Gastroenterology diseases symptoms and treatment Information

Gastroenterology

28 Dec 2023

11 minutes

Constipation From MedicationsMEDICATIONS AND DIGESTION: AVOIDING THE CONSTIPATION PITFALL Imagine you are being diagnosed with a disease that requires medicine for relief, only to find out later that the very medications prescribed to you are contributing to an unanticipated side effect: constipation. For many people around the globe managing the maze of medications and their side effects is a daily reality. For many of us, constipation is a common digestive problem. However, it takes on another dimension when it comes as a side effect of medication—one that's frequently hidden behind prescription labels and pharmacy counters. Join us to uncover the stories behind the pill bottle and bowel block to find a healthier, more comfortable life. TOP 10 MEDICATIONS CAUSING CONSTIPATION: UNMASKING THE PILL BOTTLES: 1. Opioid pain medications: Opioid induced constipation occurs in about 15% of the population [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549585/]consuming them for pain relief. Opioid drugs can cause your intestines to retain more water in your stool, which results in a hard, dry stool. Your stool remains in your intestines longer than it should because of the slower movements and hard stool making it difficult to pass feces. Some of the common drugs are: 1. Tramadol 2. Morphine 3. Fentanyl 2. Antidepressants: The level of serotonin hormone in the gut may increase as a result of taking some antidepressants. This extra serotonin slows down the normal movements of your intestines. Slower gut movement means stool moves more slowly through the intestines, making it harder for the body to push stool out, resulting in constipation. Some of the common drugs are: 1. Amitriptyline 2. Imipramine 3. Fluoxetine 3. Iron supplements: Iron supplements may cause your intestines to absorb more water and electrolytes, which might result in firmer, dryer stools. Because it is dry and firm, the stool might pass through the intestines more slowly your body finds it more difficult to pass stool due to a combination of slower movement and tougher stools. 4. Antipsychotic drugs: These drugs slow down the regular muscle movements in the stomach that carry food and waste through your intestines by inhibiting dopamine receptors in the gastrointestinal (GI) tract. Because of the slower movement, more water may be absorbed from the feces, making it tougher and dryer causing constipation. Some of the drugs are: 1. Clozapine 2. chlorpromazine 5. Antihypertensive medications: The typical rate at which food and waste flow through the intestines can be slowed down by some antihypertensive drugs by slowing down these peristaltic motions in the GI tract. As a result it causes firmer, drier stools. People may find it difficult to pass faeces as a result of slower peristalsis and tougher stools, which can lead to constipation. some common drugs are: 1. Verapamil 2. Clonidine [https://www.mrmed.in/medicines/arkapres-100mg-tablet] 3. Methyldopa 6. Anticholinergic drugs: Anticholinergic medications can cause decreased peristalsis, by blocking the effects of acetylcholine in the GI tract. Slower movements in the stomach might cause stool to stay in the intestines longer than usual, which can absorb more water from the stool and cause it to become drier and tougher. 7. Diuretics: Diuretics may possess some kind of magnesium and potassium electrolytes imbalances, severe imbalances of this can impact muscle contractions of stomach and intestines which could slow down bowel motions and lead to constipation. Some common drugs are: 1. Furosemide [https://www.mrmed.in/medicines/lasix-injection] 2. Hydrochlrothiazide 8. Antacids: The action by which antacids function is to neutralize stomach acid. Sometimes a large decrease in stomach acid can interfere with proper digestion by slowing the passage of food and waste through the intestines, which can cause constipation. Since an excessive amount of calcium and magnesium found in antacids can have the above impact on the body, taking it in excess can contribute to constipation. 9. Antispasmodic drugs: Antispasmodic medications work to lessen spasms or contractions and ease discomfort, but in certain people, they can also cause the GI muscles to relax too much, which can temporarily slow down bowel motions and cause firmer, drier stools, which can exacerbate constipation, by unduly relaxing the GI tract's muscles. 