Types, side effects, and misuse

Laxatives are a type of medicine that helps a person empty their bowels. They are generally used to relieve constipation. Most are available to buy from over-the-counter or online and without a prescription.

Laxatives can be taken orally (by mouth) in the form of liquids, tablets, or capsules. They can also be taken through the rectum – for example, suppositories or enemas.

Some people need to move their bowels 2-3 times a day, while others go 2-3 times a week; there is no “normal” number of times. It is more important to notice changes to bowel habits.

Constipation is when stools become hard, making them difficult or painful to pass.

Constipation and how laxatives help

Share on PinterestLaxatives are often used to relieve constipation, a common gastrointestinal complaint.

Constipation can cause cramps in the abdomen and can make people feel bloated or sick. It can be separated into two different types:

• Primary constipation – slow intestinal movements caused by an anatomical issue. This is often associated with not consuming enough fiber or not drinking enough fluids.
• Secondary constipation – associated with a metabolic disease (such as diabetes), neurologic diseases (stroke, Parkinson’s disease, multiple sclerosis), connective tissue disorders, or eating disorders.

Some medications can also contribute to constipation; these include antidepressants, iron, bismuth, anticholinergics, opioids, antacids, calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), sympathomimetics, and antipsychotics.

Types of laxatives

Different types of laxatives work in different ways. The choice of laxative will depend on a number of different factors.

There are four main types:

• Bulk-forming laxatives – also known as fiber supplements, these work in the same way that fiber in the diet normally does. They increase the bulk of stools by getting them to retain liquid, which encourages the bowels to push them out. Unless there is a specific reason why not, adults with constipation should start taking bulk-forming laxatives first. They usually take 12-24 hours to take effect.
• Osmotic laxatives – these soften the stool by increasing the amount of water secreted into the bowels, making them easier to pass. They may take up to 2-3 days before they start to work.
• Stimulant laxatives – these stimulate the digestive tract walls, speeding up bowel movements. Usually, they take effect within 6-12 hours.
• Stool softener laxatives – these decrease the surface tension of stools so that they absorb more water, making them softer. Usually, they work within 12-72 hours.

There are also some less common types of laxatives:

• Lubricant laxatives – these lubricate the intestines by decreasing the amount of water absorbed by the intestines.
• Saline laxatives – these are used when there is no blockage in the bowels. Often, they are enemas used to empty the bowel before invasive procedures or surgery.
• Prokinetic laxatives – these are used for severe constipation in conditions such as irritable bowel syndrome (IBS) and chronic idiopathic constipation.

Side effects

Share on PinterestNegative side effects include bloating, feeling sick, and abdominal discomfort.

Like any medication, laxatives can have side effects. Exactly what side effects a person will experience will depend on what type they are taking.

There are some common side effects, which include:

Most side effects will disappear once a patient stops taking the medication; they can mostly be avoided by starting on a low dose and increasing the dose gradually.

Serious side effects are rare. However, excessive or prolonged use of laxatives can cause diarrhea or intestinal obstruction, where stools become large and dry. Long-term use can also cause levels of salts and minerals in the body to become unbalanced.

Some laxatives react with other medications, so if a patient is taking other drugs, it is best to check with a doctor before taking laxatives.

If symptoms get worse after taking laxatives, it is important to see a doctor.

Misuse

Laxatives can be taken for the wrong reasons and misuse is relatively common; for instance, some people attempt to lose weight by the frequent and repeated use of laxatives.

Often, this occurs after eating binges under the mistaken belief that food and calories will be rushed through the body before they are absorbed. This is not the case, and laxative abuse can lead to a number of health complications.

People with anorexia and bulimia sometimes use large amounts of laxatives as part of their harmful food behavior.

While those misusing laxatives may notice weight loss, this is usually because of the loss of fluids; they do not reduce body mass, fat, or calories.

Health complications associated with laxative misuse include:

• Imbalance of electrolytes and minerals (particularly potassium) – these are necessary for the proper functioning of nerves and muscles, including the colon and heart. Imbalance can affect these organs.
• Severe dehydration – this can cause tremors, weakness, blurry vision, and kidney damage. In extreme cases, it can lead to death.
• Laxative dependency – the colon stops reacting to usual doses, meaning larger and larger doses are required.
• Internal organ damage – the colon can become stretched and the muscle wall becomes thin and flaccid.

Colon infection, IBS, and liver damage are also associated with overuse. Chronic laxative misuse can also contribute to colon cancer.

Laxative misuse often requires medical help for both physical and mental treatment. A doctor will be able to give advice on this. However, here are some basic tips for giving up laxatives:

• eat plenty of fruit and vegetables, foods high fiber, and wholemeal foods
• drink plenty of water
• avoid large quantities of bran

Safety

How someone takes laxatives, and how often they take them, will vary depending on the form they come in.

Therefore, it is important to carefully read the instructions before taking laxatives. Anyone with concerns should always ask a pharmacist or healthcare professional.

There are also some other important things to consider:

• Drink plenty of fluids – laxatives can cause dehydration; it is important to drink at least 2 liters of water a day.
• Avoid taking too much – taking too many laxatives can lead to diarrhea and blockages in the bowels.

Laxatives should only be taken occasionally and for short periods of time. People with Crohn’s disease or ulcerative colitis should not take laxatives, unless specifically told to by their doctor.

Alternatives

There are some natural alternatives to laxatives and lifestyle changes that can help alleviate constipation:

• regular exercise
• increasing daily intake of fiber
• drinking more water
• adding bulking agents, such as bran, to diet

All About Laxatives | Everyday Health

The first rule of laxatives is that you usually don’t need them.

The best remedy for constipation is drinking more fluids, adding fiber to your diet, and getting more exercise.

It’s also important to know that going a day without a bowel movement does not mean you have constipation.

Sure, some people have three bowel movements a day, but others only have three a week. Normal is relative, especially in this case.

How Do You Know When You Are Constipated?

Constipation is one of the most frequent complaints doctors hear. It’s estimated that constipation results in at least 2.5 million doctor visits annually in the United States and Americans spend hundreds of millions of dollars on laxatives every year.

Constipation occurs when stool passes too slowly through your digestive tract. This allows too much water to be absorbed, making the stool harder, drier, and more difficult to pass.

Although everyone’s digestive system is a little different, if you have not had a bowel movement in four days, you may be constipated and a laxative could help.

If you have tried adding fiber, drinking more fluids, and increasing your activity, and you are still constipated, there are many constipation remedies that are available over-the-counter. These include laxatives, stool softeners, lubricants, and tap water enemas. Here is what you need to know about laxatives:

• Bulk-forming laxatives. These laxatives work by drawing water into your stools to make them larger, softer, and easier to pass. They work slowly and stimulate your colon naturally. They are considered the safest type of laxative and the only type that might be recommended for daily use. Examples are psyllium (Metamucil), polycarbophil (FiberCon), and methylcellulose (Citrucel). It is important to drink plenty of fluids with a bulk laxative.
• Saline laxatives. These laxatives are also called osmotic laxatives because they draw extra fluid into the large intestine to help soften stool and flush out your colon. Because the active ingredients in these laxatives are commonly magnesium or phosphate, they can be dangerous for people with kidney failure. A common example of this type of laxative is Milk of Magnesia, which is magnesium.
• Stimulant laxatives. These are the roughest type of laxatives because they cause your bowel to contract and squeeze out the stool. Stimulant laxatives can be taken by mouth or by suppository. When taken by mouth they work in about seven hours; by suppository they can work in about 30 minutes. These laxatives should never be used more than once every three days because they can cause your bowel to lose its ability to contract. A common example of a stimulant laxative is bisacodyl (Dulcolax and Correctol).
• Other constipation remedies. Stool softeners and lubricant laxatives are also helpful because they make dry, hard stools easier to pass. Mineral oil can be used as a lubricant laxative, as can a glycerin suppository. Even though mineral oil is available over the counter, because it can interfere with your ability to absorb the important vitamins A, D, E, and K, it’s essential to discuss its use with your doctor.

Benefits and Risks

The benefit of laxatives is that you can purchase them without a doctor’s prescription and they are generally safe and effective. Laxatives may help prevent constipation caused by some drugs or prevent straining to have a bowel movement, which might be dangerous for some people.

Here are some risks to be aware of:

• Laxatives may cause cramping, bloating, and nausea in some people.
• Long-term use of laxatives, except for bulk laxatives, can make you dependent on laxatives to go to the bathroom and may mask important constipation symptoms.
• Laxatives can interfere with how other medications are absorbed. In general you should avoid taking a laxative within two hours of taking other medications.
• Never use laxatives for weight loss. Laxative abuse does not help you lose weight and can result in dangerous dehydration, weakness, fainting, and kidney damage.

Laxatives can be useful constipation remedies, but they are not a substitute for eating enough fiber, getting regular exercise, and drinking plenty of fluid. Other ways to avoid constipation are to never ignore the urge to have a bowel movement, set aside regular times of the day for a bowel movement, and avoid foods that are high in fats and sugar.

If you are having trouble with constipation, talk to your doctor about what type of laxative might be best for you. Never ignore symptoms of blood in your stools or dark, tarry stools. If you have constipation for more than two weeks, abdominal pain, nausea, or vomiting, talk to your doctor before starting any constipation remedy.

Learn more in the Everyday Health Digestive Health Center.

Laxatives – NHS

Laxatives are a type of medicine that can treat constipation.

They’re often used if lifestyle changes, such as increasing the amount of fibre in your diet, drinking plenty of fluid and taking regular exercise, have not helped.

Laxatives are available to buy from pharmacies and supermarkets. They’re also available on prescription from a doctor.

Types of laxatives

There are 4 main types of laxatives.

Bulk-forming laxatives

Bulk-forming laxatives work by increasing the “bulk” or weight of poo, which in turn stimulates your bowel.

They take 2 or 3 days to work.

Bulk-forming laxatives include:

Osmotic laxatives 

Osmotic laxatives draw water from the rest of the body into your bowel to soften poo and make it easier to pass.

They take 2 or 3 days to work.

They include:

• lactulose (also called by the brand names Duphalac and Lactugal)
• polyethylene glycol

Stimulant laxatives

These stimulate the muscles that line your gut, helping them to move poo along to your back passage.

