Classical medicine does not consider it necessary for health to evacuate selles on a daily basis. How often you pass a bowel movement depends on each person, but it is usually referred to as Constipation if there are less than 3 bowel movements per week and they are hard or difficult to pass.

The doctor will first determine whether it is secondary (due to another disease) or primary constipation. In the first case, he will treat the cause or he will prescribe additional examinations, such as a colonoscopy. Treat your hemorrhoids If it’s happened. They are often the cause of constipation. If your constipation is recent and you are taking a new one drug, talk to your doctor. Your medicine may be the cause of your problem.

Then the doctor will determine if it is transitory or terminal constipation.

transit constipation

The doctor will first recommend change the diet so as to increase the intake of fibers : raw vegetables, cooked vegetables, legumes, fruits rich in pectin (apple, pear, peach, berries), but above all whole grains.

We can add bran, very high in fiber, or other cereals in muffin recipes, etc. To treat the Constipation, it is recommended to consume about 1/4 cup of wheat bran per day. Whole prunes and prune juice are also very effective in relieving constipation because they contain sorbitol, a natural laxative. A daily dose of 8 ounces is usually sufficient⁴. However, it can sometimes take several weeks to feel the benefits of a diet enriched in fiber on the transit¹⁹.

At the same time, the doctor will also recommend drink enough, while avoiding alcohol and caffeinated drinks, which dehydrate and can irritate the colon. However, if constipation is chronic and is accompanied by intestinal irritation, you should avoid changing your diet too suddenly.

If constipation persists, he will recommend a laxative. There are 6 categories:

• The ballast laxatives or mass are generally mucilages or prepared dietary fibers: hydrophilic psyllium muciloid or methylcellulose. This type of laxative is the most gentle on the intestines. By binding with water, the fibers swell, which helps to form loose, bulky stools. Their volume triggers peristalsis of the intestines, which moves the stools towards the rectum. It may take a few days for the laxative effect to appear. It is recommended to drink the equivalent of 5 to 10 times the volume of the amount of ballast laxative ingested. Examples are Metamucil®, Prodiem® and Kellogs Bran Buds®.

  Possible side effects: bloating, gas and cramps. Integrating them gradually into the diet limits these inconveniences.

• The emollient laxatives, which soften the stool. For example, docusate sodium (Colace®, Ex-Lax®, Soflax®).

  Possible side effects: diarrhea and mild stomach cramps.

• The osmotic laxatives help to retain more water in the intestine, thus softening the stool. They include salts (sodium sulfate, magnesium sulfate or Epsom salt), magnesium hydroxide (milk of magnesia), sugars that cannot be assimilated by the intestine (lactulose, mannose, mannitol, sorbitol, etc. ) or glycerin (as a suppository). Polyethylene glycol-based laxatives (Miralax®, Lax-A-Day®) are osmotic laxatives available for adults complaining of occasional constipation.

  Possible side effect: diarrhea, gas, cramps, and high doses of dehydration.

• The lubricant laxatives, which lubricate the stool and facilitate their evacuation. It is most often mineral oil (paraffin oil or petrolatum). They can be used orally or rectally.

  Possible side effects: diarrhea and mild stomach cramps. Be careful, inflammation of the lungs can occur if the oil is accidentally sucked into the lungs.

• The stimulant laxatives act directly on the intestinal mucosa and all peristaltic movements (bisacodyl, anthracene, emulsified castor oil). They decrease the reabsorption of water and electrolytes in the colon. Stimulant laxatives, which are very irritating to the lining of the colon, are used as a last resort. They are not recommended in case of chronic constipation. They should not be taken for more than 1 or 2 weeks without medical supervision.

  Possible side effects: abdominal cramps, diarrhea and a burning sensation in the rectum.

  Caution. Overdose can cause addictive lazy bowel syndrome, as well as lead to low levels of sodium and potassium in the blood, dehydration and possibly more serious problems.

  Warning. They are contraindicated for pregnant and breastfeeding women.

Some preparations are composed of drugs from 2 or 3 of these groups of laxatives.

• Lubiprostone (Amitiza®). This new class drug is indicated for the treatment of chronic constipation in adults, in case of failure of other treatments.¹⁹. It works by increasing the secretion of water from the intestine.

  Possible side effects: nausea, diarrhea, abdominal pain and gas.

Terminal constipation

In case of terminal constipation, the doctor may recommend microlavements to suppositories in order to restore the evacuation reflex. In addition, by biofeedback, we can re-educate anorectal motor skills after an episode of chronic constipation, if necessary.^5,13.