Ask The Doctor: Constipation ... Health Article

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

Question:

I am suffering from constipation. Dulcolax works, but it cannot be taken too often. Could you suggest a better, non-habit-forming medicine?

Answer:

The best way to improve constipation is to use foods and medicines that increase the water content of your stool. The foods that help are those that contain fiber. Fiber is not absorbed in your intestine, so the fiber (and the water it attracts) stays with your stool as the stool collects, leading to a softer, larger mass of stool that is easier to propel.

Fiber can be taken as an over-the-counter treatment, such as Metamucil or Citrucel. If you take fiber as a medication, you should be certain to drink an extra glass or preferably two glasses of water with your fiber dose.

Salt-based laxatives (also called "osmotic laxatives") are generally safe to use on a daily basis. The most commonly used salt-based laxative is milk of magnesia, which is available over the counter. A prescription osmotic laxative (examples are lactulose or sorbitol) can also be used.

For some people (particularly people who require narcotic pain medicines), laxatives that stimulate the colon — such as bisacodyl (Dulcolax) and many others — are needed more often than desirable. Regular use of colon stimulants can lead to difficulty having a bowel movement without a laxative. In a small number of users, regular use of these types of stimulant laxatives may cause nerve damage in the colon or may interrupt normal digestion, resulting in protein malnourishment or electrolyte abnormalities.