The most common side effects of Miralax include nausea, stomach cramping, and gas. Serious side effects may include excessive bowel movements, persistent diarrhea, severe stomach pain, bloody stools, or rectal bleeding. Consult your healthcare provider right away if you experience any serious side effects. With either drug, rare but serious allergic reactions may occur.
Dulcolax should not be taken within one hour of antacids like Tums or Rolaids, or proton pump inhibitors, because the combination could increase the risk of stomach cramps and other side effects.
Dulcolax should not be taken with other stimulant laxatives because the combination could increase the risk of ulcers or colitis. Miralax should not be taken with Linzess because the combination can increase the risk of dehydration and electrolyte abnormalities. This is not a full list of drug interactions.
Other drug interactions may occur. Consult your healthcare provider for a full list of drug interactions. It is always a good idea to consult with a doctor of gastroenterology gastroenterologist if you experience bowel problems, especially if they are frequent or chronic.
The gastroenterologist can do a full workup and evaluation, to determine if you have any underlying conditions causing your constipation that need to be treated.
Dulcolax is an OTC medication that contains bisacodyl, a stimulant laxative. It is available in brand and generic and in tablet or suppository form. The suppository works quickly, producing a bowel movement within minutes, and the tablets take about six to twelve hours to work. Miralax is an OTC medication that contains polyethylene glycol , an osmotic laxative.
It is available in brand and generic in powder form. Miralax should produce a bowel movement within one to three days. Both medications are laxatives, but are different types of laxatives and work in different ways. See above for more information about Dulcolax and Miralax. There are also other types of laxatives, compared in the chart below. The two drugs have not been compared in clinical trials.
You may want to consider the type of medication you prefer tablet, suppository, or powder mixed into a liquid as well as how fast you would like to go to the bathroom. If you are pregnant or breastfeeding, consult your healthcare provider before using a laxative.
Alcohol may worsen constipation. If you are experiencing constipation, you should avoid alcohol. See the laxative chart above. There are several other laxatives that can work quicker than Miralax if you need something to work quickly.
A Fleet Saline Enema can produce a bowel movement as quickly as one to five minute s. A Dulcolax suppository can produce a bowel movement in minutes. A saline laxative, such as magnesium citrate, can produce a bowel movement in a half hour to 6 hours.
Depending on your preference enema, suppository, or liquid and your level of discomfort, you can choose one of these, and it should work very quickly. Miralax can be taken occasionally to treat constipation, but should not be used for more than seven days. If you have been using Miralax for seven days, and feel like you need to keep using it, consult your healthcare provider for guidance. Dehydration; hypocalcemia and hyperphosphatemia in patients with chronic renal failure.
Tap water. Sodium phosphate. Polyethylene glycol. Bulk-forming laxatives are natural or synthetic polysaccharide or cellulose derivatives that cause water to be retained in the colon and thereby increase stool bulk. These laxatives have few potential adverse effects and are effective in slowly reversing the symptoms of constipation. In fact, their use is essentially the same as increasing fiber in the diet. However, a number of bulking agents, psyllium in particular, at least initially result in gas formation and bloating.
These problems may be partially overcome by starting a bulk-forming laxative at less than the recommended dosage and gradually increasing to the recommended level over a few weeks. Stool softeners such as docusate Colace decrease surface tension and therefore allow stool to absorb more water. Stool softeners are generally well tolerated but are ineffective if fluid intake is inadequate. Saline laxatives e.
They may also trigger the release of cholecystokinin, which, among other effects, causes colonic prokinesis. However, in patients with renal insufficiency, saline laxatives may lead to hypermagnesemia or to hypocalcemia from hyperphosphatemia. Commercially available cleansing preparations used before colonoscopy, such as polyethylene glycol Golytely , act as nonabsorbed osmotic agents and therefore are preferable in patients with renal failure.
Sorbitol and lactulose are also osmotic agents. They are broken down into nonabsorbable organic acids in the gut. Lactulose is considerably more expensive than sorbitol but is the agent of choice in patients with hepatic failure. Stimulant laxatives are by far the most frequently prescribed and purchased class of laxatives. These agents promote stooling by altering electrolyte transport in the intestinal mucosa and increasing colonic motility.
With chronic use, however, stimulant laxatives may damage the myenteric plexus and result in colonic dysmotility. As previously noted, anthraquinone derivatives such as senna, cascara and aloe may cause colonic mucosal pigmentation and are thought to directly damage the myenteric nerves.
Phenolphthalein, a common ingredient in some over-the-counter laxative preparations, has been associated with photosensitivity, dermatitis and the Stevens-Johnson syndrome.
Phenolphthalein is no longer on the market in the United States but is still available elsewhere in the world. Patients with extreme chronic constipation have been treated with a variety of surgical procedures, including hemicolectomies and semicolectomies.
For example, subtotal colectomy with ileorectal anastomosis has been used to treat patients with severe, idiopathic slow-transit constipation that did not respond to medical treatment. Patient satisfaction with the outcome of this procedure is reported to be high. The bedridden or chair-bound patient presents special problems.
The use of potent laxatives may lead to fecal soiling because the patient may not be able to identify or rapidly respond to the defecatory urge. However, bulking agents may promote regularity and soft stools.
Behavioral programs i. Positioning the patient over the toilet and using tap-water enemas may also be successful. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. In addition, he completed a fellowship in gastroenterology at the Johns Hopkins University School of Medicine, Baltimore, and earned both a master of science degree and a doctorate in clinical psychology from Virginia Commonwealth University, Richmond.
Address correspondence to David C. Schaefer, M. Reprints are not available from the authors. Aphorisms section II. In: Lloyd GE, ed. Hippocratic writings. Hammondsworth, N. Clinical epidemiology of chronic constipation.
J Clin Gastroenterol. Constipation in the elderly living at home: definition, prevalence, and relationship to lifestyle and health status.
J Am Geriatr Soc. Prescribing patterns observed in registered nursing homes and long-stay geriatric wards. Age Ageing. Sonnenberg A, Koch TR.
Physician visits in the United States for constipation: to Dig Dis Sci. Constipation in the elderly. Prevalence of gastrointestinal symptoms in the elderly: a population-based study. How trustworthy are bowel histories? Comparison of recalled and recorded information. Br Med J. Gastroenterol Int. Eastwood HD. Bowel transit studies in the elderly: radio-opaque markers in the investigation of constipation. Gerontol Clin. Effect of age on human gastric and small bowel motility.
The treatment of chronic constipation in adults: a systematic review. J Gen Intern Med. Diverticular disease of the colon: a deficiency disease of Western civilization. Transit time in constipated geriatric patients during treatment with a bulk laxative and bran: a comparison. Scand J Gastroenterol. Marlett JA.
Content and composition of dietary fiber in frequently consumed foods. J Am Diet Assoc. Results of colectomy for severe slow transit constipation. Dis Colon Rectum. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
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Constipation in the Elderly. TABLE 2 Constipation: Causes and Treatments Causes Treatments Idiopathic possible mechanisms Dietary factors low residue Increase dietary fiber Motility disturbances colonic inertia or spasm such as inirritable bowel syndrome Increase dietary fiber, and give medication based on the underlying disorder e.
Suggested algorithm for the evaluation of constipation in the elderly. If you have any questions about the use of laxatives, check with your health care professional. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:. Other side effects not listed may also occur in some patients.
If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below.
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