They take 6 to 12 hours to work.

They include:

• bisacodyl (also called by the brand name Dulcolax)
• senna (also called by the brand name Senokot)
• sodium picosulfate

Poo-softener laxatives

This type of laxative works by letting water into poo to soften it and make it easier to pass.

They include:

• arachis oil
• docusate sodium

Which laxative should I use?

It’s difficult to know whether a particular laxative will work better than another. It depends on the person.

Unless there’s a reason why a type of laxative may be more suitable for you than another:

• start with a bulk-forming laxative
• if your poo remains hard, try using an osmotic laxative in addition to, or instead of, a bulk-forming laxative
• if your poo is soft but is still difficult to pass, try taking a stimulant laxative in addition to a bulk-forming laxative

Speak to a GP or pharmacist if you’re unsure which laxative to use.

Also see a GP if you’re still constipated after trying all of the different types of laxative, or you think your child might benefit from taking laxatives.

Things to consider

Laxatives are not suitable for everyone.

They’re not usually recommended for:

Before using a laxative, read about it in our Medicines guide or the patient information leaflet that comes with the medicine to make sure it’s safe for you to take.

Find out more about the considerations about laxatives

How to take laxatives

How you take a laxative depends on the form it comes in.

They’re commonly available as:

• tablets or capsules you swallow
• sachets of powder you mix with water and then drink
• a capsule you place inside your bottom (rectum), where it’ll dissolve (suppositories)
• liquids or gels that you place directly into your bottom

Some laxatives have to be taken at certain times of the day, such as first thing in the morning or last thing at night.

Ask a pharmacist for advice if you’re not sure how to take your laxative.

If you’re taking bulk-forming or osmotic laxatives, it’s important to drink plenty of fluids. This is because these laxatives can cause dehydration.

Never take more than the recommended dose of laxatives as this can be harmful and cause side effects.

How long should I take laxatives for?

Ideally, only take laxatives occasionally and for up to a week at a time.

Stop taking a laxative when your constipation improves.

If your constipation has not improved after taking laxatives for a week, speak to a GP.

After taking a laxative, you can make certain lifestyle changes to help stop getting constipated again, such as:

• drinking plenty of water
• exercising regularly
• including more fibre in your diet

These are better ways of preventing constipation than using laxatives.

Do not take laxatives every day to ease your constipation as this can be harmful.

Speak to a GP if you’re still constipated after making lifestyle changes.

In some cases, you may be prescribed a laxative to use regularly, but this should always be supervised by a GP or gastroenterologist (a specialist in gut problems).

The side effects of laxatives

Like most medicines, laxatives can cause side effects. They’re usually mild and should pass once you stop taking the laxative.

The side effects you may get will depend on the type of laxative you’re taking, but common side effects of most laxatives include:

• bloating
• farting 
• tummy cramps
• feeling sick
• dehydration, which can make you feel lightheaded, have headaches and have pee that’s a darker colour than normal

Ask a GP for advice if you get any particularly troublesome or persistent side effects while taking laxatives.

Using laxatives too often or for too long can also cause diarrhoea, the bowel becoming blocked by large, dry poo (intestinal obstruction), and unbalanced salts and minerals in your body.

Self-help alternatives to laxatives

It’s often possible to improve constipation without using laxatives.

It may help to:

• increase your daily intake of fibre – try to eat about 30g of fibre a day; read about how to increase the fibre in your diet
• add bulking agents, such as wheat bran, to your diet – these will help make your poo softer and easier to pass, although bran and fibre can sometimes make bloating worse
• drink plenty of water
• exercise regularly

Find out more about preventing constipation

Page last reviewed: 10 June 2019
Next review due: 10 June 2022

Laxatives | Medicine for Constipation

Some laxatives work quickly, within 15-30 minutes, and some take one or two days to work. You should drink plenty of fluid when you are taking laxatives (8-10 cups per day). Laxatives are usually taken for a few days until your bowel movements have returned to normal. A few people need to take them long-term.

What are laxatives?

Laxatives are a group of medicines that are used to treat constipation. They can be taken by mouth as liquids, tablets, or capsules, or they can be given via the back passage (rectum) – for example, suppositories, or enemas. Suppositories are pellet-shaped laxatives that are inserted into the rectum, via the anus. An enema is a liquid that is inserted into the rectum and lower part of the gut (bowel), via the anus.

There are four main groups of laxatives that work in different ways. Each laxative may have different brand names:

• Bulk-forming laxatives (also known as fibre supplements). For example, ispaghula (psyllium) husk, methylcellulose and sterculia. Unprocessed bran is a cheap fibre supplement.
• Osmotic laxatives. For example, lactulose, macrogols, (also called polyethylene glycol, or PEG), phosphate enemas and sodium citrate enemas.
• Stimulant laxatives. For example, bisacodyl, docusate sodium, glycerol, senna and sodium picosulfate.
• Faecal softeners. For example, arachis (peanut) oil enemas, and liquid paraffin.

Some laxatives work in more than one way. There are also a number of newer medicines for constipation, which work differently to the groups above. These don’t all necessarily work by their direct effect on the gut. These include prucalopride, lubiprostone, and linaclotide.

What is constipation?

Constipation is the name for the condition where stools (faeces) become hard and difficult or painful to pass. The time between opening your bowels increases compared with your usual pattern.

Note: there is a large range of normal bowel habit. Some people normally go to the toilet to pass faeces 2-3 times per day. For others, 2-3 times per week is normal. It is a change from your usual pattern that may mean that you are constipated. Sometimes crampy pains occur in the lower part of your tummy (abdomen). You may also feel bloated and feel sick if you have severe constipation.

Constipation may be caused by not eating enough fibre, or not drinking enough fluids. It can also be a side-effect of certain medicines, or related to an underlying medical condition. In many cases, the cause is not clear.

For more information see the separate leaflet called Constipation.

How do laxatives work?

Bulk-forming laxatives are sometimes called fibre supplements. They increase the bulk of your stools (faeces) in a similar way to fibre. They partly work by absorbing water (a bit like blotting paper). The increase in the bulk of your faeces stimulates the muscles in your gut to squeeze faeces along and out of the body. Fibre is the part of plant food that is not digested. It stays in your gut and is passed in the stools. Fibre adds bulk to the stools. You can increase your fibre intake by food as well as medication.

Osmotic laxatives work by increasing the amount of fluid in the large bowel by drawing fluid into it (osmosis). Less fluid is then absorbed into the bloodstream from the large bowel. The bowels become more filled (distended) because of the extra fluid, and the stools are softer. The extra volume stimulates the muscles of the walls of the bowels to contract. These muscle contractions (called peristalsis) squeeze the faeces along.

Stimulant laxatives stimulate the nerves in the large bowel (the colon and rectum – sometimes also called the large intestine). This then causes the muscle in the wall of the large bowel to squeeze harder than usual. This pushes the faeces along and out.

Stool (faecal) softeners work by wetting and softening the faeces.

Which laxatives are usually prescribed or recommended?

Mostly, laxatives are taken by mouth (orally). In some cases, your doctor may prefer to treat your constipation by giving medication via the back passage (anus). The choice of laxative usually depends on various factors. These include what you would prefer, the symptoms of constipation that you have, how severe your constipation is, the possible side-effects of the laxative, your other medical conditions, and cost. As a general rule:

• Treatment with a bulk-forming laxative is usually tried first.
• If stools (faeces) remain hard despite using a bulk-forming laxative then an osmotic laxative tends to be tried, or used in addition to a bulk-forming laxative.
• If stools are soft but you still find them difficult to pass then a stimulant laxative may be added in.

If you are pregnant or breastfeeding there are a number of laxatives that are thought to be safe to take. If you do need to take a laxative when you are pregnant or breastfeeding you should always ask your doctor or pharmacist for advice about which one you should use.

Sometimes, an enema is needed in severe constipation and can be used to clear out the lower bowel (rectum).

High doses of the macrogol osmotic laxatives are used to treat constipation when it is very severe and the stools are stuck (impacted). This should be under the supervision and advice of a doctor.

Liquid paraffin used to be commonly used as a faecal softener. However, it is now not recommended, as it may cause side-effects such as seeping from the anus and irritating the skin, and it can interfere with the absorption of some vitamins from the gut.

The newer medicine, linaclotide, is used for people with constipation due to irritable bowel syndrome who are not responding to other treatments. Lubiprostone is a newer medicine occasionally used in adults who have severe constipation not responding to other treatments. Prucalopride is for women only who have severe constipation which is not responding to other treatments.

How long do laxatives take to work?

Bulk-forming laxatives can have some effect within 12-24 hours but their full effect usually takes 2-3 days to develop.

Osmotic laxatives such as lactulose can take 2-3 days to have any effect so they are not suitable for the rapid relief of constipation.

Stimulant laxatives usually work within 6-12 hours. A bedtime dose is recommended so you are likely to feel the urge to go to the toilet sometime the following morning. However, you may try taking it at different times in the day to find the best time of day for you. Some people naturally have their bowel movements later in the day rather than in the morning.

Stool (faecal) softeners usually work within 12 to 72 hours.

Laxatives that are given via the back passage (rectum) – suppositories or enemas – usually work within 15-30 minutes. Stronger osmotic laxatives such as phosphate enemas can be used to clear the bowel quickly, in just a few minutes.

How long should I take a laxative for?

This depends on what type of constipation you have. Most people only need to take a laxative for a short time, to get over a bout of constipation. Once the constipation eases, you can normally stop the laxative. Some people get into the habit of taking a laxative each day ‘to keep the bowels regular’ or to prevent constipation. This is not advised, especially for laxatives which are not bulk-forming.

Some people have persistent (chronic) constipation and this can be more difficult to treat. In some situations, laxatives are needed for longer periods (sometimes even indefinitely) and they should not be stopped suddenly. Chronic constipation is sometimes complicated by a backlog of hard stools (faeces) building up in the bowel (faecal loading) or even partially blocking it (impaction). If loading and impaction occur they need to be treated first, often with much higher doses of laxatives. Then a normal maintenance dose of laxatives is used to keep the bowels moving.

What are the side-effects?

