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Nowadays, many people love to eat lots of meat, barbecue, and fast food. Additionally, sedentary lifestyles and work-related stress can contribute to the prevalence of constipation.
Yes, they are laxatives. We categorize four kinds of laxatives according to their acting time and potency:
1. Bulk-forming laxatives
Bulk-forming laxatives can facilitate bowel movements by absorbing water and increasing fecal mass, such as psyllium, a natural fiber. It works gently in our bodies; the onset is 72 hours, so it is usually used for chronic constipation. Though it is safe to use, you should drink plenty of water to prevent obstruction. If taken with other medicines, they should not be taken at least 2 hours apart.
2. Osmotic laxatives
The ingredients, such as lactulose, sorbitol, and macrogol (PEG 4000), are osmotic laxatives that draw fluid into the intestines, making your stool softer and easier to pass. The onset is 24~48 hours. They are available to treat chronic constipation and can be used for the long term. However, besides macrogol, taking lactulose or sorbitol may cause the side effects of abdominal bloating and flatulence.
3. Stimulant laxatives
Stimulant laxatives such as bisacodyl and senna can increase intestinal motor activity by stimulating the nerves in the wall of the intestine. The onset is 8~12 hours, and the usual use is to take them 30 minutes before sleep so that you will have a bowel movement in the morning. Some people will overuse stimulant laxatives, but taking stimulant laxatives regularly or in large amounts can cause tolerance and let the bowels lose normal activities. Thus, you should take these drugs carefully if you must use them regularly.
4. Saline laxatives
Saline laxatives such as magnesium oxide, sodium phosphate, and sodium citrate can treat acute or occasional constipation and act similarly to osmotic laxatives. The onset is 20 minutes ~ 3 hours and can be taken orally or rectally. Suppositories and enemas work more quickly than pills, but many people do not like using them.
Yes, it may happen. Severe and prolonged constipation can cause the stool to become hard and difficult to pass, resulting in anal fissures and bleeding. If this occurs, oral medicines such as Daflon or topical creams containing analgesic and anti-inflammatory agents can relieve the symptoms and promote healing.
Medications can temporarily relieve constipation, but preventing it requires a lifestyle change. A balanced diet with adequate fiber (20 to 30 g of insoluble fiber per day) and water (1.5 to 2 liters per day), supplemented with digestive enzymes as needed, can help regulate bowel movements. Regular exercise and daily routine are also critical to maintaining our body functions.
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2. UpToDate: Patient education: Constipation in adults (Beyond the Basics)
3. UpToDate: Home and office treatment of symptomatic hemorrhoids
4. PubMed: Micronized Purified Flavonoid Fraction in Hemorrhoid Disease: A Systematic Review and Meta-Analysis