Dr. Marc Basson received his undergraduate and medical education at the University of Michigan, surgical training at Columbia-Presbyterian Medical Center, Downstate Medical Center, and St. Mary's Hospital, and then earned a PhD in Experimental Pathology at Yale University before becoming an Assistant and then Associate Professor of Surgery at Yale.
If these initial measures fail, the health care professional may try a number of laxatives on a short-term basis.
The patient must consult with his or her doctor before using any of these agents, particularly on long-term basis.
Mineral oils can be very helpful in the short-term, but are
associated with health risks with long-term use. They also can cause substantial
diarrhea if too much is taken.
Sodium docusate or calcium docusate
may be useful when the patient must avoid straining for a short period of time, such as after a
during pregnancy, or after gastrointestinal surgery.
They often will lose their effectiveness after several days.
supplements as mentioned previously.
Polyethylene glycol 3350
(Miralax) is an osmotic laxative that is not absorbed by the intestines. It holds
water in the bowel, resulting in looser stools. It may be taken occasionally for
constipation (up to 2 weeks). Miralax is a drink prepared by mixing a powder with
240 mL (8 oz) of water. Some physicians may prescribe it on a long term basis.
Lubiprostone (Amitiza) stimulates
the bowel to secrete more fluid into the stool
and therefore makes it softer. It is typically taken twice daily and should be taken
on a regular basis whether or not constipation is present.
Nonabsorbable sugars such as lactulose and sorbitol may be useful.
Furthermore, they are may acceptable for long-term use. However, they
usually produce crampy abdominal pain, diarrhea, and
Saline laxatives such as
magnesium hydroxide (Phillips Milk of Magnesia) or
sodium phosphate (Phospho-Soda, Fleet enema) are not recommended if
the affected individual has 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.
A doctor may prescribe them on an occasional basis if the patient has normal
Cisapride (Propulsid) may work if
the patient has constipation caused by slow fecal movement. However, the srug has been withdrawn from US market because it
can cause lethal irregular heartbeats.
A doctor will treat any underlying diseases (intestinal obstruction, anal fissure, hemorrhoids, and bowel cancer).
If the patient has irritable bowel syndrome (IBS), he or she should
stop smoking and avoid coffee and milk-containing foods. A food diary may help to identify foods that seem to worsen
Thyroxin will be prescribed if the doctor determines through clinical and laboratory tests that
the patient has an underactive thyroid gland (hypothyroidism).