It is not possible to list all the possible side-effects of each laxative in this leaflet. However, as with all medicines, there are a number of side-effects that have been reported with each of the different laxatives. If you want more information specific to your laxative then you should read the information leaflet that comes with the medicine.

Laxatives very rarely cause serious side-effects. Common side-effects include wind (flatulence), cramps, diarrhoea, feeling sick, and bloating. Most of the side-effects can be avoided or reduced by starting off on a low dose and increasing the dose of oral laxatives gradually.

If you are taking bulk-forming laxatives, you may notice an increase in flatulence and tummy (abdominal) bloating. This is normal and tends to settle down after a few weeks as the gut becomes used to the increase in fibre (or bulk-forming laxative). Occasionally, bulk-forming laxatives can make symptoms worse if you have very severe constipation. This is because they may cause abdominal bloating and discomfort without doing much to clear a lot of stools (faeces) which are stuck further down the gut. See a doctor if you feel that bulk-forming laxatives are making your symptoms worse.

These medicines sometimes react with other medicines that you may take. So, make sure your doctor knows of any other medicines that you are taking, including ones that you have bought over the counter. See the leaflet that comes with your particular brand for a full list of possible side-effects and cautions.

When taking a laxative

Some important considerations are:

• Drinking plenty of fluid.
• Avoiding taking too much of the laxative.

Drink plenty of fluid

It is important that you drink plenty of fluid when taking any laxative. This means drinking at least two litres per day (8-10 cups). An osmotic laxative can make you dry (dehydrated). If you take a bulk-forming laxative and you do not drink enough fluid this can cause a blockage in the gut. The stools (faeces) may become dry and difficult to pass.

Avoid taking too much laxative

Taking too much of some laxatives can lead to diarrhoea and losing too much salt from the body. Taking too much of a bulk-forming laxative, or not drinking enough fluid with a bulk-forming laxative, causes a blockage in the gut rather than diarrhoea.

If you take bran, it is best to build up the amount gradually. Start with two teaspoons a day, and double the amount every five days until you reach about 1-3 tablespoons per day. You can sprinkle bran on breakfast cereals, or mix it with fruit juices, milk, stews, soups, crumbles, pastries, scones, etc.

Who cannot take laxatives?

In general, most people are able to take laxatives. You should not take laxatives if you:

What about natural laxatives?

The information above is about laxatives that are commonly prescribed. However, it is well known that certain foods have laxative properties and some people prefer to try natural remedies. Foods that have laxative properties mainly work because they are high in fibre but some foods may also have some stimulant or osmotic properties. The following are two examples of natural laxatives.

Prunes

Prunes (dried plums) have long been thought of as effective for constipation. Up until recently, there had been little scientific proof of this. However, a small research trial published in 2011 (see ‘Further Reading and References’ at the end of this leaflet) lends support to the belief that prunes are good for treating constipation. In the trial, 40 adults with persistent (chronic) constipation were studied as to the effect of prunes versus ispaghula (psyllium) – a commonly used treatment for constipation. Briefly, on average, 50 g of prunes (about six prunes) twice daily seemed to be better at easing constipation than 11 g ispaghula taken twice daily. This is just one small trial, but does seem to confirm the common belief that prunes are good for easing constipation.

The Beverley-Travis Natural Laxative Mixture

This recipe (detailed below) was studied in a research trial that involved older people in a care home. A treatment group was compared to a non-treatment group. The conclusion of the study stated that: ‘The Beverley-Travis Natural Laxative Mixture, given at a dosage of two tablespoons twice daily, is easy to use, cost-effective, and more effective than daily prescribed laxatives at producing normal bowel movements.’ So, it may be worth a try:

• Recipe ingredients – one cup each of: raisins; pitted prunes; figs; dates; currants; prune juice concentrate.
• Directions – combine contents together in a grinder or blender to a thickened consistency. Store in a refrigerator between uses.
• Dose – two tablespoons twice a day. Increase or decrease the dose according to consistency and frequency of bowel movements. 

How to use the Yellow Card Scheme

If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www.mhra.gov.uk/yellowcard.

The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:

• The side-effect.
• The name of the medicine which you think caused it.
• The person who had the side-effect.
• Your contact details as the reporter of the side-effect.

It is helpful if you have your medication – and/or the leaflet that came with it – with you while you fill out the report.

Laxatives – Tests & treatments

Laxatives are a type of medicine that can help you empty your bowels if you’re having trouble going to the toilet.

They’re widely used to treat constipation if lifestyle changes, such as increasing the amount of fibre in your diet, drinking plenty of fluid and taking regular exercise, haven’t helped.

Laxatives are available over-the-counter, without a prescription, from pharmacies and supermarkets.

Types of laxatives

The main laxatives used in the UK are:

• bulk-forming laxatives – such as ispaghula husk and methylcellulose, which work in the same way as dietary fibre; they increase the bulk of your stools (faeces) by helping them retain fluid, encouraging your bowels to push the stools out
• osmotic laxatives – such as lactulose and polyethylene glycol, which soften your stools and make them easier to pass by increasing the amount of water in your bowels
• stimulant laxatives – such as bisacodyl, senna and sodium picosulfate, which speed up the movement of your bowels by stimulating the nerves that control the muscles lining your digestive tract
• stool softener laxatives – such as arachis oil and docusate sodium, which increase the fluid content of hard, dry stools, making them easier to pass

There are also a number of alternative laxatives that are less commonly used, including bowel cleansing solutions, peripheral opioid-receptor antagonists, linaclotide and prucalopride.

Which laxative should I use?

Although laxatives have been around for a long time, there’s a lack of high-quality evidence about exactly how effective they are and whether certain laxatives are better than others.

Unless there’s a reason why specific laxatives may be more suitable than others (see below), most adults should try using a bulk-forming laxative first. These usually start to work after about 2 or 3 days.

If your stools remain hard, try using an osmotic laxative in addition to – or instead of – a bulk-forming laxative. If your stools are soft, but are still difficult to pass, try taking a stimulant laxative in addition to a bulk-forming laxative.

Osmotic laxatives usually start to work after about 2 or 3 days, while stimulant laxatives usually have an effect within 6 to 12 hours.

Speak to your GP or pharmacist if you’re unsure which laxative to use. Also see your GP if you’re still constipated after trying all of the different types of laxative, or if you think your child might benefit from taking laxatives.

Things to consider

Although laxatives are available over-the-counter, they’re not suitable for everyone.

Laxatives aren’t usually recommended for children, unless advised by a doctor, and some types of laxatives may not be safe to use if you have certain conditions, such as Crohn’s disease or ulcerative colitis.

Before using laxatives, carefully read the patient information leaflet that comes with the medication to make sure it’s safe for you to take.

Read more about the considerations regarding laxatives.

How to take laxatives

How you take laxative medication depends on the form it comes in, they are commonly available as:

• tablets or capsules you swallow
• sachets of powder you mix with water and then drink
• suppositories – a capsule you place inside your back passage (rectum), where it will dissolve
• liquids or gels that you place directly into your back passage

Some laxatives are also designed to be taken at certain times of the day, such as first thing in the morning or last thing at night.

Read the patient information leaflet that comes with your medication so you know how to take it properly. Ask your pharmacist for further advice if you’re still not sure how to take your medication.

While taking bulk-forming or osmotic laxatives it’s particularly important to stay well hydrated by drinking plenty of fluids. This is because these laxatives can cause dehydration.

Never take more than the recommended dose of laxatives because this can be harmful and cause troublesome side effects (see below).

How long should laxatives be used for?

Ideally, laxatives should only be used occasionally and for short periods of time. Stop taking a laxative when your constipation improves.

After taking a laxative, to help stop constipation returning you can make certain lifestyle changes, such as drinking plenty of water, exercising regularly and including more fibre in your diet. These types of measures are a better way of preventing constipation than excessive use of laxatives.

See your GP for advice if you’re often constipated, despite making appropriate lifestyle changes, or if your constipation hasn’t improved after taking laxatives for more than a week.

Don’t get into the habit of taking laxatives every day to ease your constipation because this can be harmful.

In some cases, you may be prescribed a laxative to use regularly, but this should always be supervised by your GP or a gastroenterologist (a specialist in digestive conditions).

Side effects

Like most medications, laxatives can cause side effects. They’re usually mild and should pass once you stop taking the medication.

The side effects you may experience will depend on the specific medication you’re taking, but common side effects of most laxatives include:

• bloating
• passing wind (flatulence) 
• painful tummy (abdominal) cramps
• feeling sick
• dehydration – which can make you feel lightheaded, have headaches and pass urine that’s darker than normal

Contact your GP for advice if you experience any particularly troublesome or persistent side effects while taking laxatives.

Excessive or prolonged use of laxatives can also cause diarrhoea, intestinal obstruction (where the bowel becomes blocked by large, dry stools) and unbalanced levels of salts and minerals in your body.

Alternatives

It’s often possible to improve constipation without having to use laxatives. Before trying laxatives, it may help to make a number of lifestyle changes, such as:

• increasing your daily intake of fibre – you should eat about 30g of fibre a day; high-fibre foods include fruit, vegetables and cereals
• adding bulking agents, such as wheat bran, to your diet – these will help make your stools softer and easier to pass, although bran and fibre can sometimes make bloating worse
• drinking plenty of water
• exercising regularly

Read more about preventing constipation.

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Treatment for Constipation | NIDDK

How can I treat my constipation?

You can most often treat your constipation at home by doing the following

Change what you eat and drink

Changing what you eat and drink may make your stools softer and easier to pass. To help relieve your symptoms

• eat more high-fiber foods
• drink plenty of water and other liquids if you eat more fiber or take a fiber supplement

Read about what you should eat and drink to help relieve constipation. Depending on your age and sex, adults should get 25 to 31 grams of fiber a day.³

You may be able to treat and prevent your constipation by changing what you eat and drink.

Get regular physical activity

Getting regular physical activity may help relieve your symptoms.

Try bowel training

Your doctor may suggest that you try to train yourself to have a bowel movement at the same time each day to help you become more regular. For example, trying to have a bowel movement 15 to 45 minutes after breakfast may help, because eating helps your colon move stool.

Make sure you give yourself enough time to have a bowel movement, and use the bathroom as soon as you feel the need to go. Try to relax your muscles or put your feet on a footstool to make yourself more comfortable.

