Potential Causes and Solutions
1. Do patients often come to you asking about constipation?
This is a very frequent complaint. On average one in four adults suffer from some degree of constipation in the United States. I hear this complaint very frequently, with about a third of my patients inquiring about what to do to help with constipation.
2. What are the five most common causes of constipation?
- Lifestyle (not enough fiber, liquids and exercise)
- Side effects of medications
- Gastrointestinal disorders: irritable bowel syndrome and functional constipation
- Manifestations of endocrine disorders (diabetes or hypothyroidism) or neurological disorders (parkinson’s, stroke)
- More worrisome causes (i.e. tumors ) usually present with other accompanying signs and symptoms.
3. What are the standard treatments for each?
First my staff and I review your medical history, including other medications used. Then depending on symptoms I will either recommend a diet modification plan, or do some routine bloodwork. Rectal exam with possible radiologic or endoscopic imaging is undertaken based on a detailed discussion with the individual person. Treatment regimen may consist of change of medications that the patient is on or addition of various laxatives medications.
4. When should a patient talk to you about constipation?
- Blood in toilet
- Change from your normal habits
- Abdominal distention
- Nausea or Vomiting
- Weight Loss
- Feeling Week
- Interferes with daily activities
- Symptoms come and go and persist for more than 3 weeks
5. Is it okay to take laxatives, or can they have serious side effects?
- It depends on the type of the laxative (mechanism of action) and the amount used, as well as whether you have any other medical conditions, especially kidney or heart or may be pregnant.
- Majority can be taken as pills or as enemas. Enemas generally work quicker.
- In general are safe if used in small doses. Consult your doctor for frequent use.
Types of laxatives:
- Bulk-forming laxatives or Fiber supplements (Citrucel, Benafiber,Konsyl, Metamucil, Perdiem, FiberCon, Fiber-Lax, Mitrolan) – take with plenty of water to avoid gas/bloating. May interfere with absorption of some other medicines.
- Hyperosmolar laxatives: provide moisture to the stool. MiriLax, Glycolas, Lactulose and Sorbitol
- Saline laxatives: draw water into the stool: Mild of Magnesia and Evac-Q-Mag
- Stimulant laxatives – cause increase muscle contractions: Black Draught, Ex-lax, Fletcher’s, Castoria, Senokot, Corrector, Doxidan and Dulcolax
- Newer medications: Amitiza and Linzess – prescription only.
6. What can patients do at home to help prevent constipation?
- Drink plenty of water
- Eat fruits and vegetables high in fiber: beans and berries
- Eat natural laxatives: prune juice, cantaloupe, figs and dried apricots
- If you feel the need to go – don’t hold it in
- Eat small frequent meals
Dr. Sofia Novak is the Director of Women’s Center at Brooklyn Gastroenterology and Endoscopy. Her clinical interests include nutrition, gastrointestinal (i.e. celiac) and liver diseases. Dr. Novak specializes in patients suffering from gas, bloating and pain. She performs a wide array of procedures including upper endoscopy, colonoscopy, enteroscopy, capsule endoscopy, and pH testing.
Our Brooklyn office provides a multidisciplinary approach to the treatments of gastrointestinal disease. Our board-certified gastroenterologists, who have worked together for many years, provide ranging from all gastroenterology procedures to the treatment of hepatitis and Crohn’s Disease.