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Finding the best laxative may not be on your "some days" to-do list; however, constipation is way more common than you think. This bothersome condition is very prevalent for the elderly. According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 16 out of 100 adults and 33 out of 100 those over sixty years old experience constipation symptoms.
Constipation symptoms vary between people. However, you are diagnosed with constipation if you meet one of the following criteria:
• Having fewer than three bowel movements per week
• Passing hard, lumpy, or dry stools
• Painful or difficult bowel movements
• After having a bowel movement, you feel like you haven't emptied all stool.
Maybe you're feeling bloated and stopped up for a few days and want to find the cause and look for a remedy -- keep in mind that constipation can happen for many reasons; certain health conditions and lifestyles can play a significant role in causing this bothersome condition. One fact that many people are not aware of is that certain medications can cause constipation. Please keep reading to learn about common drugs that can be the culprits for constipation and the remedy for it.
Iron Supplements
Iron supplements are used to treat iron deficiency anemia. Your doctor typically prescribes stand-alone iron products such as heme iron polypeptide (Hemeboost) and ferrous gluconate; some iron supplements are available over the counter without needing a prescription. If you take a multivitamin, keep in mind that some of them contain iron. Constipation is a common side effect of iron. If you have yet to use an iron-containing product, ask your doctor or pharmacist if any of your current medications have constipation as a side effect -- If yes, you can try to prevent constipation soon by making lifestyle changes such as increasing daily fiber intake by consuming more fresh fruits and vegetables.
Pain medications
Opioid pain medicines such as morphine, oxycodone, methadone, and Percocet (oxycodone/acetaminophen) are a few examples of opiate pain medicines. This type of analgesic is used short-term to alleviate severe pain after surgery or long-term to treat chronic pain. Opioid pain medicines should be used cautiously as they carry a high risk of misuse and overdose. In addition, constipation is a common side effect of these pain medications. Laxatives are typically initiated simultaneously as opioid medications to prevent constipation.
NSAIDs (nonsteroidal anti-inflammatory drugs) are used to reduce fever and pain and alleviate inflammation; NSAIDs are typically used on an as-needed basis. Some examples of NSAIDs are ibuprofen (Advil) and naproxen (Aleve). Using NSAIDs long-term can result in constipation.
Tricyclic antidepressants
Tricyclic antidepressant (TCA) is an older family of drugs that treat depression, anxiety, and insomnia (sleep problems). Amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin) are examples of some commonly prescribed tricyclic antidepressants. Anticholinergic effects are one of the properties of TCAs. Notably, anticholinergic drugs are known for their side effects of dry eyes, dry mouth, and constipation.
Antihistamines
Similar to tricyclic antidepressants, antihistamines are also anticholinergic agents. Some examples of antihistamines include Benadryl (diphenhydramine), Zyrtec (cetirizine), Allegra (fexofenadine), and Claritin (loratadine). These are the commonly used over-the-counter products to alleviate seasonal allergy symptoms. Benadryl is also used to help with sleep problems due to the sedating effect.
Pepcid (famotidine) is another type of antihistamine used to treat heartburn. Pepcid (famotidine) are available as an OTC mint chewable tablet; higher strengths (20 mg and 40 mg oral tablets) can be obtained with a doctor’s prescription. Suppose you take an antihistamine occasionally to help with allergy symptoms or alleviate acid reflux with Pepcid. In that case, you don't have to worry about constipation. However, if you take these medications long-term, you should look into different lifestyle changes to prevent constipation.
Urinary incontinence medications
Like antihistamines and tricyclic antidepressants, the drugs in this family are also anticholinergics. These medications are indicated to treat overactive bladder and alleviate other urinary symptoms such as loss of bladder control leading to urinary incontinence or bladder leakage. Like other anticholinergics, constipation is one of the biggest concerns with these medications. Once you start taking medicines for overactive bladder, you should add fresh fruits and vegetables to increase your fiber intake, which is helpful to prevent constipation while, at the same time, benefiting your overall health.