Stop taking certain medicines or dietary supplements

If you think certain medicines or dietary supplements are causing your constipation, talk with your doctor. He or she may change the dose or suggest a different medicine that does not cause constipation. Don’t change or stop any medicine or supplement without talking with a health care professional.

Take over-the-counter medicines

Your health care professional may recommend using a laxative for a short time. He or she will tell you what type of laxative is best for you

• fiber supplements (Citrucel, FiberCon, Metamucil)
• osmotic agents (Milk of Magnesia, Miralax)
• stool softeners (Colace, Docusate)
• lubricants, such as mineral oil (Fleet)
• stimulants (Correctol, Dulcolax)

You should only use stimulants if your constipation is severe or other treatments have not worked.

If you’ve been taking laxatives for a long time and can’t have a bowel movement without taking a laxative, talk with your doctor about how you can slowly stop using them. If you stop taking laxatives, over time, your colon should start moving stool normally.

Your doctor may suggest using a laxative for a short time. He or she will tell you what type of laxative is best for you.

How do doctors treat constipation?

If self-care treatments don’t work, your doctor may prescribe a medicine to treat your constipation. If you’re taking an over-the-counter or prescription medicine or supplement that can cause constipation, your doctor may suggest you stop taking it, change the dose, or switch to a different one. Talk with your doctor before changing or stopping any medicines.

Prescription medicines

Your doctor may prescribe one of the following medicines for constipation

• lubiprostone—a medicine prescribed to increase fluid in your digestive tract, which can help reduce pain in your abdomen, make your stool softer, and increase how often you have bowel movements
• linaclotide or plecanatide—medicines that help make your bowel movements regular if you have irritable bowel syndrome with constipation or long-lasting constipation without a known cause
• prucalopride—a medicine that helps your colon move stool if you have long-lasting constipation without a known cause

Biofeedback therapy

If you have problems with the muscles that control bowel movements, your doctor may recommend biofeedback therapy to retrain your muscles. By using biofeedback therapy, you can change how you make your muscles work.

Surgery

Your doctor may recommend surgery to treat an anorectal blockage caused by rectal prolapse if other treatments don’t work. Your doctor may perform surgery to remove your colon if your colon muscles don’t work correctly. If your doctor recommends surgery, ask about the benefits and risks.

How can I prevent constipation?

You can help prevent constipation by doing some of the same things that treat constipation

• get enough fiber in your diet
• drink plenty of water and other liquids
• get regular physical activity
• try to have a bowel movement at the same time every day

Learn more about how you can help prevent constipation with eating, diet, and nutrition.

References

[3] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2015-2020(PDF, 10.3 MB). 8th ed. Published December 2015. Accessed May 1, 2018.

90,000 Laxatives – pros and cons

If from the set of diseases and conditions we try to single out those that they prefer not to talk about among friends, then among them there will undoubtedly be constipation. However, constipation significantly affects the quality of life, and many people face bowel problems on a daily basis.

This contradictory state of affairs gives rise to a frivolous and not always adequate attitude of patients to the problem of constipation, and also makes it difficult to determine the effectiveness and safety of laxatives.

In a situation where society prefers not to discuss this problem, it is naturally forgotten that constipation can often be one of the signs of a formidable disease. Intestinal function is no less important for maintaining homeostasis of the body than the function of the kidneys or lungs, and voluntary interference with the bowel can lead to a number of undesirable consequences.

WHAT SHOULD BE CALLED STACK

Constipation is often defined differently by patients and professionals.From the point of view of doctors, one of the main signs of constipation is a decrease in the number of bowel movements. According to modern concepts, constipation should be considered the absence of bowel movements for 3 days. Although the majority of the population of European countries believes that the frequency of defecation should be at least once a day (Cerulli A.M., Schuster M.M., 1991).

PREVALENCE CONSTRUCTION

The incidence of constipation is also estimated in different ways. According to Russian authors, chronic constipation is observed in 10.5–43% of the population (Frolkis A.V., 1991), and the incidence of this disorder increases significantly with age. In a survey conducted in Germany, 25% of women and 10% of men reported that they experience digestive problems and indicated constipation (Knopf H., Braemer-Hauth M., 1995), in the USA – 12.8% of respondents (Sandler RS, Jordan MC, Shelton BJ, 1990).

CONSISTENCING CAUSES

A sedentary lifestyle, dietary errors are the most common causes of constipation, but far from the only ones.Constipation occurs against the background of diseases of the digestive tract (peptic ulcer, chronic pancreatitis, dysbiosis, irritable bowel syndrome), anorectal lesions (hemorrhoids, anal fissure, paraproctitis), neurological pathologies (stroke, multiple sclerosis, Parkinson’s disease, injuries and tumors of the spinal cord) ), endocrine disorders (hypothyroidism, premenstrual syndrome, pregnancy, diabetes mellitus). Heredity also has a certain influence on the development of constipation.Recently, the question of the influence of microbial flora on intestinal motility has been actively discussed.

Numerous causes of constipation lead to a variety of approaches to their treatment. With the exception of some cases (mechanical obstruction, neurological disorders, side effects of drugs), therapy should be started with changes in lifestyle, diet, especially in relation to fluid intake and food with a high fiber content.

Restoration of the normal functioning of the body takes a long time, so most patients often resort to the use of laxatives.For example, in the UK, 20-30% of people over the age of 60 take laxatives once a week or more. Along with this, about 80% of patients regularly exceed their prescribed doses of drugs (Cooke W. T., 1981). In Germany, about 39 million packs of laxatives are sold annually (Knopf H. et al, 1995), in the United States, 500-725 million dollars are spent for these purposes a year (Sweeney M., 1997).

Along with pain relievers, laxatives are drugs that are often bought without a doctor’s recommendation and whose use is usually abused.While these drugs are highly effective, consumers do not always pay attention to the risk of side effects without being aware of them, or considering them inevitable.

EXTREME CAUTION IS NECESSARY WHEN SELECTING Laxatives

According to scientific studies that have been carried out in the last decade, great care should be taken when choosing a laxative.

In 1996-1997 in the United States and Germany, severe restrictions were imposed on the use of highly sought after herbal stimulant laxatives based on senna, buckthorn, rhubarb, aloe, as well as on the use of bisacodyl and phenolphthalein.

In 1998, the US Food and Drug Administration (FDA) proposed the transfer of bisacodyl, aloe, senna from Category I (drugs found to be safe and effective) to Category III (drugs subject to additional research) (Federal Register / Vol. 63, No. 118 / Friday, June 19, 1998). The German Federal Institute for Medicines and Medical Products (BfArM) has restricted the use of andira, senna, buckthorn, rhubarb and aloe to short-term use for constipation only (BfArM, Drug Approval and Registration Notice of 21.06.1996).

The active substance of these drugs are anthranoids. In addition to a pronounced laxative effect, according to studies by H. Steer, D. G. Colin-Jones (1975), J.F. Riemann, H. Schmidt (1980), anthranoids cause degenerative changes in nerve fibers in the colon wall. The product of bacterial cleavage of anthranoids in the colon, anthrone, is comparable in cytotoxic effect to cytostatics (Siegers C.P., 1993).

A large-scale colonoscopy study found an association between the abuse of anthranoid-containing laxatives and colon and rectal cancer.The risk of developing colorectal carcinoma was observed in patients who took anthranoid-containing laxatives for a long time (Siegers C.P., 1993).

Scientists from BfArM concluded that “… with regular administration of anthranoid-containing drugs, the risk of developing dangerous effects outweighs the potentially beneficial effect” (BfArM, Restriction in indication of anthranoid – containing laxatives, 1996). With prolonged use of such drugs, addiction develops, the recommended dose no longer has the desired effect and it has to be increased, which causes a chronic overdose.In this case, the risk of developing side effects increases significantly.

Synthetic stimulant laxatives are no less dangerous.

Phenolphthalein has been withdrawn from the US, Canada, Italy (Ex-Lax reformulated after FDA moves. SCRIP, 1997; New laxatives guidelines in Italy. ERA-News, 1998). In 1998, the FDA proposed a study on the mutagenicity of bisacodyl. The carcinogenic effect of sodium picosulfate is also under suspicion (Bronder E., Klimpel A., Helmert U .: BUS, 1999).

So the question arises whether synthetic stimulant laxatives are actually safer than herbal laxatives.

Increased awareness of the potential dangers of stimulant laxatives is forcing manufacturers to gradually switch to alternative laxatives.

A truly revolutionary solution to the problem of constipation was the emergence of drugs, the laxative effect of which is realized due to the interaction of the active substance with the contents of the intestine, which today allows us to speak of them as safe and the most promising in the treatment of constipation.

Taras Makhrinsky

90,000 What to do if the intestines do not work without a laxative

“I heard that a laxative is harmful to health.And what if the intestines do not work without it? ” Olga Nikolaevna, Vitebsk.

– The treatment of constipation, which is most common in the elderly, is a long and complex process, and the use of laxatives is just one of its components. First of all, it is possible and necessary to cope with the help of a diet, proper drinking regimen, and therapeutic exercises. But if there is no other way out, it is worth remembering the complications of uncontrolled drug intake. Don’t grab onto the strongest laxatives.It is better to achieve the effect gently and gradually, giving preference to the most harmless.

It is very important for patients with such problems to contact a specialist to be examined and to establish the cause. In most cases, chronic constipation develops as a result of diseases of the digestive system, so you can start with simple recommendations. Every morning, 40 minutes before breakfast, drink 1-2 glasses of water at room temperature to activate the digestion process.It is recommended to do a gentle massage of the abdomen in a clockwise direction and apply pressure to the navel area. Introduce honey, beets, cabbage, apricots, carrots, prunes into the diet. It is good to drink fresh kefir before going to bed.

The most powerful laxatives are irritants (bisacodyl, sodium picosulfate), herbal remedies (rhubarb root, senna leaves, zhostera fruit, buckthorn bark). They irritate receptors in the colon and stimulate peristalsis. But with the regular use of funds of this kind, receptors are depleted, intestinal tone decreases, the risk of atony and electrolyte imbalance in the blood increases.As a result, addiction develops. An exception is the senna leaf (Alexandrian leaf). Such drugs are prescribed to regulate stool for hemorrhoids, spastic and atonic constipation. The group of bulky intestinal fillers includes wheat bran, agar-agar, flax seeds, flavorta, methylcellulose. They swell by sucking in water, thereby stretching the intestinal walls. But if it is sluggish, then the effect may not be. It is very important when using such funds to drink a large amount of liquid – at least 2 liters of water.

