Gastroenterology diseases symptoms and treatment Information

Gastroenterology

28 Dec 2023

11 minutes

Constipation From MedicationsMEDICATIONS AND DIGESTION: AVOIDING THE CONSTIPATION PITFALL Imagine you are being diagnosed with a disease that requires medicine for relief, only to find out later that the very medications prescribed to you are contributing to an unanticipated side effect: constipation. For many people around the globe managing the maze of medications and their side effects is a daily reality. For many of us, constipation is a common digestive problem. However, it takes on another dimension when it comes as a side effect of medication—one that's frequently hidden behind prescription labels and pharmacy counters. Join us to uncover the stories behind the pill bottle and bowel block to find a healthier, more comfortable life. TOP 10 MEDICATIONS CAUSING CONSTIPATION: UNMASKING THE PILL BOTTLES: 1. Opioid pain medications: Opioid induced constipation occurs in about 15% of the population [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549585/]consuming them for pain relief. Opioid drugs can cause your intestines to retain more water in your stool, which results in a hard, dry stool. Your stool remains in your intestines longer than it should because of the slower movements and hard stool making it difficult to pass feces. Some of the common drugs are: 1. Tramadol 2. Morphine 3. Fentanyl 2. Antidepressants: The level of serotonin hormone in the gut may increase as a result of taking some antidepressants. This extra serotonin slows down the normal movements of your intestines. Slower gut movement means stool moves more slowly through the intestines, making it harder for the body to push stool out, resulting in constipation. Some of the common drugs are: 1. Amitriptyline 2. Imipramine 3. Fluoxetine 3. Iron supplements: Iron supplements may cause your intestines to absorb more water and electrolytes, which might result in firmer, dryer stools. Because it is dry and firm, the stool might pass through the intestines more slowly your body finds it more difficult to pass stool due to a combination of slower movement and tougher stools. 4. Antipsychotic drugs: These drugs slow down the regular muscle movements in the stomach that carry food and waste through your intestines by inhibiting dopamine receptors in the gastrointestinal (GI) tract. Because of the slower movement, more water may be absorbed from the feces, making it tougher and dryer causing constipation. Some of the drugs are: 1. Clozapine 2. chlorpromazine 5. Antihypertensive medications: The typical rate at which food and waste flow through the intestines can be slowed down by some antihypertensive drugs by slowing down these peristaltic motions in the GI tract. As a result it causes firmer, drier stools. People may find it difficult to pass faeces as a result of slower peristalsis and tougher stools, which can lead to constipation. some common drugs are: 1. Verapamil 2. Clonidine [https://www.mrmed.in/medicines/arkapres-100mg-tablet] 3. Methyldopa 6. Anticholinergic drugs: Anticholinergic medications can cause decreased peristalsis, by blocking the effects of acetylcholine in the GI tract. Slower movements in the stomach might cause stool to stay in the intestines longer than usual, which can absorb more water from the stool and cause it to become drier and tougher. 7. Diuretics: Diuretics may possess some kind of magnesium and potassium electrolytes imbalances, severe imbalances of this can impact muscle contractions of stomach and intestines which could slow down bowel motions and lead to constipation. Some common drugs are: 1. Furosemide [https://www.mrmed.in/medicines/lasix-injection] 2. Hydrochlrothiazide 8. Antacids: The action by which antacids function is to neutralize stomach acid. Sometimes a large decrease in stomach acid can interfere with proper digestion by slowing the passage of food and waste through the intestines, which can cause constipation. Since an excessive amount of calcium and magnesium found in antacids can have the above impact on the body, taking it in excess can contribute to constipation. 9. Antispasmodic drugs: Antispasmodic medications work to lessen spasms or contractions and ease discomfort, but in certain people, they can also cause the GI muscles to relax too much, which can temporarily slow down bowel motions and cause firmer, drier stools, which can exacerbate constipation, by unduly relaxing the GI tract's muscles. 