Anti-nausea medications
Ondansetron (Zofran) prevents nausea and vomiting after surgery or chemotherapy. Though the risk of constipation is not high when used as needed, frequent, chronic use of Zofran can lead to constipation.
Blood pressure medications
Like any drug, blood pressure medications can also cause side effects, and constipation is one of the side effects of certain medicines. Keep in mind that only certain classes of antihypertensives can cause constipation; specifically, beta-blockers, calcium channel blockers, and alpha agonists could make you stopped up.
Beta-blockers have drug names ending in "-lol," such as atenolol (Tenormin), metoprolol (Lopressor), and propranolol (Inderal). Clonidine (Catapres) is a commonly prescribed alpha-agonist. Examples of calcium channel blockers are diltiazem (Cardizem) and amlodipine (Norvasc).
You may not feel the effect of blood pressure medications; however, if you or your loved ones have high blood pressure, you probably know how essential these medicines are. Keeping your blood pressure in the recommended range will reduce the risk of stroke, heart attacks, and heart diseases in the future. Therefore, the benefits of taking blood pressure medications regularly as prescribed outweigh the risks. You should talk to your doctor or pharmacist if you are unsure if your blood pressure pill can cause constipation. Your healthcare provider provides you with guidance and tips on how to prevent constipation.
How to relieve constipation?
Non-drug remedy
• Staying active: 10 to 15 minutes of walking a few times daily can help move your bowel.
• Staying well hydrated by drinking plenty of fluids.
• Eating a balanced diet with a high fiber intake containing fresh fruits and vegetables
• Avoid fried or fast food, alcohol, and red meat if you feel bloated since these foods are low in fiber and can potentially exacerbate constipation.
Try taking vitamin D and magnesium. There's a high chance that you’re deficient in them and they can lead to constipation. Some studies have found that up to 80% of the population are deficient in these two important minerals and they can cause constipation if not corrected. It is important to check with your doctor when you do start and check your vitamin D levels periodically.
Chronic functional constipation is strongly linked to vitamin D deficiency - PMC
Association of dietary magnesium intake with chronic constipation among US adults: Evidence from the National Health and Nutrition Examination Survey - PMC
Medications to treat constipation
You can choose from many over-the-counter stool softeners and laxatives to alleviate the symptoms of constipation. Below are some of the constipation reliefs we offer at significant savings at our Canadian pharmacy:
OTC products:
• Sennosides (Senokot): take these only temporarily so your colon does not get lazy and rely on them
• Docusate sodium (Colace)
• Bisacodyl (Dulcolax)
• Polyethylene glycol (Miralax)
Below are prescription medications that require a doctor’s prescription. Prescription drugs for constipation are reserved for people with severe constipations that do not respond to over-the-counter constipation drugs.
• Motegrity (generic Prucalopride Succinate), other brand names include Resolor, Resotran, Resotrans – this product is indicated for chronic constipation where OTC laxatives and stool softeners do not provide adequate relief.
• Movantik (Naloxegol Oxalate) – this medication is specifically used for opioid-induced constipation. Movantik is not a traditional laxative, and it only works for constipation due to chronic opioid use because this medication works on the opioid receptors in the intestines.
• Moviprep – this product is an osmotic laxative; it works by pulling a large amount of water into the colon resulting in watery bowel movements. Moviprep is used strictly as a preparation for a colonoscopy in adults over 18 years.
Wrapping up
Understanding your medication regimen and what side effects to watch for are essential steps to taking ownership of your health. Having this knowledge will help you to create and maintain a healthful lifestyle. Constipation can result from many factors, such as medical conditions, lifestyle, and medications. For most people, some medicines mentioned above are meant to be taken as needed, such as pain relievers and anti-nausea medications. However, for chronic therapy, such as blood pressure medications and other drugs that might need to be used long-term, such as incontinence medications and antidepressants, the best way to manage constipation and other side effects are to work with your doctor and pharmacist. It may be overwhelming with so many choices of laxatives and stool softeners; your providers can evaluate your current medication therapy and help you choose a medication that works best for you. A dietitian can provide dietary recommendations for a healthful, balanced diet that helps prevent constipation and fits your dietary preferences.
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