The group of saline laxatives consists of sodium and magnesium sulfate, magnesium hydroxide, polyethylene glycol, Karlovy Vary salt. You can take them for dyskinesia of the gallbladder, to cleanse the intestines before research, in case of poisoning with salts of heavy metals and cholecystitis. Despite the fact that such laxatives can be used for a long time, their regular use for several months upsets the water-salt balance.

Prebiotics are the safest modern remedies for overcoming constipation.They can be used even during the period of gestation and during feeding. This group includes lactulose, inulin, fructooligosaccharides. Although they act slowly, they are more persistent than any irritant and saline laxative, and do not have serious side effects. Prebiotics can be taken for both acute and chronic constipation, for the treatment of intestinal dysbiosis.

Since many laxatives are sold over the counter, it is worth knowing that there are contraindications: acute and chronic in the stage of exacerbation of the rectal disease, severe hemorrhoids, inflammation; constipation caused by intestinal spasm; inflammation of the bladder and urethra; pregnancy; acute inflammation of the digestive tract; signs of appendicitis, pain syndrome of unexplained origin in the abdomen; bleeding of uterine, gastrointestinal genesis; individual intolerance to components and milk sugar; heart failure, arrhythmia, hypertension; kidney problems.Drugs from the excipient category significantly reduce the effectiveness of antibiotics, anticoagulants, and cardiac glycosides. In addition, bloating and pain are possible. For a medicine to work, it must match the type of digestive disorder. Only a doctor can determine this. It is imperative to consult with him.

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90,000 Treatment of constipation in pregnant women in a private clinic

This is one of the most common, but at the same time the most delicate problems that occur in at least 50% of pregnant women.In a normal state, bowel movements should be daily and in sufficient volume. Any deviations in this process require attention and adjustments to the diet, lifestyle and even psychological mood. From a physiological point of view, problems in the work of the gastrointestinal tract are also explained by hormonal shifts and the physiological characteristics of a pregnant woman’s body (under the influence of various processes in different phases of pregnancy, the contraction of intestinal smooth muscles is weakened, in addition, the enlarged uterus compresses the intestines, etc.).NS.).

Among other – non-medical reasons – the most common features of a woman’s lifestyle can be considered: systematic stress; lack of mobility; lack of fiber; a small amount of water consumed (not liquid!) and / or a high consumption of refined foods and foods with a large composition of sugar, homogenized fats and salt (fast food). “Refined products are refined oils, refined from most of the nutrients, polished rice, white flour and the familiar white refined sugar, plus fast food with a large composition of sugar, homogenized fats and salt, slow down the process of assimilation of nutrients by the body and the passage of food in the intestines.” (Laima Lankmane, naturopath, herbalist).

Homeopaths assert that constipation is a “problem” not only of the rectum, “it is a problem of the whole organism as a whole and it must be solved comprehensively” (D.V. be an allergic reaction to certain foods. Therefore, constipation is, in principle, an individual problem, and an individual approach will be the most effective solution to the problem: “Even equally pregnant women do not have 2 identical constipations: some of them had them before pregnancy, others did not eat properly, and others did not move.All good wishes with real constipation will work only in 10% of cases. The only correct decision is a full-fledged visit to a homeopath, who will approach the solution of the disharmony that has arisen, taking into account all the individual characteristics of a woman, looking at her as an integral unique system ”(A.S. Gavrilenko, obstetrician-gynecologist, Ph.D., homeopath , reflexologist).

First, how can NOT solve the problem of constipation: pregnant women are contraindicated in classic laxatives such as hay, aloe vera and castor oil – they can cause premature contractions.

Now about what you POSSIBLE and NECESSARY.

DIET

• You need to temporarily exclude dairy products. “The main milk protein casein is one of the most difficult to digest proteins and also a strong allergen. The fact that cottage cheese itself is capable of causing constipation is probably known to everyone. If you solve the problem with constipation in this way, then carefully introduce natural fermented milk products into the diet (preferably without flavorings and sugar) “(D.V.Arkhipova, MD, PhD, homeopath). It is not worth worrying that the baby will not receive something – he will take everything he needs from his “mother’s reserves”, and the question is not in the amount eaten, but in the amount absorbed by the mother’s body. From the point of view of homeopathy, if you want – eat, no – you do not need to force yourself, because food addictions and aversions correspond to our constitution, which means our needs (of course, this applies to healthy and healthy eating habits).
• It is necessary to monitor the fluid you use – or rather, drink a sufficient amount of clean water.Volume – from one to three liters per day, if desired, but not less than a liter. “If you don’t feel like drinking water, you need to remove sugary drinks and teas from the diet and compensate for this with clean water (preferably raw, artesian origin, pleasant to the taste, and even better thawed).” (TG Sadovaya, obstetrician, author of the lecture “Nutrition during pregnancy”).
• “Dried fruits are obligatory (you can pour prunes with water at night and drink infusion in the morning), and / or drink a glass of water in the morning on an empty stomach (you can add a little lemon juice there) and a glass of water with honey at night” (I.S. Arefieva, obstetrician-gynecologist).
• There should be a sufficient amount of fiber in the diet: at least 50% of the diet of natural plant foods, raw and processed (fiber stimulates the work of peristalsis). This can be whole grain cereals, foods made from wholemeal flour, fruits before meals or in between, vegetables, berries (the same lingonberry helps with constipation).
• A daily intake of 1 to 3 tablespoons of unrefined oils has a good effect on the body.“Sweet almond oil (edible) has a pronounced laxative effect and does not irritate the intestinal walls. Olive and linseed oils and oils, as well as walnut oil, also have a mild laxative effect. Do not forget that unrefined oils should be kept in the refrigerator (with the exception of olive oil), and flaxseed should be eaten within a month after opening the bottle. ” (O.L. Bannikova, obstetrician).
• Add magnesium-rich foods such as green leafy vegetables, walnuts and almonds, sunflower seeds (uncooked and preferably pre-soaked for 5-7 hours), green buckwheat, and spinach.“You can try this recipe – soak 1 teaspoon of flax seeds in ½ glass of warm water and leave for several hours. Then eat it just like that or add it to porridge, soup ”(L. Lankmane, naturopath, phytotherapist).
• You can try to consume more foods that normalize the balance of intestinal flora, such as kefir (preferably homemade), miso soup, sauerkraut.
• You should not get carried away with strong tea, black coffee, cocoa, chocolate, white bread, flour and slimy soups, semolina porridge, blueberries.All these products, like dry food, have a strengthening effect. For the time of problems with the gastrointestinal tract, it is better to observe separate fractional meals, drink liquid 15 minutes before meals or some time later, etc. – that is, to facilitate the assimilation of the food consumed as much as possible. Make sure that there are no distortions – the daily diet should be balanced.

HOW TO HELP

• You can drink enzyme preparations for a short time. If these are preparations of animal origin – no more than 7 days, plant enzymes can be taken longer.You can take probiotics, which are good gut bacteria that aid digestion. Long-term use of these biological products not only normalizes the intestinal flora, but also contributes to a less pronounced manifestation of dysbiosis in a newborn child. (D.V. Arkhipova, homeopath, PhD, pediatrician)
• Check the level of iron with a doctor – against the background of its deficiency, intestinal disorders are also possible. “But keep in mind that some iron-containing dietary supplements, unfortunately, can only worsen this condition (not to mention dosage forms).Better to add iron-rich foods such as almonds, pine nuts, apricots, avocados, sunflower and pumpkin seeds, wheat germ ”(L. Lankmane, naturopath, phytotherapist).
• Freshly squeezed juices, diluted 1 to 1 with water 15 minutes before meals, stimulate the production of enzymes by the pancreas and promote digestion in the most natural way. (D.V. Arkhipova, homeopath, PhD, pediatrician)
• Drink hot – as much as possible – water on an empty stomach, a little later, eat half a banana, chewing for a long time and soaking it abundantly with saliva to a liquid gruel (the banana must be ripe!).(OL Bannikova, obstetrician).
• Starting from the second trimester, you can use essential oils: exotic basil (Ocimum basilicum in Latin), seaside pine (Pinus Pinaster), saro (Cinnamosma fragrans, Saro), rose tree (Aniba rosaeodora). “Oils should only be edible, of good quality! It is not recommended to use essential oils during the first 3 months of pregnancy. 1st composition – take 1 drop of basil, 2 drops of pine on a small piece of sugar or honey and suck under the tongue in the morning on an empty stomach.2nd composition – basil 30 drops, rosewood 20 drops, saro 10 drops and 40 drops of apricot kernel oil or any other edible unrefined oil. Mix. Take 3 drops of this mixture under the tongue with sugar or honey in the morning and evening before meals for 5-7 days or as needed. ” Be sure to check when buying aroma oils if there is information on the packaging that this oil can be eaten. (O.L. Bannikova, obstetrician)
• If this does not help, you can try using Duphalac for a short time.

LIFESTYLE

Adequate physical activity, swimming in the pool. Walking for at least one hour. But the loads should be increased gradually. To get started, one lesson should be no more than 30 minutes. The pace should be slow, the shoes are comfortable, and the route should be taken away from highways. Gymnastics for pregnant women at least 30 minutes daily. As gymnastics, our yoga instructor for pregnant women Svetlana Shnyrova recommends a few simple exercises:

• spinal deflections in a cat pose (standing on all fours),
• alternating leg raises from a sitting position on the floor with support on hands,
• Certain types of soft twisting of the spine from a sitting or lying position,
• Breathing exercises, such as deep belly breathing, can also help.

During classes, you should carefully monitor your well-being and if any discomfort occurs, immediately get out of the position. And watch how your little one reacts to exercise.

These exercises stimulate bowel movements, improve blood circulation in the abdominal cavity, and help maintain regular bowel movements. In general, the problem of constipation should be approached comprehensively, drink more water in the morning, adjust nutrition, move more, walk, swim, do yoga.

