At first I looked at him like he had 10 heads. The idea that all the pain could have been stopped with a little OTC medication was insane. Of course off I went to try it. Thank God I did. I love this product. I now know how much to use to get the job done. It worked very fast, and cramping was nothing compared to other products I’ve used. Depending on your dose you can still go out and run you errand a few hours later and not worry. Unless you take the amount I had to, then you should just stay in for the day and relax. I’m so happy to have found MOM.

Review by Dot

After becoming dehydrated (I did not drink enough water) and having the hard stool affect my motility, I mentioned this to my gynecologist after having a hysterectomy. I had tried the standards – Citrucel, Colace etc, and she said there was no reason for me to be in such pain, which was coming on after going to the bathroom. I mentioned to my GI that I had just had surgery and could not strain. He said to try milk of magnesia. It took him two years to offer any advice, but it did help. I am debating right now whether to take it again, a few years later, as I’m suffering from hard stools and flatulence. I am 70 and still a hard-working grandmother.

Review by Sharron

I have always had bowel problems, but at this age (59) it was getting worse. Seven years ago I was tested and they found diverticulitis. Then about three months ago I was diagnosed with IBS. Probably had it all along. Same symptoms as many of the people here, the usual stuff.

I was put on Dicetel, which was pretty good for cramps and pain, but I was still not going right. Then I started taking milk of magnesia – wow, great. For the first time in years I felt empty and light without all the pain and cramps. Just been doing it for three days now so I am going to cut back and slowly incorporate some insoluble fiber, which I had to give up and go for soluble fiber only. I will try to take one tablespoon only every other day. I did start with the recommended two tablespoons at bedtime followed by lots of water, then one-and-a-half, then one.

Review by Colin

I have been suffering from painful stools for over five years off and on. Recently they have become more frequent. They would be so severe that anal bleeding would accompany the hard stools. My specialist instructed me to take 20-25 grams of fiber a day for three weeks and everything should return to normal. I tried it and it didn’t work. I had more pain because of more movement and still no relief.

One evening I found this website. I was in intense pain. After a bowel movement I would be incapacitated for at least six hours, and sometimes for two days because of the tears in my tissue. I was desperate and willing to try anything. I tried Dulcolax, but it didn’t do too well for me. So, I found this page and after reading all of the good reviews about MOM, I had to try it out.

I prayed, drank my first dose, had a bowel movement the next morning and I’ve been thanking Him ever since! No more pain, no more bleeding. Milk of magnesia is just what the doctor ordered. I take about one or two tablespoons a night. I am 230lbs and a former pro athlete. I am mostly muscle, so I have to take a larger dose.

Review by Jeanne

I was diagnosed with IBS six months ago. I just stopped being able to go to the bathroom on my own at all. This was beyond constipation. My gastroenterologist recommended a high fiber diet. I tried that for several months and continued to get worse with pain, pressure, and bloating. Finally I decided to try milk of magnesia on my own. I take a full dose using the cup provided, and I am doing fine now. I am so grateful because I was at the end of my rope.

Review by Gail

I was surprised when my doctor prescribed milk of magnesia for my IBS. I have had IBS for years and nothing worked. My mother use to treat my constipation with MOM but I had forgotten about it. You may have to figure out what dosage is best for you. I have been very successful on two caplets a day. When starting out you may want to use the liquid MOM. Drink lots of water with it and you may be very happy with the results.

Review by Natasha

I’ve had severe IBS-C for almost nine years now. I tried milk of magnesia a couple of years ago and it did not help at all. I was up almost all night with severe gas, bloating, and cramps. It didn’t agree with me sadly.

Review by Allison

I have tried everything to help with my constipation/IBS symptoms, and only suppositories have worked until recently, but now they only cause horrible gas. I had to give them up pronto, but I decided to buy a bottle of milk of magnesia. And lo and behold, the next morning I was happy to have some awesome movement. It seemed to continue throughout the day though, which kept me from doing my daily workout. But I will give up one day of running for daily movements. I think milk of magnesia is the only cure for me at this point. And as a bonus, magnesium seems to help with my athleticism and acne. Strange but awesome.

Review by Tammi

I have had some constipation in my life on and off since I was a little girl, but it was never anything like what I began experiencing a few months ago – severe unbearable constipation, incredible abdominal pain and cramping, and bad gas from taking fiber and laxatives to try and cure the problem.

After five separate ER visits I was finally diagnosed with IBS and prescribed Miralax and fiber supplements which provided no relief. Next I was given Lactulose and Colace, still no relief. I tried everything OTC, Dulcolax, Exlax, senna, etc. Nothing helped! Only uncomfortable enemas provided some relief.

Finally out of desperation I tried milk of magnesia, and it worked like a charm the very next day! I now take two tablespoons every night, it works so well. The only worry I have is whether it is OK in that dosage for long-term usage.

Review by Lauren

I’m a 54 year-old female who’s had IBS-C for more than 20 years that I know of for sure. I also have diverticular disease, and in September, 2007 had part of my colon removed, still leaving disease, just not as bad, in the rest of my colon. Since the surgery, my bowels have been functioning even worse than they already were.

