Medications

If these initial measures fail, your doctor may try a number of laxatives on a short-term basis. You must consult with your doctor before using any of these agents, particularly on long-term basis.

• Mineral oils
  
  
• Sodium docusate or calcium docusate are useful when you must avoid straining, such as after a heart attack, during pregnancy, or after gastrointestinal surgery.
  
  
• Saline laxatives such as magnesium hydroxide (Phillips Milk of Magnesia) or sodium phosphate (Phospho-Soda, Fleet enema) are not recommended if you have renal insufficiency (an inability or reduced capacity of the kidney to remove waste). These laxatives may produce severe side effects if used on long-term basis.
  
  
• Polyethylene glycol 3350 (Miralax) is an osmotic laxative that is not absorbed by your stomach. It holds water in the bowel, resulting in looser stools and a laxative effect. It may be taken occasionally for constipation (up to 2 wk). Miralax is a drink prepared by mixing a powder with 240 mL (8 oz) of water.
  
  
• Nonabsorbable sugars such as lactulose and sorbitol may be useful. Furthermore, they are usually acceptable for long-term use. However, they usually produce crampy abdominal pain, diarrhea, and electrolyte imbalance.
  
  
• Cisapride (Propulsid) may work if you have constipation caused by slow fecal movement. However, it has been withdrawn from US markets because it may cause lethal irregular heartbeats.

Your doctor will treat any underlying diseases (intestinal obstruction, anal fissure, hemorrhoids, and bowel cancer).

• If you have irritable bowel syndrome, you should stop smoking and avoid coffee and milk-containing foods. A food diary may help to identify foods that seem to worsen symptoms.
  
  
• Thyroxin will be prescribed if the doctor determines through clinical and laboratory tests that you have an underactive thyroid gland (hypothyroidism).