Best bet for long-term constipation is an over-the-counter drug
Nearly everybody will experience constipation at some point in their lives. On any given day, an estimated 35 to 45 million people in the U.S. are afflicted with this condition. And the holiday season can play havoc with your bowels. Traveling and the disruption in your usual diet and routine that goes hand in hand with the holidays can trigger constipation. Both prescription and nonprescription drugs can provide relief, but how do you choose among the wide selection of treatments.
Our Consumer Reports Best Buy Drugs project took a close look at which drugs work best, whether you have constipation on its own or as part of a condition called irritable bowel syndrome (IBS).
Most episodes of constipation are temporary and don't require a doctor's visit. Including more fiber-rich foods, such as fruits, vegetables, and whole grains in your diet is often all that's needed to get things moving again. If you need a fiber supplement, we recommend those that contain psyllium because it's the active ingredient that's been studied the most in treating chronic constipation. Metamucil is the best known brand containing psyllium but you can also find it in generic versions, which are often less expensive.
If diet changes and/or fiber supplements don't help, our Best Buy Drug report found that the over-the-counter drug polyethylene glycol (MiraLax) is your best bet. This drug offers greater improvements for constipation symptoms than the prescription drug lactulose, according to studies that have compared the two remedies head-to-head in adults. It also has a track record of being safe and well tolerated. In addition, since it is available without a prescription, it's a less expensive option. Note that MiraLax is also available as a more costly prescription drug. If your doctor prescribes it, you should ask him or her why since you’ll generally save money by buying the non-prescription version.
Our report cautions against the long-term use (beyond a few days) of the laxatives senna (Ex-Lax, Senokot) and bisacodyl (Correctol, Dulcolax). They generally don't help improve chronic constipation.
If you have IBS with constipation as the main symptom, there's a newer prescription drug called lubiprostone (Amitiza) that's approved to treat women with this condition. However, it may not be any better or safer than other constipation medicines. It's also a very expensive treatment option. So try other medicines first, in addition to lifestyle changes, and only turn to Amitiza—with your doctor's guidance—if those strategies fail to bring you relief.
—Steve Mitchell, associate editor, Best Buy Drugs
Download the free Best Buy Drug report in PDF form. You also may want to read an article on constipation from our chief medical adviser, Marvin Lipman.
Posted by: Anne | Mar 12, 2009 3:26:38 AM
The market for laxatives is now approaching 1 billion each year. It appears that constipation is an issue that most of us have to deal with at one time or the other. Using natural means to clear constipation is what this e-book is all about. I believe that to have good health we need to use mostly foods and supplements that are free of additives and food enhancers that are harmful to the body. We need to eat the right foods and watch how we prepare them so we can digest and absorb them without creating or leaving residues that get turned into toxic matter in our colon.
Posted by: C Teply | Feb 28, 2009 12:19:00 PM
I read these,you don't need drugs drivel, use this, or that instead, I have been on Rx pain killers for severe injuries, for 30 years. I tried all the garbage you suggest and Miralax worked after 3 days, and the funny part is, no side effects. Getting more fluid in your intestine is really all you need. Miralax does exactly that and no more rock hard stools. And before you give me, you don't need pain killers, Take a baseball bat and break half the bones in your body and you try some herb to stop pain. You have no idea of what pain is, like I do. The simple addition of Miralax, which doesn't enter your blood stream, and keeps the drugs and processed food from leaching the fluid from your intestines, finally has made constipation a non issue. Most people take "natural remedies" and don't know these same ingredients are in the laxatives they are trying to avoid. Read the labels,you take half a dozen "Remedies "if you want , I take Miralax 3 times a week and have not one cramp or loose stool. You really should try something before you claim your way is better, as I have used All these other fixes over 30 plus years with no real relief.
Posted by: Robert W. Brown | Dec 27, 2008 10:13:28 AM
It's really not necessary to buy drugs. The right kinds of food will not give anyone constipation. I would recommend the following website: www.naturalnews.com and www.vitacost.com
I have Hepatitis C and Diabetes Type 2 and I treat myself. It isn't as complicate as you might think. I go to a doctor for blood tests and when I get my results I go home and treat myself. If you can read, you can treat yourself. Many students don't want to be doctors and the regular doctors are leaving the medical establishment. They go to groups of doctors that don't follow the lies of the pharmaceutical industry. You will learn that there are ways to cure cancer. The doctors won't tell you that.
It has been proven that mammograms can CAUSE cancer. This information is on the Internet. You just have to do some research. One of the reasons people get cancer is because they don't get enough sun. Odd but true.
Posted by: Susan Miller | Dec 26, 2008 11:44:10 AM
In response to Vern Luce, 12/19, I have also had severe problems from constipation from methadone, and other meds I take for chronic pain... my pain doc started me on a new med last month made just for this, the first one available specifically for constipation from opioids. It is Relistor, given by injection at the doc's office. It really works well! I also take Amitiza, Miralax, Citrucel,stool softener, and use Aciphex for the GERD. Crazy, huh? Take 4 to handle side effects of 2. Hope this helps your friend.
Posted by: Sandra Sommer | Dec 25, 2008 11:35:44 AM
I have had stomach trouble such as constipation and cramping since I was a child. After 50 years, I have finally found relief. Perhaps this will help your friend. I take a 2 tablespoons of psyllium every morning in a 10 ounce glass of water. I avoid dairy products and have all but eliminated the burning in my stomach (ulcer?) by taking a product called "Healthy Gut" , a probiotic by Northstar Nutrition. (You can Google it to find the website.) It is not cheap, but after a week on it I could really tell the difference. I order it online because it is stronger than what I could find in the health food stores. Also, your friend should ask his doctors to check him for H. pylori. It is a bacteria that causes ulcers and can be treated with antibiotics. Also your friend should research methadone treatment on the internet. My understanding is that it can be just as harmful as the heroin. Best of Luck to you both.
Posted by: vern luce | Dec 19, 2008 8:39:40 AM
I have a friend who has revealed that he is on a methadone treatment program for withdrawal from heroin addiction. After several years of treatment and gradual lowering of the methadone dosage, he says he is suffering debilitating effects from the methadone: low energy levels and fatigue, a stomach ulcer and extreme constipation. These are making it expensive [ER visits and expensive prescription drugs] and physically difficult for him day to day. Working is difficult and a constant challenge for him. He says doctors recommend laxatives and getting off of methadone, suggesting this is the prime cause of his physical problems. He is determined to get through the methadone program, another 3-6 months, but it seems to me he is in a corner. The ulcer and constipation are conspiring to undo his hard work. Any suggestions?