The only relief that I’ve found is milk of magnesia. The surgeon yesterday advised that I use one tablespoon daily, and I’m hesitant to do that, since I have almost an immediate response to the drug, and it does weaken me from so much elimination. I don’t want to be chained to the bathroom! I will decide how to proceed from here, but I’m grateful that there is a product that can give me relief. I’ve tried so many others, including Miralax, to no avail. I’m on a fiber-high, healthy eating plan, and I drink enough liquid. None of that has helped. Milk of magnesia does.

Review by Dale

I am a 66 year-old female and I have had IBS-C all of my life. A doctor prescribed Senokot granules when I was in my 40s. It was like a miracle. Two teaspoons in hot water every night and I had no symptoms of IBS for almost 25 years. Then it was discontinued. The Senokot pills didn’t work. For the past four years I have tried everything – Zelnorm, Amitiza, Miralax, fiber and 10 glasses of water. Nothing helped.

I finally tried milk of magnesia because of the positive reviews on this site. It definitely works better than any laxative I’ve tried since Senokot. I take three tablespoons as needed (about every four to six days). However, it causes watery stools the next morning. I do feel better, though, and I don’t have bloating for a few days afterwards. I may try taking a teaspoon every night, as suggested by other reviewers. I would definitely recommend it.

Review by Ann

I’ve suffered with the painful cramps of IBS for years. No doctor has ever offered any help other than Bentyl or Levsin to help with the spasms. My IBS constipates me and laxatives only made the cramps and spasms worse. A friend suggested I try milk of magnesia and it has made a world of difference. I no longer have the knife-sharp cramps and the feeling of not fully emptying my bowels.

The milk of magnesia gave me gentle, positive relief. It’s wonderful. Every evening I take a tablespoon of the cherry flavor which is very tasty. I’m not worried about it becoming habit forming because it does the job. It’s an old remedy so why don’t doctors tell us about it?

Review by Jason

I have been taking milk of magnesia for about two months now. I am 22 years old, and because of a recent car accident I was prescribed oxycontin which is an opiate painkiller. One of the side effects of this pain medication is constipation. Before I discovered milk of magnesia I wouldn’t be able to go for days, it was torture. I’ve tried everything, Exlax pills, fiber pills, etc.

I took a capful of milk of magnesia in the evening and lo and behold the next morning I was flowing like Niagara Falls. It was such I relief and I am very happy with the results.

Review by Janet

I have had IBS with constipation all of my life. I am 60 years old, and it started as a child. At the time my mother took me from one doctor to another, I was constantly having stomach pain and couldn’t go to school. I was finally put in the hospital for tests and lo and behold, I was impacted, who knew?

I am now seeing a specialist who I love and respect after seeing many GI doctors who just rolled their eyes at me. I have taught myself through much research how to eat and what to avoid eating, especially only insoluble fibers, no wheat, no dairy, nuts, legumes, etc.

This is not a very nice way to live your life, but I have made the best of it with the help of my doctors. My doctors didn’t want me on Zelnorm, side effects worse than the cure, Citrucel and such make everything worse, and Miralax does not work, so I take milk of magnesia every night with a large glass of water. I drink peppermint tea for pain, and also take Bentyl for bad pain if I am going through an episode.

This is not fun, but I feel better than I did, knowing that I am not alone in this. I have been on a low dosage of Prozac for a short time, don’t really know if it helps, but it’s a vicious circle, this disorder. I also have an anxiety disorder, which I take Xanax for, which also helps the IBS.

My doctors told me just last week to take milk of magnesia, and it is gentle, no cramping and it works for me without side effects. Diet, exercise, and peppermint tea are also wonderful for cramping, flat ginger ale for the nausea, also ginger tea does wonders to calm the IBS.

Review by Neil

It’s pretty certain I have had IBS for many years, but recently it has almost come to an end. After at least five or six years of seeing the doctor every now and then I was at last referred to a specialist. It was recommended that I take milk of magnesia each night, and to find the level that suited me: I was told I could take five to nine 5ml measures from the cap of the container for this, but I take between four and six, dependent on diet.

The specialist advised me that by taking on board more fruit and fiber I might not need so much, but would probably not be able to ever stop taking it completely. In short, after much delay I can assure you all it’s a minor miracle as I am virtually free of all the IBS symptoms/issues. It has also improved my acid indigestion. If only there was one potion for all ailments.

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.

Parkinson’s Treatment Tips for Constipation » Movement Disorders & Neurorestoration Program NORMAN FIXEL INSTITUTE for NEUROLOGICAL DISEASES » UF Health » University of Florida

Constipation is an alteration in stool frequency, consistency, and/or passage of stool. The normal pattern of bowel movements can and will vary by 1 to 3 days. A stool-voiding pattern of every day or every other day is encouraged.

Causes

  • Change in diet or activity
    • Lowered activity – Exercise and increased activity will assist in establishing regular bowel patterns.
    • Diet – Be sure to include fiber-rich foods:  bran, whole-grain breads – oat, rye, fruits, vegetables (leave peel on), whole-grain cereals, oatmeal, pasta, nuts, popcorn and brown rice.
  • Medical Reasons –  cancer, pregnancy, hemorrhoids, neurological disorder, muscular disorder, intestinal inflammation.
  • Medications –  narcotics, sedatives, antacids, antispasmodics, iron supplements
  • Not drinking enough fluids – Drink at least 6 to 8, 8 ounce glasses of fluids per day. This is all inclusive (everything you drink like water, tea, coffee, juice, colas, etc.), but water is best, and we encourage you to drink primarily water. Bladder patients should reduce fluid intake after the evening meal.