10. Antiparkinsonian drugs: Parkinson's disease, a disorder marked by a dopamine shortage in the brain, dopamine is essential for controlling how the muscles in our gastrointestinal (GI) tract work, which facilitates the easy passage of waste and food through our intestines. Constipation can result from this natural cycle being disturbed in people with Parkinson's disease. 10 KEY STRATEGIES FOR RELIEVING MEDICINE-RELATED CONSTIPATION: Let's take a look at some effective ways to cope up with constipation caused by medicines. 1. Stay hydrated: Try to drink plenty of water throughout the day, the amount of water absorbed in the colon directly affects the consistency of the stool. If there is insufficient water in the colon, the stool can become hard and dry. On the other hand, if the body is well-hydrated, the stool remains soft and moist. 2. Fibre up for easy going: Try making up a diet plan [https://www.mrmed.in/health-library/gastroenterology/diet-plan-for-constipation-how-to-control] that includes a lot of fibre since it encourages regular bowel motions and gives stool more volume. Eat plenty of fruits, vegetables, whole grains, legumes, and other high-fibre meals. 3. Regular exercise: Try to engage in regular physical activities like yoga, walking or light cardio everyday to make sure your digestive system functions properly. 4. Laxatives: Medications or chemicals formulated expressly to encourage bowel motions and relieve constipation are known as laxatives. Depending on their kind and mode of action, they can assist relieve constipation in a variety of ways. Consult your physician before taking any of these medications as specific types are essential for your constipation. Various kinds of laxatives are available: 1. Stimulant laxatives ( senna, bisacodyl) 2. Osmotic laxatives (lactulose, milk of magnesia) 3. Emollient laxatives (docusate sodium or docusate calcium) 5. Add prunes or prune juice : In addition to containing high fibre prunes also contain sorbitol which ferments in the gut and absorbs more water into the stool [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531972/], this action producing an laxative effect ultimately relieving your constipation. 6. Establish a routine: Try to eat your meals at almost the same time each day, it can stimulate the digestive system and ensure regular bowel movements, also many people naturally have the urge to have bowel movements after meals or waking up and try establishing regular and timely visits to the bathroom. 7. Avoid constipation triggers: Stay away from foods that can cause constipation [https://www.mrmed.in/health-library/gastroenterology/foods-cause-constipation] or stimulate the condition badly. Some foods to avoid include processed foods, red meat, diary products, white flour, and alcohol. It is important to make a note that not all these foods cause constipation, it may vary within individuals, speak with your doctor if you feel your foods make your bowel sick. 8. Switching your medications: Speak with your doctor and adjust the dosage of your medications or either switch to alternative drugs if you suspect your constipation is caused by medicines. This may relieve your sick bowel most of the time. 9. Add probiotics: Probiotics contain various strains of good bacteria that promote and support gut health. By restoring the microbial balance in the stomach supports smooth movements and increased stool frequency. Consult your physician before taking probiotics as it is important to choose the right strain for your constipation. 10. Enema: A medical technique known as an enema involves inserting a liquid solution through the anus into rectum. The liquid solution that is injected during an enema aids in lubricating and softening the feces .This may provoke a bowel movement and becomes a good option for people who need rapid relief from severe constipation because they typically start to work within minutes to an hour of administration. This medical procedure must be carried out only under medical supervision. FAREWELL TO CONSTIPATION, HELLO TO COMFORT: In the era where medicines have become a day to day routine in each home an unwanted guest silently accompanies behind our daily pills. Constipation and its side effects [https://www.mrmed.in/health-library/gastroenterology/10-side-effects-of-constipation] can significantly impact your quality of life . We have uncovered the mysteries behind the medications causing constipation and gave you an insight into the ways to overcome constipation. Let us overcome this bowel barrier and lead a healthy life! “Unblock, Unburden, Unwind”