90,000 Intestinal function as a criterion of health

Ancient Aesculapians believed that a person whose intestines does not work well cannot be called healthy. “Good health presupposes perfect unloading,” asserted the great Hippocrates. Chronic constipation is not just an unpleasant phenomenon, but also the cause of many dangerous diseases, ”says Yury Anatolyevich Provotorov, a proctologist at the State Budgetary Healthcare Institution“ GP No. 201 ”.

– Yuri Anatolyevich, how to determine that a person suffers from constipation?
– Constipation is a malfunction in the functioning of the intestines, in which defecation occurs at intervals of several days or occurs with great difficulty and is accompanied by painful sensations.Normally, the act of defecation should be carried out at least once a day. However, having 2-3 bowel movements per day is also considered normal, as is the absence of stool for 2 days. Deviations can be individual and are not always a cause for concern.

– What is the cause of this disease?
– Lack of physical activity, a sedentary lifestyle, nervous tension negatively affect the bowel function. Constipation can be a consequence of some diseases from the endocrine and digestive systems, being in uncomfortable living conditions (travel, business trip).Constipation can also be caused by taking certain medications that suppress intestinal motility. But most often, the main cause of constipation, not complicated by medical pathology, is inappropriate nutrition, in which high-calorie and refined foods and a minimum amount of dietary fiber enter the body.

By the way, one of the bad habits that provoke constipation is the habit of sitting for a long time in the “room of thoughts”. The toilet is not a library, so you need to go there for a short time and only for direct business.

– What is the danger of chronic constipation?
– The unhealthy complexion, oily skin, acne, acne, bad breath, heartburn, belching, flatulence (gas), obesity, etc. can be unhealthy consequences of chronic constipation. But this is just the tip of the iceberg, since much more unpleasant processes take place in the body. All systems, blood, lymph are slagged, the liver, heart, lungs, kidneys suffer, forced to work with a much greater load, trying to somehow free the body from toxic waste.

Constipation causes a feeling of heaviness and fullness in the intestines. When trying to perform an act of defecation, strong straining is required, which can cause cracks in the anus, bleeding, and the formation of hemorrhoidal cones. Gradually, all of this can lead to hemorrhoids, inflammation of the rectum, or worse, colon cancer. That is why the problem of constipation must be dealt with immediately.

– What’s the first thing to do?
– The first thing to do is check your diet.The main menu items for dealing with constipation are dietary fiber and fluids. Large amounts of both are needed to keep the stool soft and pass freely through the colon. Large meals should be avoided, which stretches the intestinal tract and thus aggravates constipation. Better to get up from the table with the feeling: just a little more.

If you get up from the table hungry, it means that you are full,
if you are full, you have overeat,
if you feel that you have overeat, it means that you are poisoned.

Try to eat at the same time and chew thoroughly. Focus on plant foods that are high in fiber (fresh vegetables, fruits, nuts). But add fiber gradually so you don’t get gas. When it comes to bread, go for whole grain or bran baked goods. It is also useful to include buckwheat in the diet and limit the consumption of rice. Every day in the diet should be fermented milk products enriched with bifidum flora, it is better to use them at night.But you cannot limit yourself in liquid. The volume of liquid consumed must be at least two liters. In addition, to facilitate bowel movements, it is recommended to drink a glass of clean water in the morning on an empty stomach.

Use laxatives only in extreme cases! Their constant use not only does not solve the problem of constipation, but makes it completely insoluble, since the body gradually gets used to laxatives and stops responding to them. You can, of course, support the process by increasing the dose and changing the drugs, but this is a dead-end path.

Exercise is the best remedy for any form of constipation. In the complex of morning exercises, include special exercises recommended for constipation. Swim, take long walks, exercise in any way you can.

When you are scared or stressed, your intestines stop working properly. You need peace of mind, and mental stress, unpleasant emotions are contraindicated. Don’t worry about trifles. Deliberately slow down the rhythm of your life, relax more often, allow yourself a daytime sleep.

How to stop taking a laxative for the brain so as not to flush your life down the toilet

“For every expert, there is an opposite expert, equal in absolute value.” © T. Sowell (1995). The Vision of the Anointed.

One day the time will come when we will be able to learn everything about everything, avoid most of all kinds of problems, live in harmony with nature and the people around us, enjoying every new day in wealth and health.Until then …

In this part of our opus there are no conspiracy theories and a magic pill for all problems, all coincidences with them are accidental. Here is only our vision of a problem that permeates all spheres of our life, as well as possible solutions. We do not pretend to be true. As the saying goes, “it usually happens in different ways.”

We live in a world where scientific data are mixed and contradict each other, and the education system is lagging behind reality every day. Subjects and branches of science are out of sync, which does not allow realizing something close to the truth at the junction of sciences.Defocused attention, lack of time and the inability to simultaneously follow what is happening in different areas greatly complicate the knowledge of the world and understanding of the processes taking place in it. In this regard, it is difficult to form a conceptual apparatus through the expansion of knowledge in different areas of knowledge.

Often we are looking for a short answer to our question, but we get thousands of links with similar sheets of texts, and even not containing a clear reasoned answer. Or we avoid parsing folders with heterogeneous files, get confused in the materials accumulated during the work on the project, ask questions of higher matters, but find only contradictory opinions of “authority gurus”.Often, the more we delve into the essence of the question, the more additional questions appear and the “question-answer” process is repeated, sometimes endlessly. It’s scary to imagine how much precious and irreplaceable resource – time – we waste on solving these and similar routine tasks.

The evolution of understanding of these and related issues is presented below. We invite you on a fascinating journey through the edges and layers of reality, where we will surely find the answers.

“Many things are incomprehensible to us, not because our concepts are weak; but because these things are not included in the range of our concepts.»© Kozma Prutkov

Every person from birth (actually even earlier) through the senses and the brain receives a huge flow of information, which allows us to cognize the world around us in all its manifestations available to us. This flow is generated by absolutely all participants in the environment and space – parents, relatives, their acquaintances, random passers-by, flora and fauna, weather conditions, objects of creation of mankind and much more, including various processes in the human body, learning a new world for him.Later, closer interaction with the country’s culture, society, traditions, media, books, education and other aspects begins. This entire set of data can be denoted by one term – environment. Along with genes, it is she who forms the personality and therefore the permanently updated “firmware” of each person is so different from all the others in its unique content. That is why we are who we are, with our own set of beliefs and endless belief in their truth. If faith weakens, the ego will add expertise to the convictions.

“Reality is infinitely complex for our knowledge. We have to simplify. ” © Aldous Huxley

Consider each person as a separate world – consciousness placed in an avatar with a personal genetic code and conceptual apparatus formed under the influence of the environment. For each individual consciousness, everything that happens in our matrix is ​​a space consisting of an endless stream of information units that affect each other.It is difficult (impossible?) For our consciousness to present a general picture of the world, not only because it is constantly changing chaotically, but also because objective reality is the consensus of all the subjective opinions of the creatures inhabiting it. Our brain, based on the subjective conceptual apparatus, is like a searchlight illuminating only the personal facet of general reality. For this reason, we all live in a kind of animal world, where initially everyone is for himself, guided by innate instincts, and only then tries on social roles, corresponding to the idea of ​​man – the pinnacle of evolution.

Our internal algorithms are aimed at satisfying basic needs and further ascending for happiness to the top of the pyramid of needs, whose structure today looks more like crowd – “elitism” . On the way to it, among the race participants, a large society engenders a struggle for a “comfortable” place in the sun, excluding consensus at many points of intersection of interests. Since there is not enough space for everyone at the top, some players gain a foothold on it and receive preferences, throwing others to the base of the pyramid, infringing on their rights, opportunities, achieving their goals and other needs.Some people cling to the middle levels, but it is not so easy to stay there either. The picture is sad: locally – these are personal conflicts, globally – it is tough competition, the struggle for resources and power, the side effect of which is the oppression of many people and the destruction of nature.

“It is impossible to help someone who does not want to change his life.” © Hippocrates

, in the end we will still eat each other, ”as it should be in the animal kingdom.But everything is much more interesting, it is not for nothing that we are endowed with the ability to think, analyze, draw conclusions and create. Thanks to these distinctive features, humanity invented not only rich oral speech, but also written , which brought us to that technological point of evolution in which we are today. It is the ability to record and transmit information processed by the brain on various media through space and time that allows humanity to accumulate and improve data arrays.

“Education is a wonderful thing, you just need to remember at least sometimes that nothing worth knowing is impossible to teach.” © Oscar Wilde

Today we no longer need to learn any area of ​​knowledge from scratch, collecting rake of experience with inquisitive foreheads, like our distant and not very ancestors. We have a rather fragmented knowledge base in the form of books, scientific papers, a government-approved education system, their digital copies and analogues on the Internet.All of the above is not perfect, since it is created in a rather limited information environment, and sometimes under pressure from the outside, giving rise not only to followers, but also supporters of opposing opinions, theories, hypotheses and practices resulting from them. Some of the valuable knowledge can be completely blocked by the scientific elite or other persons for various reasons, despite their proven advantages. Because of this, they do not become less valuable, but are lost among the lobbied “competitors”.

Yes, many officially recognized knowledge are quite effectively applied in practice, but such an assessment is positive only if we compare the current world achievements with what was before, that is, with the absence of these achievements.If you contrast them with global goals that have not been achieved for many years, the positive quickly dissolves. Nevertheless, breakthroughs and quantum leaps are being made, but more in spite of than thanks to the existing knowledge base.

“I believe that a person lives on the planet, not in a state.” © Viktor Tsoi

Each new generation believes that it will definitely change everything and then we will live in a wonderful new world. But time goes on and the baton of “trial and error” is passed on to the next generation.Slipping the achievement of global goals negatively affects everyone’s life and the environment. Until 2015, the UN referred to the set of global goals as “ Millennium Development Goals ”, and in 2015 transformed it into “ Sustainable Development Goals ”. Achieving the goals set on the UN agenda will indeed radically change the state of affairs in the world for the better. But it is one thing to declare, and another to admit that if the achievement of goals stalls, then the mechanism is malfunctioning.To find out with which ones, it is worth determining the state of its constituent parts, down to the screws.

When plunging into causal relationships, we somehow run into the informational component of any process, knowledge gaps and destructiveness of their base.