Note that the daily recommended fiber intake:  20 – 30 grams

A Natural Recipe

Miller’s (unprocessed wheat) Bran*        1 cup

Applesauce                                      ½ cup

Prune Juice                                      ½ cup

Mix these ingredients together and refrigerate. Replace the mixture each week. Take 1 – 2 Tablespoons daily for one week for desired results. If needed, you may increase dose by 1 Tablespoon each week. Stool frequency and gas may increase the first few weeks but will usually adjust after one month.

*Miller’s Bran is unprocessed wheat bran. This may be purchased at most large grocery stores and is found with either the hot cereals or flours and baking goods. The most commonly found brand name is Hodgson Mill and it comes in a brown 14 oz. box. Miller’s Bran may also be purchased in bulk at health food stores.

You can also sprinkle bran on food to supplement your fiber intake.

Bowel Clean Out

The bowel clean out should be done before starting on the bowel program that is outlined for you by your physician. This should be done on a day when you will be at home all day to minimize the risk of accidentally soiling your clothes. The bowel clean out is a two-part procedure:

In the morning take 2 oz. of Milk of Magnesia and follow that with a hot drink. This could be hot coffee, hot tea or even hot broth. This helps to stimulate the bowel and enhance the effects of the Milk of Magnesia.

That evening, after dinner, give yourself a Fleet enema. This helps to make sure the rectum is empty. You should be able to rest the night without worry or discomfort.

This procedure may be repeated the next day if needed.

Medications

  • Bulk producing:  Metamucil, Fibercom or Citrucel. Mix 1-2 Tablespoons in juice or water and take by mouth 1 to 2 times daily. This adds consistency or bulk to the stool and facilitates water retention in stool – must take adequate fluids by mouth to avoid causing constipation.
    • Note: some practitioners do not recommend these but other practitioners find it useful. See the quote below.
  • Stool Softeners:  Colace. Softens stool by facilitating the admixture of fat and water (detergent activity). Do not use with mineral oil. Take 1 tablet by mouth 1 to 2 times daily.
  • Combinations:  Pericolace. Mild stool softener and laxative combined. Take by mouth 1 to 2 times daily.
  • Irritant/Stimulant:  Products containing Senna. Laxative with direct action on the intestinal mucosa and the nervous plexus of the bowel.
  • Suppositories:  Glycerin, Dulcolax. Inserted rectally every other day or when needed. Stimulates the rectum and assists with evacuation.

Dr. Janis Miyasaki at the University of Toronto, recently shared her experiences in treating constipation in PD patients over many years, and I have found her approach particularly helpful (here is a blurb from her):

I learned in practice never to ask patients, “do you have a problem with constipation?” Most People With Parkinson’s don’t have a problem with constipation – they’ve been living with it for years. Now, I ask, “how often do you have a bowel movement?” Most people – even with Parkinson disease – can have a bowel movement every day. Constipation is present in more than 60% of patients and may occur even before motor symptoms like tremor and stiffness start.

Constipation is a problem because stomach emptying is also slow. As a result, your pills don’t get delivered to the part of the bowels where they can be absorbed. Your pills may be less effective. You will feel bloated and uncomfortable. Your appetite may reduce. There is evidence that constipation increases your risk for bowel cancer. In extreme cases, bowel obstruction may occur. This means that your bowels can not move because all of the stool (poop) in your gut. This is a problem because the blood supply to the gut is also blocked and your bowels can have a “stroke”. Then you will need to have surgery and possibly an ostomy bag (the gut is attached to your abdominal wall and a bag collects your stool and must be emptied at least daily).

Prevention is the key! Exercise, proper diet and enough water to help your bowels work are essential (generally eight glasses of water a day or more if you are sweating – this is more than your body needs to keep hydrated, but enough to keep your stool soft). Changing the diet to include more whole grains, avoiding white bread, pasta and rice will also help.

Your body wants to have a bowel movement in the morning. Help it by taking hot oatmeal in the morning with a hot strong cup of coffee. You can add dried figs or dates.

Avoid Metamucil or other forms of psyllium since in the slow gut, this tends to become hard and make constipation worse in Parkinson disease.

Polyethylene glycol 1350 or Miralex (available in drug stores over the counter) is also effective in Parkinson disease. The dose used in a study was 7.3 grams of macrogol dissolved in 1 cup of water twice a day.

If this doesn’t work, ask your Primary Care Physician, neurologist or movement disorders specialist for prescribed medications.

Get more Parkinson’s Treatment Tips…

References:

Ramjit AL, Sediq L, Leibner J, Wu ss, Dai Y, Okun MS< Rodriguez RL, Malaty IA, Fernandez HH. The relationship between anosmia, constipation and orthostasis and Parkinson’s disease duration: results of a pilot study. Int J Neurosci 2010 Jan;120(1):67-70.

Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, Miyasaki J, Iverson DJ, Weiner WJ. Practice parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74(11):924-31.

A Florida Blog by Michael S. Okun, M.D.

UF Center for Movement Disorders & Neurorestoration, Gainesville FL

Health: Science and technology: Lenta.ru

A 38-year-old man was diagnosed with serious liver damage due to the intake of magnesium sulfate (magnesia), which is recommended by naturopaths as a means of “detoxification” of the body. The patient used magnesium to get rid of gallstones, but the side effects of this remedy can be deadly. An article describing the case was published in the medical journal BMJ Case Reports. This is reported by Science Alert.