Dr. Thamizhakaran K S

Types, causes and treatment of constipation

Gastroenterology

18 Dec 2023

9 mins

Know About The Types Of Constipation And Their TreatmentsConstipation is an uncomfortable and often frustrating condition that many of us face, sometimes without even realising it. Understanding the classification of constipation provides a clear scope and objective to address this common problem effectively. Whether triggered by lifestyle factors, medical conditions, or seasonal habits like those in winter, understanding the nuances of constipation is essential for relief and prevention. Let’s delve into the types of constipation, explore how specific classifications influence treatment, and uncover practical solutions to make life more comfortable. WHAT ARE THE TYPES OF CONSTIPATION? Constipation isn’t one-size-fits-all. Identifying the different types of constipation is the first step in addressing the root constipation causes and treatment effectively. There are two major types of constipation. Here’s a closer look at the different types of constipation and how they’re categorised: 1. PRIMARY CONSTIPATION A. CHRONIC IDIOPATHIC CONSTIPATION (CIC) * What it is: CIC occurs without a clear medical reason and is persistent over time [https://pmc.ncbi.nlm.nih.gov/articles/PMC8547593/]. * Causes: Often linked to poor dietary fibre intake, sedentary lifestyle, or stress [https://www.mrmed.in/health-library/mental-wellness/mental-stress-causes]. * Impact on treatment: Focuses on long-term changes such as high-fibre diets, exercise, and possibly medications to stimulate bowel movements. B. FUNCTIONAL CONSTIPATION * What it is: This type is related to slow movement of stool through the colon without underlying structural or medical conditions. * Causes: A diet low in fibre, dehydration, and ignoring the urge to pass stool. * Impact on treatment: Often improved with lifestyle modifications and occasional use of laxatives. C. SLOW TRANSIT CONSTIPATION * What it is: A condition where bowel movements are infrequent due to sluggish colon activity. [https://pubmed.ncbi.nlm.nih.gov/30978764/] * Causes: Neurological conditions or disruptions in gut motility. * Impact on treatment: May require prokinetic agents, a high-fibre diet, and targeted therapies like pelvic floor exercises. D. OUTLET OBSTRUCTION CONSTIPATION * What it is: Difficulty passing stool due to issues with rectal muscles or anatomical obstructions. * Causes: Rectal prolapse, anal fissures, or weakened pelvic floor muscles. * Impact on treatment: Includes physical therapy, biofeedback, or surgery in severe cases. 2. SECONDARY CONSTIPATION * What it is: Occurs as a result of underlying medical conditions or the side effects of certain medications. Unlike functional constipation, this type is directly linked to an identifiable cause that needs specific attention for effective management. Causes: a. Medical Conditions: * Hypothyroidism: Reduced thyroid hormone levels slow down the metabolism, including digestive processes. * Diabetes: Nerve damage caused by poorly managed diabetes can impair bowel function. * Neurological Disorders: Conditions like Parkinson’s disease or multiple sclerosis affect the nerves controlling bowel movements. * Irritable Bowel Syndrome (IBS): This condition can cause a mix of diarrhoea and constipation. * Intestinal Blockages: Tumors, scar tissue, or other obstructions can prevent stool from passing. b. Medications: * Opioids: Frequently prescribed for pain, opioids can reduce bowel motility. * Antidepressants: Tricyclic antidepressants and SSRIs may interfere with normal bowel function. * Antacids: Those containing aluminium or calcium can lead to constipation. * Iron Supplements: Commonly used for anaemia, they often harden stools. HOW DOES THE CLASSIFICATION OF CONSTIPATION GUIDE TREATMENT? The classification of constipation helps guide treatment strategies effectively, ensuring a targeted approach based on the underlying cause. If you're wondering, "How can I treat my constipation?", the strategies below offer tailored solutions: CategoryTreatment StrategyDietary adjustmentsHigh-fibre foods like whole grains, fruits (e.g., apples, pears), and vegetables (e.g., spinach, broccoli) increase stool volume, simplifying elimination.HydrationDrinking plenty of water is crucial, especially for functional constipation. Proper hydration softens stools and facilitates smoother movement through the intestines. Herbal teas or warm water with lemon in the morning can also help.Behavioural changesEstablishing a regular bathroom routine, ideally after meals, and responding promptly to the urge to pass stool are essential for managing functional and outlet obstruction constipation.Physical activityRegular exercise, such