Almost everyone has an encounter with constipation or diarrhea at some time, even though the disorder is usually related to the diet and not serious. If medication is needed, it can usually be purchased without a prescription, but on occasion one needs to contact a health care provider.
Constipation may be defined as infrequent or hard stools or difficulty passing stools, causing abdominal pain. This can sometimes result in an anal tearing (fissure) or more often, hemorrhoids—painfully swollen and itchy veins in the lower rectum or anus. Constipation may occur during pregnancy due to hormonal changes and/or the pressure exerted by the uterus on the intestines.
Lifestyle causes of chronic constipation include lack of exercise, emotional stress, insufficient roughage or fiber in the diet, even improper use of laxatives. Various medications can be responsible such as chemotherapy drugs, narcotics, antispasmodics, antidepressants, diuretics, iron supplements, anticonvulsants, tranquilizers, some sleeping medications and calcium and aluminum-based antacids. Other causes of constipation may be the result of genetics, hormonal disturbances and digestive disorders caused by disease.
To help prevent constipation, drink generous amounts of fluids, increase the amount of fiber in the diet, and exercise. Good sources of fiber are fruits, vegetables, and bran cereals or other whole grains. Increasing these foods also limits fats; excess fat in the diet slows digestion, which can lead to heartburn, bloating and constipation. If you are just starting a high fiber diet, proceed gradually until your body gets used to the change, and drink more water than usual, as without extra water, fiber may cause constipation.
Check with your doctor before trying laxatives, as they can be dangerous and may become habit-forming. Addiction to laxatives may in time cause loss of muscle strength in the bowel wall, making it difficult to have normal bowel habits. Moreover, the digestive system may not be able to absorb the nutrients in food. Fiber supplements such as Metamucil and Citrucel and stool softeners such as docusate or senna are safe for short term use, but dietary changes and exercise may eliminate their need and should be tried first. See your doctor if constipation persists, is accompanied by abdominal pain or vomiting, or if your bowel habits change suddenly. In addition to laxatives, suppositories or enemas should only be taken under the supervision of your physician, since there may be more to the situation than you realize.
Diarrhea can have varied causes, but most of the time it is dietary and mild. See a doctor when symptoms are severe or persistent, if you’re losing weight, or if you see blood in your stool. Loperamide (Imodium) is an excellent drug for mild diarrhea and cramping and is available without prescription. This medication quiets down the gastro-intestinal tract, slows the passage or transit time, thickens the stool, and decreases fluid losses. It is not advised in children or pregnant or nursing women without the physician’s approval. Any diarrhea in a child, especially an infant, can be dangerous, so definitely contact your health care provider in that situation. Several medications can cause diarrhea. Examples are some antibiotics, magnesium containing antacids, colchicine, Inderal, quinidine, theophylline, diuretics, ACE inhibitors, and antidepressants. If this occurs, contact your pharmacist or physician. A simple aid for mild diarrhea is plain non-fat yogurt, especially the type that contains lactobacillus and bifido bacteria, known as the “good” bacteria.
Fluid replacement is important during diarrhea. Drink clear liquids to replace fluid loss and prevent dehydration. In the first 12 to 14 hours, limit your intake to mild liquids to allow the bowel to rest. A diet of flat ginger ale, broth, herbal tea or gelatin is appropriate; Gatorade and Pedialyte are excellent. The next 24 hours you can choose from clear soups, bread, rice, salted crackers, cooked cereals, baked potato, bananas, boiled eggs, dry toast or applesauce. Avoid fresh fruit and vegetables and fried, fatty or spicy foods for a few days. If you are very hungry, but want a light meal as you are recovering, try non-fat cheese on dry toast with applesauce on the side.
For traveler’s diarrhea, fluid replacement and loperamide are proper. If the diarrhea is prolonged or is accompanied by other symptoms, (nausea, vomiting, fever, blood in stools), treatment with prescription drugs can be instituted, although medications like bismuth subsalicylate (Pepto-Bismol) will often help.