Magnesium sulfate is a drug used by physicians as a laxative or against eclampsia in pregnant women.However, magnesia is also used in alternative medicine to cleanse the body of “toxins” and “toxins”, although there is no scientific evidence for the “detoxification” of the body with this substance.

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00:05 – August 20, 2016

It is reported that the patient drank 50 grams of magnesium solution every day for two weeks according to one of the recommendations. The man hoped that the remedy would help expand the bile ducts and facilitate the passage of stones. On the 12th day of treatment, he lost his appetite, and his urine darkened strongly.Two days after completing the course, he noticed yellowing of the skin and eyes, which is a sign of severe liver damage.

While vomiting and diarrhea may cause side effects from magnesium for most people, long-term use can lead to a drop in blood pressure, respiratory depression, and impaired cardiac conduction.

The doctors noted that the patient’s liver functions began to return to normal only more than a month after hospitalization.

Naturopathy is a type of alternative medicine based on the belief that some processes in the body are controlled by a supernatural force, and diseases need to be cured with the help of natural substances.Fasting and detoxification are the main and popular practices. Scientists and doctors criticize these approaches, noting that naturopaths do not have a precise definition of “toxins” (in biology, toxins are called poisons produced by living organisms). In addition, a number of scientific tests have shown that naturopathic methods have no therapeutic effect.

Magnesia Milk: Benefits

Magnesium is an essential mineral for the body as it helps to carry out vital functions, especially for muscles and nerves.There are many magnesium supplements available that provide the body with the required daily intake so that it does not suffer from a deficiency of this mineral.
This is the case with milk of magnesia, an aqueous suspension of white color, the result of a mixture of water with magnesium oxide, which has the ability to reduce stomach acid and increase the amount of water present in the intestines. This can be of great help if you suffer from constipation and heartburn.
Other Benefits:
Laxative
Acts as an osmotic laxative because the substance has the ability to draw water into the colon from the surrounding tissue.This allows the stool to circulate more freely, avoiding irritating constipation. You can feel the effect after half an hour, maximum six hours.
Leather
Used as an ingredient in cosmetic and medicinal skin care products. The product is mainly suitable for getting rid of excess oil on the face. In addition, the milk of magnesia has a mattifying effect, which is ideal for removing oily sheen.
Bones
Very good for regulating calcium levels in the body, making magnesium an excellent natural remedy to help maintain strong bones, teeth, hair and nails.It also prevents calcium in the form of oxalates from being converted into kidney stones.
Acne and skin pigmentation
In this case, the milk of magnesia works wonders. If you have acne, it will help regulate oiliness, which will also be very helpful if you have oily skin. The active ingredients act on the different layers of the skin to prevent clogging and infection of the pores. It can also be used as a home remedy to lighten age spots that are caused by pregnancy, the sun or diabetes.
Deodorant
If you suffer from excessive perspiration, Magnesia Milk will help keep you fresh and fight off unpleasant sweat odor. In addition, it is a natural ingredient that does not stain clothes.
Burns
The milk is endowed with antioxidant properties thanks to its rich content of vitamin C, which helps damaged skin to regenerate faster. In the event of a burn, apply milk of magnesia to the affected area to soothe and moisturize damaged skin, preventing blistering and scarring.
Irritations
The component can be used even for babies. Magnesia Milk is rich in Vitamin A to moisturize and soothe baby’s delicate skin. It has a very liquid texture, which makes it easier for the skin to absorb, preventing dryness. Therefore, one of the best uses is to soften the skin and relieve irritation caused by the continuous use of diapers.
Weight Loss
There is scientific evidence that one of the great benefits of milk of magnesia is its ability to stimulate various metabolic processes.It is especially good for activating digestive enzymes and better absorption of nutrients.
Magnesia can be consumed in liquid form or in tablets.
Although the drug is safe, keep in mind that it can cause some of these side effects:
Upset stomach
Vomiting
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Impact – Rogaška Medical Center

The ratio of acids to bases is of paramount importance for metabolism. Normal cellular metabolism requires a balance between acids and bases. The state of proteins, the structure of cellular components, the permeability of membranes, enzymes and hormones, the distribution of electrolytes and the structure of connective tissue depend on this balance.

The acid-base state of the body is determined by measuring the pH of the blood, which in healthy people is 7.4. If, due to illness, the pH value drops below 7.37, metabolic disorders occur as a result of acidification (acidosis), an increase in pH to 7.44 leads to an excess of bases (alkalosis). As you know, each cell fluid has its own specific pH (for example, gastric juice: 1.2 – 3; saliva: 7.0; pancreatic juice 8.0; urine: 5.6 – 7.0).

The body has effective regulatory mechanisms (buffer systems in the blood, lungs, kidneys) to maintain pH within narrow limits, but, despite this, the acid-base balance is easy to disturb.Disorders of acid-base balance can occur as a result of pathological causes (diabetes mellitus, hyperaldosteronism, chronic renal failure, alcohol intoxication, hypokalemia, edema, etc.), as well as due to certain medications, infections and malnutrition (obesity) …

Acid-base balance is one of the foundations of a healthy lifestyle
According to the prevailing opinion of modern medicine (varies from country to country), food should not affect the acid-base balance in the body.Studies have shown, however, that imbalance is most often due to diet, which leads to increased production of acids in the body.
The body has its own mechanisms to neutralize excess acids. Excessive consumption of processed and “empty” food, animal protein and concentrated carbohydrates limits their capabilities.