10. Antiparkinsonian drugs: Parkinson's disease, a disorder marked by a dopamine shortage in the brain, dopamine is essential for controlling how the muscles in our gastrointestinal (GI) tract work, which facilitates the easy passage of waste and food through our intestines. Constipation can result from this natural cycle being disturbed in people with Parkinson's disease. 10 KEY STRATEGIES FOR RELIEVING MEDICINE-RELATED CONSTIPATION: Let's take a look at some effective ways to cope up with constipation caused by medicines. 1. Stay hydrated: Try to drink plenty of water throughout the day, the amount of water absorbed in the colon directly affects the consistency of the stool. If there is insufficient water in the colon, the stool can become hard and dry. On the other hand, if the body is well-hydrated, the stool remains soft and moist. 2. Fibre up for easy going: Try making up a diet plan [https://www.mrmed.in/health-library/gastroenterology/diet-plan-for-constipation-how-to-control] that includes a lot of fibre since it encourages regular bowel motions and gives stool more volume. Eat plenty of fruits, vegetables, whole grains, legumes, and other high-fibre meals. 3. Regular exercise: Try to engage in regular physical activities like yoga, walking or light cardio everyday to make sure your digestive system functions properly. 4. Laxatives: Medications or chemicals formulated expressly to encourage bowel motions and relieve constipation are known as laxatives. Depending on their kind and mode of action, they can assist relieve constipation in a variety of ways. Consult your physician before taking any of these medications as specific types are essential for your constipation. Various kinds of laxatives are available: 1. Stimulant laxatives ( senna, bisacodyl) 2. Osmotic laxatives (lactulose, milk of magnesia) 3. Emollient laxatives (docusate sodium or docusate calcium) 5. Add prunes or prune juice : In addition to containing high fibre prunes also contain sorbitol which ferments in the gut and absorbs more water into the stool [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531972/], this action producing an laxative effect ultimately relieving your constipation. 6. Establish a routine: Try to eat your meals at almost the same time each day, it can stimulate the digestive system and ensure regular bowel movements, also many people naturally have the urge to have bowel movements after meals or waking up and try establishing regular and timely visits to the bathroom. 7. Avoid constipation triggers: Stay away from foods that can cause constipation [https://www.mrmed.in/health-library/gastroenterology/foods-cause-constipation] or stimulate the condition badly. Some foods to avoid include processed foods, red meat, diary products, white flour, and alcohol. It is important to make a note that not all these foods cause constipation, it may vary within individuals, speak with your doctor if you feel your foods make your bowel sick. 8. Switching your medications: Speak with your doctor and adjust the dosage of your medications or either switch to alternative drugs if you suspect your constipation is caused by medicines. This may relieve your sick bowel most of the time. 9. Add probiotics: Probiotics contain various strains of good bacteria that promote and support gut health. By restoring the microbial balance in the stomach supports smooth movements and increased stool frequency. Consult your physician before taking probiotics as it is important to choose the right strain for your constipation. 10. Enema: A medical technique known as an enema involves inserting a liquid solution through the anus into rectum. The liquid solution that is injected during an enema aids in lubricating and softening the feces .This may provoke a bowel movement and becomes a good option for people who need rapid relief from severe constipation because they typically start to work within minutes to an hour of administration. This medical procedure must be carried out only under medical supervision. FAREWELL TO CONSTIPATION, HELLO TO COMFORT: In the era where medicines have become a day to day routine in each home an unwanted guest silently accompanies behind our daily pills. Constipation and its side effects [https://www.mrmed.in/health-library/gastroenterology/10-side-effects-of-constipation] can significantly impact your quality of life . We have uncovered the mysteries behind the medications causing constipation and gave you an insight into the ways to overcome constipation. Let us overcome this bowel barrier and lead a healthy life! “Unblock, Unburden, Unwind”