as daily walks or yoga, boosts digestive system activity, promoting bowel regularity.Natural remediesRemedies like prunes, psyllium husk, or flaxseeds serve as gentle laxatives, particularly for functional constipation.Medications Different constipation types call for specific medicines: - Fiber Supplements for stool bulking. - Osmotic Laxatives to retain water in the bowel. - Stimulant Laxatives for enhanced bowel contractions. TherapiesOutlet obstruction or slow transit constipation may require advanced therapies such as biofeedback and pelvic floor exercises.Medication classificationCertain medications can contribute to constipation. Consulting a healthcare professional can help identify alternatives or adjust dosages appropriately. MEDICATIONS FOR CONSTIPATION: Here's a list of effective medications available at MrMed to help you find relief and restore digestive balance. 1. Dulcolax (Bisacodyl) – A stimulant laxative that works by stimulating the muscles of the bowel, helping to relieve constipation. It is widely used for short-term constipation relief. 2. Lactulose Syrup – An osmotic laxative that draws water into the colon, making stool softer and easier to pass. It’s often used for more chronic cases of constipation. 3. Movicol – A well-known brand for treating constipation, containing macrogol (Polyethylene glycol) that helps by retaining water in the stool, making it easier to pass. 4. Magmaxx 400mg Tablets [https://www.mrmed.in/otc/magmaxx-400mg-tablet] – These tablets are commonly used to treat constipation by increasing the amount of water in the intestines to help soften stools and ease bowel movements. 5. Psyllium Husk (Isabgol) – A natural fibre supplement that helps bulk up stool, making it easier to pass. It's commonly recommended for functional constipation. Sofolyte 180gm Powder [https://www.mrmed.in/otc/sofolyte-180gm-powder] is one of the medications used. WHAT ARE THE CAUSES OF FREQUENT CONSTIPATION? Frequent constipation can stem from various factors: 1. Medications: Certain drugs, including pain relievers, some antacids, and antidepressants, can slow bowel movements as a side effect. If medication is a concern, consult a healthcare provider for alternative options. 2. Health conditions: Chronic illnesses like irritable bowel syndrome (IBS), diabetes, or hypothyroidism can interfere with normal digestion and contribute to constipation. Proper management of these conditions is essential for improving bowel health. 3. Dietary habits: Consuming a diet low in fibre, such as white bread, processed snacks, and cheese, can slow bowel movements by providing insufficient bulk to the stool. Fibre-rich foods like whole grains, fruits, and veggies help maintain regularity and should be included in daily meals. 4. Hydration: Drinking inadequate amounts of water leads to hard, dry stools that are very difficult to pass. Staying hydrated softens stools, promoting smoother bowel movements and preventing constipation. 5. Lack of exercise: Physical inactivity can reduce intestinal motility, slowing down digestion. Regular activities like walking or yoga help stimulate bowel function and encourage regularity. 6. Stress: Chronic stress disrupts gut-brain communication, often resulting in slower digestive processes. Managing stress can improve overall gut health. HOW DOES WINTER AFFECT CONSTIPATION? Winter and constipation often go hand in hand due to seasonal changes in lifestyle and environmental factors that impact the digestive system. Here's a deeper look at how the colder months can contribute to this uncomfortable condition: 1. REDUCED WATER INTAKE In winter, people tend to feel less thirsty, leading to a reduction in water intake. This can result in dehydration, which hardens stools and makes them more difficult to pass. Adequate hydration is crucial for maintaining stool consistency and promoting regular bowel movements. Scientifically, water helps soften stool by being absorbed in the colon [http://asian.universityeprint.com/id/eprint/1688/]. Without sufficient water, the stool becomes dry and hard, increasing the risk of constipation. 2. COMFORT FOOD CRAVINGS The cold weather often triggers cravings for high-fat, low-fibre "comfort foods" like creamy soups, cheesy dishes, and baked goods. While these foods provide warmth and satisfaction, they lack the dietary fibre necessary to support healthy digestion. Fibre is vital because it adds bulk to stools and helps them pass more easily through the intestines. The absence of fibre-rich foods like fruits, vegetables, and whole grains slows down gut transit time, leading to sluggish bowel movements. 