The body cannot remove all the acids accumulated in the intercellular space, as a result of which the acid load on tissues and organs increases.By losing alkaline minerals, the body tries to deposit excess acid and toxins into the intercellular space in the joints. Due to the overload of the body, this “temporary storage” turns into a dump, which affects all metabolic processes in the body.

The consequences of chronic oxidation are: deficiency of certain minerals, chronic fatigue (“burnout syndrome”), sleep disturbances, digestive problems, impaired concentration, muscle cramps, diarrhea, headache, nervousness and much more.A constant influx of acids into the body can lead to certain diseases such as osteoporosis and certain types of kidney stones, cardiovascular disease, inflammatory degenerative changes in the musculoskeletal system, gout, type 2 diabetes, uric acid elevation, allergies, dentin (teeth ), disorders of the autonomic nervous system and many others.

Oxidation of body fluids leads to a change in the properties of red blood cells. They become less elastic, deformed and lose the ability to change their appearance.It is more difficult for them to pass through the capillaries, so they gather in clusters in the form of plugs. The viscosity of the blood decreases, as well as the local saturation of tissues and vital organs (heart, brain) with oxygen.

Role of hydrocarbonate ions:
Sodium bicarbonate, which is a strong basic substance, plays an important role in maintaining this equilibrium. It serves to neutralize excess acids and release digestive juices in the so-called basophilic organs: liver, gallbladder, salivary glands and digestive glands of the small and large intestines.

Donat Mg natural mineral water contains a large amount of hydrocarbonate ions and an alkaline mineral magnesium, which helps to effectively regulate the acid-base balance.

How can I use milk of magnesia?

Milk of magnesia or magnesium hydroxide is a familiar medicine for many. It has most to do with treating heartburn or constipation. There are several forms of medication on the market, but many people know best about the liquid forms, which are sold over-the-counter under brand and generic brands in most places.The best advice on how to use magnesia milk can be obtained from doctors or from drug labels. However, the use can be discussed in general terms, although people should always ask their doctors or pharmacists for more specific and individualized information.

As mentioned, people most often use magnesium milk for heartburn or as a laxative. It should be noted that using magnesium hydroxide for one condition may result in another.It should be understood that treating acidic indigestion can cause involuntary bowel movements or actual diarrhea, although the dose is lower. If constipation is not a problem, people may want to get a medication that is meant only to treat an upset stomach.

When people use magnesium milk in liquid form, the experience can be a little unpleasant. Although the medicine is flavored with things like mint or cherries, many people find the consistency unpleasant. For fewer problems, take the dose with a full glass of water, and chilling the medication between doses is also a great idea.Colder magnesium hydroxide tends to produce less taste and an unusual mouthfeel. An alternative for some people is to take the medication in pill form, although doctors sometimes recommend a liquid, especially for constipation.

There are several different uses of magnesia milk for the treatment of other diseases. It has been suggested as a dandruff treatment and acne facial. Another suggested use is as a deodorant.These are usually not prescribed or recommended uses, although there is some evidence that this form of magnesium may be beneficial in a variety of uses.

The fact that people can use magnesium milk in other ways does not diminish the fact that this medicine can have serious health effects in some people. Those taking certain types of antibiotics should not use this medication, and heart medications such as warfarin (Coumadin®) and digoxin can cause adverse reactions.Magnesium hydroxide can sometimes cause serious allergic reactions that require immediate medical attention. People should get emergency medical attention if they develop hives, skin rashes, swelling of the mouth or lips, asthma, or other symptoms that make breathing difficult.

Most people should not plan to consume magnesium milk daily unless directed by their doctor, and daily intake may require supplementation with other minerals such as potassium.It is especially important if people are taking this drug for constipation relief that they see a doctor if constipation continues after use. This could indicate a serious gut problem that requires more care.

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How to deal with excessive sweating – Rossiyskaya Gazeta

Excessive sweating brings a lot of grief.

In the heat, the problem is exacerbated many times over.They put on an elegant T-shirt, shirt, dress, and untidy spots immediately appear on the back and armpits. Can these troubles be avoided?

What are the reasons

Experts advise: before starting to deal with the problem of sweating, be sure to consult your doctor. Because increased sweating (scientifically, hyperhidrosis) often indicates a serious illness. In particular, this is how some diseases of the thyroid gland, pituitary gland, disorders of the nervous system (neurasthenia, vegetative dystonia) and metabolism, tuberculosis, some oncological and infectious diseases and diabetes are manifested.

In such cases, it is important to treat the underlying disease, and you cannot do without qualified medical care.

But it happens that excessive sweating is just a feature of the body. As a rule, palms, armpits, and feet are affected. Local hyperhidrosis, as a rule, does not pose a direct threat to health, but it causes many inconveniences in everyday life. In addition, profuse sweating contributes to the development of skin diseases, especially fungal infections of the feet and dermatitis.

How to fight

There are effective ways to cope with this ailment. Here are 5 simple rules:

1 Showers. It must be taken at least 2 times a day, especially after various physical activities, stressful situations. A contrast shower is very useful.