What is wrong with the existing knowledge base? Its outdated analog functionality and information processing methods have led to the following consequences:

• The world around us is rapidly transforming, changes again and again catch us by surprise with unexpected turns, which, it would seem, were unrealistic to predict, like the black swans Nassim Taleb .The information that permeates every person in society contains a significant percentage of unnecessary noise, is presented in scattered pieces, and contradictions meet and are supported by arguments in all areas. In this connection, it becomes extremely difficult to cognize something close to objective reality.

“The lie will go around half the world before the truth has time to put on its shoes.” © Mark Twain

• Most of the media, parasitizing on the emotions of readers, have turned into generators of “fakenews”, distracting from really important events.Instead of informing and rallying the population, it is split, which leads to brutal aggression of people with opposite points of view in relation to each other. Negativeness is now in the price, through it the masses are controlled, who, through an emotional buildup, will always be prompted who to hate and who is the real enemy. Stratification based on religious, ideological, national, political, gender, ethical and other preferences was the result of lobbying the interests of certain groups. It has long been possible to manage your online reputation and you can “paint” your image in a favorable light for yourself (hello to Dmitry Sidorin ).

“Each person contains a number of abilities and inclinations that need only be awakened and developed, so that when applied to business, they produce the most excellent results. Only then does a person become a real person. ” © August Bebel

• The total uncertainty of people’s perception of local and global processes is based on the chaotic nature of heterogeneous information flows, and therefore the idea of ​​the world is perceived as in a kaleidoscope.In this regard, any individual, to one degree or another, has a narrow-mindedness and stereotyping of thinking with the loss of the opportunity to see the most objective picture of the world (or a separate industry) for making the most rational and effective decisions. Understanding causal relationships, logical chains and cognitive biases has become as rare a skill as personality traits like sincerity, reliability, decency and others.

“The last times will come when nine sick people will come to one healthy person and say:“ you are sick because you are not like us.»© Elder Anthony the Great

• Facts are erased, concepts are replaced, which is why an ordinary individual has a narrow subjective conceptual apparatus that is not able to productively synchronize with other members of society: speaking about the same thing, both sides have a chance of not being understood by each other. Often, even in one community / company / ministry and other associations, one can observe communicative desynchronization of people. In this connection, each individual in one way or another at least does not contribute, and more often interferes with the achievement of common goals and solving problems.

“Happiness is a side effect of a well-organized life.” © Viktor Frankl

• False information has flooded the information background, people are in a worldview collapse, often not even realizing the structure of their psyche and physiology, not to mention the world in which they live, which negatively affects interaction with each other friend and the development of society. Numerous diseases have become the norm even in children, to say nothing of the older generation.The year 2020 showed that immunity is weak in the population around the world, especially in the most economically developed country – the United States. From which we can conclude that the well-being of an individual state is not equal to the good health of its inhabitants. The inability of most people to prevent health problems from occurring destroys their mental health, personal priorities and national economies. Total misinformation can devalue any financial investment anywhere.

“The true calling of everyone is only one thing – to come to oneself.»© Hermann Hesse

• Difficulty getting pleasure from life without“ doping surrogates ”, lack of understanding of your role in society and options for realizing your potential, a lot of restrictions imposed by the system entail the inability to wish for a better life or the setting of“ permissible ”Low planks, and when set high – painful burnout. The syndromes FOMO , FONO , doom scrolling and many others, under the influence of a toxic information environment, have generated a permanent race and stress in the vast majority of society, which may no longer be felt, since they have become the norm along with interpersonal conflicts, betrayal, and the destruction of families and the institution of the family as such, increasing inequality, infringement of human rights and freedoms and other destructive processes.And now the wheel of life balance does not look like a circle, and the priceless balance disappeared over the horizon. And so I want to live in pleasure right now, and not rehearse before the “true life”, which may not come.

“True wisdom comes to each of us when we realize how little we understand in life, in ourselves, in the world around us.” © Socrates

• Children, and sometimes quite adult people, often cannot determine their place in this world: what to do, earn money, how to arrange their life on a personal level and not make a mistake.Society imposes on such people generally accepted values ​​and needs, often hindering the disclosure of natural potential. The area of ​​application of your skills in an environment where your innate qualities and acquired skills are sorely lacking becomes something mythical and abstract. The life of such people turns into a burden instead of a holiday. Parents do not talk about ways to solve these fundamental problems, since they themselves do not have competence in such issues. This ignorance is hereditary and spreads like a virus.Parents with children often find themselves in opposition to each other, although from the first days of their lives they influence their beliefs, writing the first lines of the code in their subconscious. But then the environment takes its toll and family synchronization weakens, sometimes transforming into two camps on opposite sides of the barricades.

“No one knows the strength of their abilities until they have tested them.” © John Locke

• Our brains are quite powerful tools, but memory has certain limitations, especially without regular training.Perfectly complements the memory of recording and structuring information, keeping it up to date with dynamic updating, filtering from noise and focusing on important aspects, which significantly affects the increase in efficiency and acceleration of personal or corporate processes. To varying degrees, these functions for processing huge amounts of data are possessed by modern digital tools, which will be discussed in the next article. It is noteworthy that it is rare to find a user who is completely satisfied with the functionality of a single tool, so many people use several at once.Again we run into the fragmentation of information and the diffusion of attention. Here it is important to mention the scale in the needs of users: some need to streamline everyday tasks, others need to organize business processes in a group of people, someone wants to have access to a single database of problems and their solutions to bypass “minefields” and choose the best ways to implement their needs, another intends to build an information model of our world by synchronizing all available data, and someone is trying to predict the future, etc.p. The tool that satisfies all tasks in the public domain does not exist at the moment.

  Sergey Kapitsa wrote quite succinctly on the topic of efficiency in his book “Growth paradoxes. The laws of the global development of mankind “:” In the modern world, the productive forces have reached such a level that 15-20% of its workforce is enough for the life support of mankind. ” He also explained in the book and interview why people did not work less. And this is just a drop of useful knowledge in a chaotic ocean of information, most of which is not applied in practice, which we can fix.

“The forest was shrinking rapidly, but the trees continued to vote for the ax because its handle was made of wood and they thought he was one of them.”

• Information platforms of various departments and companies have their own data format, which complicates interaction and correlation with other platforms, the introduction of third-party tools and bringing data sets to a single structure. With this approach, public administration will remain a loose, ineffective system for a long time to come.

• State relations with citizens and business are a vivid example of a broken telephone and the loss of transmitted information from the bottom up. The authorities seem to live on another planet and adopt laws in their own way, often infringing on the rights of those who do not fit into the circle of interests of the lobbyists.

• Laws are written in such a language that it is sometimes easier for an ordinary citizen not to understand their content than to receive the prescribed subsidy or benefit.

• The allocated budgets are distributed and spent extremely inefficiently, this was once again confirmed by the recent post on Habré about Russian Railways .

• A brief example of numerous absurd facts: a third of the regions of the Russian Federation are not supplied with gas, given that the country is among the leaders in gas export.

• The cherry on the cake is a struggle for world peace at the same time as the arms race. At this point, just right “to drink to health and rape for virginity.” Even such a seemingly competent body as the Ministry of Foreign Affairs, which is obliged to prevent countries from physical conflicts, is not doing its job.Apparently, there are more serious interests.

“It is easier to fool people than to convince them that they are fooled.” © Mark Twain

• New technologies have become not only reliable assistants, but also spawned scams of all stripes. Now it is no longer necessary to leave your home to give your hard-earned savings to the scammers. The phone rings and the person on the other end, clearly according to scripts using social engineering, bred a respectable citizen, posing as a bank employee or any other specialist.There are practically no lucky ones left who would not have been called at least once with a proposal to invest money at a huge percentage, purchase some miraculous product with 100% prepayment, use “free” legal services, take a “free” course of cosmetic care or extend a false – insurance pseudo-car policy. The lack of at least some information on this topic forced a substantial share of our compatriots to fork out. Fraud aggregators such as Contributor save part of the population, but to eradicate this attack, a more comprehensive solution is required.

• We live in an era of “talent”, “professionals” and “all-knowing” gurus. Never before has a person had so many opportunities to succeed: you read a book – you are an expert, two – a specialist of the highest category, three – an expert in this field, or even related ones. And if you also carried out analytics, made a squeeze of the main postulates, seasoned with your conclusions – that’s it, you are a guru and a founder of a new movement. Broadcast on social networks, recruit a flock, arrange a tour of different cities. What are the cities – scale your business empire, enter the international information market, they are tired of waiting for you, messiah!

  And yes, it works. The Dunning-Kruger Effect , spiced with charisma and self-confidence and success, monetizes well. But, as they say, “the amount of intelligence on earth is a constant value, and the population is growing.” There is little practical use for the information disseminated in this way, and the followers of the “info-business boom”, left at the bottom of the trough, are in the majority.

• And much, much more …

The sage was asked: “How long will we wait for changes?”

The sage replied: “Well, if you wait, then it will take a long time …” , realize more clearly and take action, but our goals are much more global.In any case, most of the causes of the above problems at all levels are rooted in:

• scattered arrays of information,

• distorted knowledge about reality,

• inability to navigate in them,

• consequences.

Even this modest overview of the phenomena in society is developing into a trend, under the influence of which, one way or another, we will encounter events, in comparison with which the “covid pandemic” will seem like a children’s holiday.Local processes also do not inspire optimism, and global processes are formed from them, our world is fractal. You can drive negative thoughts away from yourself in every possible way, devalue the significance of negative processes, substitute concepts, but the facts are obvious and all the new consequences following their causes, we will be constantly contemplating. And given that “everything affects everything,” no one will be able to hide, except to delay the onset of destructive events. The realization of any predictions in our world is measured by probabilities, so they are now on the side of negative consequences.Most live with hopes and faith in a bright future, but for it to come, it must be created. This will require ordering the chaos that surrounds us, but not with the tools that we have. To solve heterogeneous problems, a set of tools is needed that not only solve each of them, but also be able to interact with each other, multiplying the effectiveness of each other.