3. DECREASED PHYSICAL ACTIVITY Shorter daylight hours and colder temperatures can discourage outdoor activities and exercise. Physical activity stimulates the muscles in the gastrointestinal tract, promoting peristalsis, the wave-like motion that moves stool through the intestines. Without regular exercise, gut motility slows down, increasing the likelihood of constipation. Studies [https://granitegastro.com/the-role-of-exercise-and-movement-in-digestive-health/] have shown that even light activities, such as walking, can enhance bowel regularity. 4. DRY AIR AND DEHYDRATION Winter air, exacerbated by indoor heating, is typically dry and can dehydrate the body. When the body is dehydrated, it prioritises conserving water for essential functions, often at the expense of bowel hydration. This can result in harder stools and a slower digestive process. Additionally, the mucosal lining of the intestines relies on proper hydration to function effectively, further highlighting the impact of dry conditions. FREQUENTLY ASKED QUESTIONS (FAQS) 1. HOW TO AVOID HARD STOOLS? To avoid hard stools, prioritise a high-fibre diet with fruits, vegetables, and whole grains. Drink plenty of water throughout the day to keep stools soft. Regular physical activity also supports smooth digestion. Avoid excessive processed foods that can slow digestion. Lastly, don't ignore the urge to go to the bathroom to prevent stool from hardening. 2. WHAT SIMPLE TRICK EMPTIES YOUR BOWELS IMMEDIATELY? A simple trick to empty your bowels quickly is to drink a glass of warm water, especially in the morning. The warmth can stimulate the digestive system and help get things moving. Additionally, gentle exercise, like walking or stretching, can encourage bowel movement by increasing intestinal motility. Eating high-fibre foods like fruits or drinking a small amount of prune juice may also help promote regularity. However, if constipation is persistent, it's important to consult a doctor for proper treatment. 3. IS BANANA GOOD FOR CONSTIPATION? Yes, bananas can be helpful for constipation. They contain a type of fibre called pectin, which can aid in bowel movements by absorbing water and helping to soften stools. Bananas also have a high potassium content, which can support the healthy functioning of muscles in the digestive system. However, for some people, especially those with chronic constipation, unripe bananas may cause a temporary slow-down in digestion due to their higher starch content. It’s best to choose ripe bananas to reap the benefits for constipation relief. 4. WHAT IS THE BEST MEDICINE FOR CONSTIPATION? Many people ask, 'What is the treatment of constipation?', and the answer lies in a combination of lifestyle changes, dietary adjustments, and, in some cases, medications tailored to the underlying cause. For gentle relief, fibre supplements like psyllium can add bulk to stools and promote regularity. If you're looking for something to soften hard stools, stool softeners such as docusate might be the answer. For more immediate relief, laxatives like polyethylene glycol help draw water into the intestines, while stimulant laxatives (like bisacodyl) encourage bowel movement. WHAT TO KEEP IN MIND Constipation may be common, but it doesn’t have to be a constant struggle. By understanding the types, causes, and solutions for constipation, you can take control of your digestive health and feel better every day! Whether it’s adding fibre to your diet, drinking more water, or seeking medical advice for persistent issues, small changes can make a significant difference. READ MORE 1. Foods that cause constipation [https://www.mrmed.in/health-library/gastroenterology/foods-cause-constipation] 2. Home remedies for constipation [https://www.mrmed.in/health-library/gastroenterology/10-home-remedies-to-relieve-constipation] 3. Diet plan for constipation [https://www.mrmed.in/health-library/gastroenterology/diet-plan-for-constipation-how-to-control] 4. Medicines that may cause constipation [https://www.mrmed.in/health-library/gastroenterology/medications-causing-constipation] REFERENCES 1. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment [https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment] 2. https://www.nhs.uk/conditions/constipation/ [https://www.nhs.uk/conditions/constipation/] 3. https://www.webmd.com/digestive-disorders/constipation-relief-tips [https://www.webmd.com/digestive-disorders/constipation-relief-tips] 4. https://pmc.ncbi.nlm.nih.gov/articles/PMC3170709/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC3170709/] Note: This blog offers general information and is not medical advice. Consult a healthcare professional before altering your diet, exercise, or medication, especially with existing health conditions. Treatment effectiveness can vary, so seek personalised guidance from a healthcare provider.

Sakshi Anil More