2 Food. Eliminate spicy, spicy and highly salty foods from your daily diet, as eating them increases sweating. Coffee and alcohol should also be avoided.

3 Clothes. Try to wear clothes made only from natural fabrics, since synthetics cause a lot of sweating in humans, and even retain a strong smell of sweat for a long time.

4 Vitamins. It is useful to take fortifying agents – preparations of iron, calcium, phosphorus, valerian, multivitamins, herbal infusions, for example, lemon balm, sage (take half a glass warm 2-3 times a day). Please note that the decoctions must be sugar-free.An infusion of dry sage leaves is prepared as follows: two teaspoons of leaves are infused in two glasses of boiling water in a sealed container. Remember that herbs can cause allergies. Therefore, when choosing even an unconventional treatment, it is more correct to consult an experienced physician.

5 Deodorants and antiperspirants. They kill odors produced by bacteria and reduce the activity of the sweat glands. In addition to deodorants, you can use special ointments and powders that have the same effect. Dermatologists advise lubricating heavily sweating areas of the body with Teymurov’s paste – it is harmless and well tolerated even by especially sensitive people.

Folk recipes

Treatment of sweating with folk remedies does not require special expenses, but at the same time they are quite effective.

  • Mint will help with general sweating of the body. Pour a tablespoon of herbs with a glass of boiling water, leave for thirty minutes, drain. Infusion wipe problem areas.
  • You can prepare an infusion of chamomile (6 tablespoons of chopped flowers, pour 2 liters of boiling water, leave for an hour), add 2 tbsp. spoons of baking soda. Use a solution to wipe the skin in areas of profuse sweating.
  • An effective remedy – a cold compress (15 -18 degrees). It helps to shrink pores, reduce sebum and perspiration. It should be applied for five to ten minutes. The compress is contraindicated for owners of cold and bluish skin.
  • Baths with oak bark, white willow, sage help well.

Pour half a kilogram of chopped oak bark with four liters of water, boil for thirty minutes, drain.

Pour five teaspoons of powdered white willow with two liters of cold water, leave for eight hours, strain, drain into a bath.

Pour a kilogram of chopped sage leaves with three liters of cold water, leave for ten minutes, then bring to a boil, boil for five minutes, leave for another ten minutes, strain and pour into the bath.

Take a bath for twenty to thirty minutes and no more than once a week.

Choice

Deodorant or Antiperspirant?

There are many antiperspirant drugs on the market. The two main groups of drugs are deodorants and antiperspirants. In advertisements, an equal sign is often put between them, but in reality they differ fundamentally in the way they affect the body.

Deodorants inhibit the growth of bacteria caused by perspiration on the skin, and thus eliminate unpleasant odors, but they do not actually reduce the perspiration. So their main advantage is harmlessness, and their main drawback is low efficiency.

Antiperspirants do not fight bacteria, but sweat. Of course, no drug can get rid of sweat at all, and it shouldn’t, since sweating is a normal behavior of the body. But the salts of aluminum or zinc in antiperspirants temporarily block the ducts of the sweat glands and limit perspiration.Therefore, if the use of conventional deodorants does not save you from discomfort, you can resort to antiperspirants in the fight against hyperhidrosis. True, they must be used with caution.

By “locking” the sweat glands, they do not release sweat, which can lead to inflammation of the sweat glands.

Tips

Here’s what else can be used in cases of local hyperhidrosis.

Armpits

The armpits can be wiped with 1-2% salicylic alcohol.

Horsetail herbs infused with vodka (1:10), tincture of walnut leaves with vodka (1:10) or alcohol (1: 5) help. Before use, dilute with boiled water in a ratio of 1: 1 or 1: 2, wipe the skin 1-2 times a day.

Another recipe: in a glass of boiling water, brew 1 teaspoon of oak bark and add the juice of one lemon. Soak a cotton swab in the resulting broth and wipe problem areas with it several times a day. Such a decoction will reduce the secretion of sweat glands, and the body will acquire a fresh lemon scent.

By the way, in an emergency it would not hurt to have a lemon and a pack of wet wipes with you. Before an exciting event (an exam, an important performance, a date), wipe the skin of your armpits with a sanitary napkin, and then with a slice of lemon, and you can forget about the smell of sweat and ugly circles on your clothes for a while.

Face

Rub strong cold tea or unboiled milk on your face twice a day. The face should dry naturally.

Legs

Excessive sweating of the feet can be treated with oak bark.Grind some bark thoroughly and sprinkle this powder over socks or stockings. Repeat this process every day until sweating returns to normal. Two or three weeks is enough, you should not use oak bark longer, otherwise the secretion of sweat may stop altogether, and this is harmful to the body.

Oak bark can be used for foot baths. 50-100 g of plant materials per 1 liter of water, boil for 20-30 minutes over low heat.

Baths with chamomile infusion, strong tea, and potassium permanganate help well (the solution should be light pink).Or contrasting baths with ordinary very cold and very hot water.

Another way: wash your feet with salt water in the morning and evening. Dissolve 1 teaspoon of salt in a glass of hot water, then cool slightly.

In summer, you can try shifting your toes with fresh birch leaves 2 times a day.