Each of us has unresolved tasks, unanswered questions, unfulfilled desires and unreached goals.Sometimes everything is decided and life changes radically thanks to one phrase, article or book, but they still need to be found and rationally perceived. Now imagine that you can accumulate information that is important to you so that it can be reused later. This will allow you not to miss the very pieces of information that are not enough to put the images together. So that any search for information would more and more shake the good-quality knowledge system, which, upon reaching a critical mass, would generate new discoveries in understanding the essence.Let’s assume that this can be done using a set of tools with powerful functionality. These tools should provide approximately the following capabilities:

1. To collect and link together an infinite number of pieces of information;

2. Carry out their transformation and enrichment with new connections;

3. Find new layers of information and mark them;

4. Visually display the accumulated information in different sections and using different views;

5. Form a squeeze for further use;

6. Share ready-made images with the world;

7. Organize a joint study of the topic and find associates;

This all can be used not only in personal affairs, education, science, business, public administration and others, but also to get closer to understanding the “picture of the world”, thanks to the maintenance of up-to-date and reliable information in all areas.The tools will help to identify meanings and form rational thinking, satisfying the vast majority of the needs of the most sophisticated people, regardless of their type of activity, type of thinking, abilities, age, goals and social status. Anyone can use these tools and the result of their work, as well as contribute to the common cause.

“It is natural for a person to take the boundaries of his own horizons beyond the boundaries of the world.” © Arthur Schopenhauer

Together we are able to direct our collective mind to create such a powerful set of tools that will expand the boundaries of knowledge and solve the overwhelming number of personal and common problems.Of course, it will not be possible to completely tame the world of chaos – there are too many factors, but it is imperative to raise your productivity and awareness to unprecedented heights.

“You can learn a lot by keeping your mind open to other opinions.” © Konosuke Matsushita, Japanese businessman

In the next article in our series, we will determine the current state of affairs: which modern tools solve the most frequent and important queries in the field of information structuring, which knowledge bases are the most convenient and what is their limitations.

We will be glad to receive your constructive suggestions, wishes and developments in the comments and TG-channel @ Knowledge_Instruments . Those who especially keenly understand the stated problems and are ready to take part in the project – join us! They disagree with something and you know how to do it better – great, alternative and even the most daring ideas are welcome! The impossible is possible … piecemeal.

instructions for use, analogs, composition, indications

The frequency of side effects is indicated as: very often (≥1 / 10), often (from ≥1 / 100 to <1/10), infrequently (from ≥1 / 1000 to <1/100), rarely (from ≥1 / 10000 up to <1/1000), very rare (<1/10000), or unknown (cannot be estimated from the available data).
From the immune system
Not known: allergic reactions.
Nervous system disorders
Uncommon: dizziness.
Unknown: fainting.
Dizziness and / or fainting that occurs after taking the drug may be associated with straining during bowel movements (Valsalva effect) or a vasovagal response to abdominal pain.
Disorders from the gastrointestinal tract
Very common: diarrhea.
Often: discomfort and pain in the abdomen, spastic pain in the abdomen.
Uncommon: nausea, vomiting.
Skin and subcutaneous tissue disorders
Not known: Skin reactions such as angioedema, drug rash, rash, pruritus.
Prolonged and excessive use of the drug GUTTALAX can cause loss of fluid, potassium and other electrolytes. This can lead to muscle weakness, heart failure, especially if GUTTALAX is taken concomitantly with diuretics or corticosteroids.
In case of adverse reactions, including those not specified in this instruction, you should stop using the drug and consult a doctor.

Overdose can lead to loose stools (diarrhea), abdominal pain of a crampy nature, and clinically significant loss of fluid, potassium and other electrolytes.
In cases of acute overdose, the effect of GUTTALAX can be reduced or prevented by causing vomiting and gastric lavage as soon as possible after ingestion. Fluid replenishment and electrolyte balance correction are recommended. In certain circumstances, the use of antispasmodics may be considered.
There have been reports of individual cases of ischemia of the mucous membrane of the colon in connection with the intake of sodium picosulfate in doses significantly higher than those recommended for the treatment of constipation.
Chronic overdose of GUTTALAX, like other laxatives, can cause chronic diarrhea, abdominal pain, hypokalemia, secondary hyperaldosteronism, and urolithiasis. Long-term use of a laxative in excessive doses can lead to renal tubular damage, metabolic alkalosis, hypokalemia, and muscle weakness.

Without a doctor’s prescription.

Information about the manufacturer (applicant)
Sanofi-Aventis Deutschland GmbH, Germany, manufactured by Institut de Angeli S.R.L., 50066 Regello, Prulli 103 / S, Florence, Italy
For drug quality claims and reports of adverse reactions, please contact:
Representative office of Sanofi-Aventis Groupe JSC French Republic
in the Republic of Belarus (Belarus): 220004 Minsk, st. Dimitrova 5, office 5/2, tel./fax: (375 17) 203 33 11, Pharmacovigilance-BY @ sanofi.com
in the Republic of Uzbekistan (Uzbekistan, Turkmenistan, Tajikistan): 100015 Tashkent, st. Oybek, 24, office block 3D, tel .: (998 71) 281 46 28/29, fax .: (998 71) 281 44 81, [email protected]
in the Republic of Georgia (Georgia and Armenia): 0103 Tbilisi, st. Metekhi, 22, tel .: (995 59) 533 13 36
in the Republic of Kazakhstan (Kyrgyzstan): 050013 Almaty, st. Furmanova, 187 “B”, Business center “STAR” 3rd floor, tel .: +7 (727) 2445096/97, fax .: +7 (727) 2582596; for questions about the quality of the drug e-mail: [email protected]; on pharmacovigilance issues e-mail: [email protected]

90,000 Travel Constipation: What to Do

In medicine, the concept of traveler’s constipation (as opposed to traveler’s diarrhea) does not yet exist. There is no term, but there is a problem, and many have probably come across it. Together with the gastroenterologist of the Rassvet clinic, Yulia Kogrusheva, we figure out what we are talking about and how to deal with it.

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What is constipation

From a medical point of view, constipation is not only stool retention for more than two days, but also very hard stools, small stools with a feeling of incomplete emptying, or painful defecation. A diagnosis is made if symptoms persist for at least three months.

“Traveler’s constipation is mentioned in the specialized literature,” explains Yulia Kogrusheva, a gastroenterologist at the Rassvet clinic. “But we are not talking about an independent disease, but about an exacerbation of one of two diseases: functional constipation or irritable bowel syndrome.”

Functional constipation is said when the large intestine does not want to contract and requires additional stimuli. Elderly people and small children suffer more often, but this sometimes happens with people of other ages.

With irritable bowel syndrome , constipation occurs, on the contrary, due to excessive motility: the intestine spasms and does not give up its contents. In this case, antispasmodics will be more effective than laxatives. Irritable bowel syndrome is less dependent on mechanical factors and more on psychological ones.

Let’s figure out what exactly can aggravate intestinal problems on a trip and how to deal with it.

Mechanical causes of constipation

Intestinal motility, that is, its ability to move the remnants of digested food to the exit, depends on many factors: some enhance this ability, others inhibit. Here is a list of the most common vacation mistakes that lead to decreased bowel motility and exacerbation of functional constipation.

Dehydration

If the body lacks fluid, the intestines squeeze out and suck in all the water from the food bolus.What is left becomes so dry and hard that it is difficult to move towards the exit.

When traveling, dry air on airplanes and heat on the street, alcoholic beverages and, of course, diuretics (which are often abused to “get in shape for vacation”) often lead to dehydration. Studies have shown that large amounts of coffee can also worsen functional constipation.

What to do? Drink more water (especially on the plane), less coffee and alcohol.

Incorrect power supply

Foods with a large amount of fiber activate peristalsis, while refined foods (for example, baked goods made from white flour), on the contrary, inhibit. The fact is that for normal functioning of the intestine, it is necessary to feel the mass and volume that need to be promoted to the exit, and it is fiber that is responsible for this. If the main part of what is eaten is absorbed into the blood (this happens, for example, with simple carbohydrates), then the intestine begins to be lazy: it simply has nothing to do.

What to do? Ideally, there are more vegetables and fruits. If this is not an option, so-called volumetric laxatives will solve the problem. But if you are used to a certain type of laxative and it works well at home, you shouldn’t change it while traveling (although you may need to increase the dose).

Lack of physical activity

The more we move, the more active the intestines, and vice versa. Accordingly, if you lie on the beach all day, the intestines, like the rest of the body, are also inactive.

What to do? Walk, dance, jump on a trampoline, do not ignore beach activities – and, of course, swim. This is not only physical activity, but also a massage of the abdomen (since the water presses on the abdominal wall). The perfect combination that can wake up a dozing intestine.

Psychological causes of constipation

The work of the intestines is very closely related to the emotional sphere and habits. In those diagnosed with irritable bowel syndrome, this relationship is especially pronounced.This is how it manifests itself on vacation.

Flight stress

Wouldn’t oversleep, would not be late, would not forget documents, would not lose luggage – the stress caused by the flight can lead to intestinal spasm and short-term stool retention. As a rule, as soon as the hassle ends and the rest begins, bowel functions are restored.

What to do? Rest. But if the doctor prescribed an anti-anxiety agent in the pre-vacation life, it must be taken on vacation.

Mode violation

If you usually go to the toilet at the same time, and on vacation for various reasons, the regime is disrupted (due to excursions or, for example, due to the difference in time zones), the intestines, instead of emptying themselves, focus on to keep everything to yourself, and gets used to it.

What to do? If you need to use the toilet, go to the toilet. Yes, at the airport, on the train, and on the plane. Well, knowing this peculiarity behind yourself, if possible, do not plan flights and excursions for the time that you usually spend in solitude.

Shyness and disgust

It is unpleasant in public toilets, in a cramped room with a friend behind the wall – awkward. Psychological discomfort is perhaps the most common cause of a traveler’s constipation. Usually after a couple of days, nature takes its toll, but the problem can stretch for the whole vacation.

What to do? “If you are not able to go to the toilet at all, anywhere except your own apartment – because of disgust, for example, or because you are afraid of an infection, it makes sense to turn to a psychologist: all this can be symptoms of obsessive-compulsive disorder”, – says psychologist Karina Kuranova.

If the question is only about the tension from the unfamiliar environment, consult a gastroenterologist: perhaps the doctor will select a remedy that will help the intestines return to normal work faster.