There are few problems that can’t be solved by a good poop and a nap. As a pharmacist, I spend roughly 50% of my time either getting people to start pooping or stop pooping so over the years I’ve developed quite a bit of experience on the topic.
There are a few strategies I like to use for constipation. Here’s my approach when someone is having a tough time going.
Step 1: Food, Water, and Exercise
If you aren’t putting anything in, nothing is going to come out. By that I mean, if you aren’t eating or eating very little, you can’t expect to be having the same volume and quality of bowel movements as you once did. Having fewer stools doesn’t necessarily mean that you are constipated but if you are going longer than 3 days between bowel movements or if you are straining when trying to have a bowel movement – you are indeed constipated.
If you can tolerate increasing your fibre – do it! Add in veggies or bran. You might also try other foods to help with constipation: prunes or papaya.
Water is also key in preventing and treating constipation. If you are dehydrated, your stool can be dehydrated as well, making it more difficult to pass. Essentially if you can bulk up your poop with fibre or water – your constipation will lessen.
You know I’m a big advocate for exercise, no matter where you are at in life. Constipation is no different. Exercise will assist if you are struggling with constipation. Walk around the house, around the block, or head to the gym.
Step 2: Medications For Constipation
First thing I will say – none of these medications will have you running to the bathroom. That is the first thing that everyone wants to know. These medications will take somewhere between 8 -72 hours to start to work so you don’t need to be concerned about being tied to your house. I have no plans of cleaning you out.
These are my top three choices of what to try first if you are constipated:
Option 1: Sennoside (Senokot)
Administration: Oral Tablet
Starting Dose: 1-2 tablets at bedtime
When will it start to work: ~8 hours
Side effects: Abdominal cramping
Sennoside is an oral tablet that works as a stimulant laxative. It works by stimulating the gut to move along and therefore eliminated your stool quicker. Some people find that they get mild abdominal cramping as it is stimulating the bowels. Start with 1-2 tablets at bedtime and in the morning, you should be able to expect a bowel movement. If not, repeat a dose in the morning.
Option 2: Polyethylene Glycol (e.g. Lax-a-day, Restoralax)
Administration: Oral Powder (mixed with any liquid)
Starting Dose: 1 capful (17 g) once daily
When will it start to work: ~24-72 hours
Side effects: Upset stomach, flatulence (most people tolerate very well)
Polyethylene glycol is one of my person favorites for constipation. It is a tasteless and odourless powder that mixes into any liquid (hot or cold). It works by drawing water into the gut and bulking up the stool. It does take a little bit longer to work so you may need to take daily for 1-2 days before having a bowel movement.
Option 3: Lactulose
Administration: Oral Syrup
Starting Dose: 15 ml once daily
When will it start to work: ~ 24-48 hours
Side effects: Sweet taste, abdominal distention, abdominal cramps
Lactulose is a good option to try if the above two options are not appealing to you. Lactulose is a non-absorbable sugar. If you are diabetic or concerned about your sugar intake, this should not be too concerning as it will not be absorbed form the gut. It works by promoting gut motility and moves stool out of the bowels.
There are lots of different medications to try outside of the three listed above. However, start with one of these three and you should be off to a good start.