Hands

Arrange for them salt rinses: dissolve 1 teaspoon of table salt in a glass of hot water and rinse your hands 2 times a day.Do not wipe, let your hands dry.

How to take vitamins to make them work

Nutritionist, lecturer and founder of the online health school Nina School Nina Khodakovskaya talked about how best to combine vitamins and at what time of day they will be most effective for your body.

If you are just going to drink vitamins, I recommend contacting a specialist who will select drugs for you based on your health indications and taking into account all the nuances in the combination of vitamins.But if you want to figure out on your own when and how to drink vitamins, then this information will be useful for you.

Vitamins must be taken consciously, considering that their combination must be correct and balanced . You must understand:

a) what vitamins you need to drink at one time or another of the day

b) the difference between fat-soluble and water-soluble vitamins

c) vitamins may have antagonists.Antagonists are vitamins that interfere with the absorption of each other when taken together.

When to drink vitamins

During breakfast it is recommended to drink: iron, vitamin C, B vitamins, omega-3, iodine, vitamin D, vitamin K, magnesium citrate or malate. Some of these nutraceuticals can be invigorating, so taking them is advisable in the morning.

During the daytime you can drink: vitamins A, E, C, D and K, as well as copper, zinc, omega-3, magnesium citrate or malate.Taking these nutraceuticals is allowed at lunchtime, since some of them are better not to be combined.

During dinner you can take: vitamin C, zinc, selenium and magnesium (citrate, glycinate, taurate, threonate). These nutraceuticals have a calming effect or do not interfere with sleep.

How to take vitamins correctly

Vitamins are also divided into fat-soluble and water-soluble. Water-soluble includes vitamin C and B vitamins.Their peculiarity is that they do not accumulate in the body and are quickly excreted. You can take such vitamins before, during or after meals, but at the same time drink plenty of water, so they are best absorbed in the body.

Fat-soluble vitamins include vitamins A, D, E and K. These vitamins are accumulated mainly in the liver. And they are best absorbed during a heavy meal that contains healthy fats.

It is important to drink amino acids and collagen on an empty stomach – so their absorption will be maximally effective, and all other nutraceuticals can be taken with meals.

Combination of vitamins with each other

Vitamin D, vitamin K and vitamin C combine well with each other. A couple of vitamin D – vitamin K can be supplemented with calcium. Vitamin K enhances the effects of vitamin D, vitamin D enhances calcium, and calcium and vitamin K are responsible for bone strength and health. A very powerful trinity. Also, these vitamins combine well with magnesium and phosphorus.

Vitamins E and C are ideally combined with vitamin A. Vitamin E protects vitamin A from oxidation, and vitamin C enhances the absorption of the other two.In addition, iodine, zinc and iron work well with vitamin A. And in tandem with vitamin E, there is selenium.

A very interesting group of B vitamins:

– Vitamin B1 is combined with vitamin C and magnesium.
– Vitamin B2 combined with vitamins C, D3, B9 and iron
– Vitamin B3 is “friendly” with chromium and zinc
– Vitamin B5 combined with copper
– Vitamin B6 can be combined with magnesium, vitamin D3 and iron
– Vitamin B9 (folic acid) is “friendly” with vitamin B2, D and iron
– Vitamin B12 combined with calcium

Vitamin C is ideally combined with iron and chromium.Each of the three substances serves as a catalyst for the absorption of the other two. Also, along with vitamin C, you can take vitamin A, vitamin E, vitamin D3 and vitamins B1 and B2.

Separately from each other, you need to drink zinc and copper, since when taken together, they displace each other from the body. Also, apart from zinc, it is recommended to take iron, calcium, magnesium, vitamins B6 and B9.

It is not recommended to combine intake of vitamin A and vitamin E with copper. Also, vitamin E should be drunk separately from vitamin D and iron.Under the influence of vitamin E, these vitamins are less well absorbed by the body.

With B vitamins, everything is a little more complicated, because many of them are not compatible with each other.

– Vitamin B1 is not combined with vitamins B2, B6 and B12.
– Vitamin B2 is not combined with vitamin B1 and calcium
– Vitamin B3 is not “friendly” with vitamin B12
– Vitamin B6 should not be combined with vitamins B1, B9, vitamin E and zinc
– Vitamin B9 conflicts with vitamins B6 and B12
– Vitamin B12 is not combined with vitamins B1, B3, B9, vitamin C, copper and iron.

But if we are talking about complex preparations, which already have all the B vitamins, then this form of administration is permissible. In the complexes, a certain time of release of each vitamin is calculated, so that they do not interfere with each other.

Iron should not be drunk together with calcium, magnesium, zinc and chromium. The first three reduce the level of iron, and chromium negatively affects the ability of iron to penetrate into the cell.

Constipation – Coloproctology – Day (surgical) hospital – Departments

Constipation

Constipation is a decrease in bowel movement (bowel movements), stool retention for more than 48 hours.The stool is hard and dry, after stool there is no feeling of complete emptying of the intestine. Constipation, therefore, should include not only stool retention, but also those situations when stools are daily, but in an extremely small volume. Constipation is a common condition, especially in developed countries. In most cases, without threatening a person’s life, they cause a lot of suffering.