Dr. Thamizhakaran K S

Gastroenterology

18 Dec 2023

9 mins

Types Of ConstipationWhat is constipation? Constipation happens when you deal with uncomfortable or not-so-frequent trips to the bathroom. If you are constipated, your visits to the toilet result in passing small amounts of hard, dry stool – typically less than three times a week. Your body might signal that it's time to make things smoother in the bathroom. What brings about this constipation? Join us in this blog as we uncover the diverse types of this common condition. TYPES OF CONSTIPATION Constipation can be broadly classified into primary and secondary: * Primary constipation either comes directly from an issue with the colon or happens without a clear reason. * Secondary constipation shows up because of lifestyle choices or an underlying illness. Constipation can also be classified as short-term (acute) or long-lasting (chronic). * Short-term constipation (acute) happens suddenly, maybe due to changes in what you eat, your habits, or using certain medications for a short time. * Long-lasting (chronic) constipation is a persistent problem that sticks around. UNDERSTANDING PRIMARY CONSTIPATION Doctors sometimes call primary constipation "functional" or "idiopathic." These words mean that constipation is the main health concern by itself, not caused by another hidden medical problem or happens for unknown reasons. Now, let's talk about the three kinds of primary constipation. I. Normal Transit Constipation Primary constipation comes in different forms, each with its quirks and remedies. First up is the familiar normal transit constipation, where you might sense a bit of constipation, but there is no need to fret—it's the most common type. Stools here maintain their regular consistency and move through your digestive system at a steady pace. You might experience some abdominal bloating and pain, but fear not! The remedy trio includes upping your fiber intake, staying hydrated, and throwing in a bit of exercise or yoga. If things don't budge, laxatives are there to save the day. II. Slow Transit Constipation Next on the list is the elusive slow transit constipation, a rare condition that tends to affect middle-aged females. This one tricks the usual bowel stimulation, resulting in a sluggish movement of food through the digestive tract and infrequent trips to the bathroom. The remedy playbook is pretty similar: more fiber, ample water, a sprinkle of exercise or yoga, and, if needed, the trusty laxatives after consulting your doctor. III. Outlet Constipation Lastly, we have outlet constipation, a situation where damage to pelvic floor muscles, also known as dyssynergic defecation, wreaks havoc. The coordination between the pelvic floor and anal sphincter goes a bit haywire, making it tough to pass stools. This leads to uncomfortable symptoms like straining, delays in bowel movements, and the occasional need for some hands-on assistance. The superhero remedy for this one is biofeedback therapy, swooping in to restore harmony between those pelvic muscles and your body's natural rhythm. So, whether it's the regular traffic jam, the slow cruiser, or the tricky pelvic maneuvers, there's a tailored plan to get things moving smoothly again! What is a biofeedback therapy? Biofeedback therapy [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073852/] involves a skilled therapist placing a small device in the anal sphincter. The therapist then provides feedback, either visually or verbally, on how the person is using their pelvic floor muscles and anal sphincter when they are having a bowel movement. This feedback is behavioral therapy and valuable for helping the person retrain and improve the coordination of their pelvic floor muscles, overcoming outlet constipation. DECODING SECONDARY CONSTIPATION Secondary constipation happens when there's an underlying health issue or as a side effect of certain medications. The usual suspects causing secondary constipation include: * Hypothyroidism * Diabetes * Brain or blood vessel-related diseases (like dementia) * Depression * Certain medications (like opioids and chemotherapy-induced constipation [https://www.mrmed.in/health-library/cancer-care/diet-during-chemotherapy]) * Irritable bowel syndrome [https://www.mrmed.in/health-library/gastroenterology/ibs-symptoms-causes-treatment] (IBS) * Inflammatory bowel diseases (like Crohn's and ulcerative colitis) Less common reasons for secondary constipation involve: * Deficiencies in vitamins and minerals * Tiny tears in the anal tissue (anal fissures) * Nerve damage * Spinal cord injuries * Nervous system-related diseases (like Parkinson's disease and multiple sclerosis) * Colon cancer [https://www.mrmed.in/health-library/cancer-care/colon-cancer-symptoms-causes-risk-factors-treatments] TREATMENT FOR SECONDARY CONSTIPATION If you're dealing with secondary constipation, the first thing to do is find and fix what's causing it. Let's say you have diabetes that's not under control, and it's causing nerve issues leading to constipation. In this case, taking charge of your diabetes is crucial to help with the constipation. Sometimes, surgery might be needed for folks dealing with secondary constipation, especially if there's a troublesome part of the colon that needs fixing or removing. What Can You Do to Help? Supporting your gut health alongside medical treatment can be a way forward. While adjusting your diet and increasing physical activity won't directly address the main issue causing secondary constipation, these changes can prevent the situation from worsening. So, consider being more active, adding fiber-rich foods to your diet, and ensuring you drink enough fluids. Avoid food that causes constipation [https://www.mrmed.in/health-library/gastroenterology/foods-cause-constipation] and Try foods that relieve it. It's like providing your body with additional support while the doctors focus on the primary problem. FACTORS THAT INFLUENCE YOUR GUT HEALTH: RISK FACTORS What can make you more likely to get constipated? Here are some things to keep in mind: 1. Not Enough Water: If you don't drink enough water, your poop can become hard and tough to pass. Water helps make your poop softer and move through your belly better. 2. Lifestyle Choices: Certain lifestyle habits might cause or add to constipation. Not moving around much, not eating enough fiber, and holding in your poop for too long can be factors. 3. Gender: Females are more prone to constipation than guys. Things like pregnancy or childbirth can also play a role, causing certain types of damage to the pelvic floor. 4. Pregnancy: Changes in hormones during pregnancy can slow digestion, leading to constipation. 5. Health Conditions: Some chronic health issues like hypothyroidism, diabetes, or Parkinson's disease may cause constipation. 6. Medications: Certain medications can slow digestion or affect nerves, making constipation more likely. This includes things like antacids, certain pain meds (like opioids), some antidepressants, blood pressure meds, and medications used for Parkinson's disease. 7. Using Laxatives and Enemas: Relying too much on laxatives and enemas for a long time can make it harder for you to poop without them. WHEN SHOULD I CALL A DOCTOR? If you sometimes get constipated, and it gets better with things you do at home, no worries. But, it's a good idea to see a doctor if: * Constipation sticks around, even when you try home remedies. * You can't go to the bathroom without using laxatives every time. * You notice constipation after starting a new medicine. * You have extra symptoms like really bad stomach pain, blood in your poop, or pain when you go to the bathroom. TO SUM UP So, in a nutshell, constipation can mean struggling with painful bathroom moments or having fewer trips than usual. It's like a puzzle with different pieces - primary or secondary, short-term or long-lasting. But the good news is, for the everyday kind, you can try simple things like drinking more, eating foods with lots of fiber, and moving around more. Just tweaking your daily routine can make a big difference. But here's the deal - if you let constipation stick around without doing anything, it might bring some unwanted friends like stomach pain, bloody stools, or hemorrhoids. So be aware and create awareness about constipation [https://www.mrmed.in/health-library/gastroenterology/constipation-awareness-month-2022]. If it's getting serious or hanging on for too long, it's time to chat with your doctor, especially if other not-so-great signs are also showing up. "Beat the bind, free your behind!"

Dr. Vijayalakshmi