Constipation is caused by a violation of the processes of formation and movement of feces through the intestines. With constipation, the flow of fluid into the intestinal cavity decreases, its absorption from the intestinal cavity into the intestinal wall increases, intestinal movements intensify, which mix the feces in the large intestine and at the same time weaken those movements that move the feces to the exit into the rectum.In order for the excretion of feces (defecation) to occur, a certain amount of it must accumulate in the rectum. Feces affect the nerve endings located in the rectum and a reflex to defecate occurs. In some patients suffering from constipation, the excitability of these nerve endings weakens and a paradoxical situation arises – there is a lot of feces in the rectum, but its excretion does not occur.

Causes of constipation

Eating disorders. This refers to the reduction in the diet of foods containing dietary fiber.These are substances that are not exposed to the action of digestive juices, they were also called ballast substances, since they believed that they did not matter much. It turned out that dietary fiber attracts water to itself, swells and increases the mass of feces, which contributes to the normal functioning of the intestines. Most of these fibers are in cereal products, bran, therefore, baked goods from wholemeal flour should be eaten, where the bran does not go to waste. Quite a lot, but less than in cereals, dietary fiber in vegetables and fruits.

Psychological factors. The disappearance of the reflex to defecate is mainly important here. Late getting up, morning rush, work in different shifts, irregular food intake contribute to disturbances in the usual rhythm of bowel emptying.

Hypodynamics (small physical activity). This is the cause of constipation in the elderly and old people who move a little due to illness, in patients of hospitals and hospitals forced to stay in bed for a long time.

Diseases of the intestine and, especially, rectum – irritated colon, diverticulosis of the colon , megacolon, dolichosigma, hemorrhoids , anal fissure . In these diseases, all the factors causing constipation are important.

Mechanical factors preventing the movement of feces. Here we are talking about tumors of the colon, which close the lumen of the intestine, adhesions in the abdominal cavity.

Toxic effects. This happens when working with lead, mercury, thallium, with the abuse of certain laxatives.

Medicinal influences. Constipation is a side effect of many medications. This includes atropine, codeine, drugs for depression, some hypnotics, diuretics. This usually happens with long-term medication.

Endocrine diseases – myxedema, hyperparathyroidism, diabetes mellitus, pheochromocytoma, pituitary disorders.

Constipated patients often have abdominal pain, which is better after stool or gas. They also complain of decreased appetite, belching, heartburn, and nausea.

Persistent bloating can be painful for people with constipation. Constipation is often accompanied by decreased performance, headaches, sleep disturbances, and mood disorders.

As can be seen from the list of causes of constipation in most cases, they are caused by improper diet, a small amount of vegetables and fruits in the diet, psychological moments.But they can also be a sign of more serious diseases of the intestines and other organs of the digestive system, especially tumors. A particularly alarming sign is constipation, which arises and intensifies within a relatively short time – 1-2-3 months. Therefore, persons suffering from constipation should consult a doctor in a timely manner in order to undergo the necessary examinations. These include digital examination of the rectum, sigmoidoscopy, colonoscopy, careful questioning of the patient. Here, diseases that require surgical intervention are revealed, first of all, tumors; or active methods of treatment – hemorrhoids, rectal fissures, rectal prolapse.

Treatment of constipation

1. Treatment of diseases contributing to constipation , primarily rectal diseases, inflammatory bowel diseases, endocrine disorders, rational use of drugs.

2. Diet. It is necessary to begin the treatment of constipation itself with it, and it is desirable to limit ourselves only to it, although this is not always possible. The main requirement for the diet is regular nutrition and the use of an increased amount of foods that promote bowel movement and reduce foods that interfere with emptying.

  • Foods that promote bowel movement: sour milk, fruit juices, brown bread made from wholemeal flour, sour fruits, honey, vegetables and vegetable dishes, buckwheat, barley, white grape wines.
  • Foods that delay bowel movement: blueberries, strong tea, coffee, cocoa, red grape wines, mashed dishes, very hot, semolina and rice porridge, slimy soups, jelly.
  • Products that do not affect bowel emptying: minced meat and fish, unleavened cottage cheese, wheat bread.
  • Compulsory in the diet is fluid intake up to 2 liters per day.

3. Use of laxatives. They should be prescribed if dietary measures do not give the desired effect.

  • The most important in this group are the so-called bulking agents – increasing the volume of intestinal contents. These funds are essentially dietary, they are suitable for long-term use. They should be assigned first. Chief among them are wheat bran, lactulose, seaweed – substances containing indigestible fibers, absorbing water, increasing the volume of intestinal contents and contributing to the normalization of intestinal motor function.Wheat bran, now produced by the food industry under different names, is doused with boiling water before use. They can be used in the form of a chatterbox for oral administration, as well as added to compotes, jelly, soups, cereals. The first 2-3 days, bran is prescribed 1 teaspoon 2 times a day, then every 2-3 days the dose is increased by 1 teaspoon per day until normal stool appears; then the amount of bran is slowly reduced until a dose is reached that guarantees a normal rhythm of bowel emptying (once a day or every 2 days).Bran can be used for a long time. In the first days of treatment with bran, abdominal pain may appear or increase, they are stopped by taking antispasmodics, the pain subsides, and then stops. Psyllium gives a good effect from this group of drugs.
  • The second group of laxatives – drugs that inhibit the absorption of water in the colon and increase the flow of fluid into it. There are medicinal herbs and preparations from them – senna, buckthorn, rhubarb; synthetic drugs – phenolphthalein, bisacodyl.