Constipation Causes and Remedies Explained by Gastroenterologist Leo Treyzon M.D.

Treatment concepts:

What is Constipation?
1. Infrequent Bowel Movements
2. Difficulty in evacuating stool (strain, push)
3. Altered stool form (e.g. hard rocks)
4. Discomfort or Pain before, during, or after stool passage (often seen in IBS-C)


How long does it take for food to travel your system?


How is a bowel movement generated?
1. Peristalsis of intestine occurs on a periodic schedule
2. Coordination of diaphragm muscle and abdominal wall muscles to
3. Relaxation of the pelvic floor muscles, and puborectalis muscle
4. Relaxation of the anal sphincter


Types of Constipation:
1. Slow transit or colonic inertia
2. Pelvic floor dysfunction and anismus

Secondary causes of

Constipation:
1. Medications  

- Narcotics  
- Antibiotics
- Anticholinergics    
- Antidepressants , Antipsychotics,
Anti-Parkinson’s medications  
- Calcium-channel blockers  


2. Metabolic conditions  
- Hypercalcemia  
- hypothyroidism  
- Diabetes mellitus (with autonomic neuropathy)  
- Hypokalemia

3. Central nervous system diseases  
- Parkinson’s disease  
- Multiple sclerosis  
- Spinal cord injury  
- Depression


4. Enteric myopathies or neuropathies  
-
Scleroderma  
- Chronic pseudo-obstruction  
-
Amyloidosis


5. Organic colorectal diseases  
- Rectocele  
- Cancer  
- Strictures (postinflammatory, postischemic, postdiverticulitis)


6. Lifestyle Factors:
- Lack of hydration
- Weight loss
- Sedentary lifestyle
- Traveling/ Barometric Pressure changes



Treatments
Over the Counter:
1. Fiber
- Metamucil® (Psyllium)
- Benefiber® (Wheat Dextrin)

- Konsyl® (Psyllium)
- Citrucel®(Methylcellulose Fiber)
- Sunfiber® (Guar Gum)
- Cereals (Fiber One®, All Bran®)
2. Stool softener
s:
- Docusate Sodium 100mg
3. Miralax® (Polyethylene Glycol-3350)
4. Magnesium treatments
a.
- Magnesium Oxide 500 mg (Philips Brand for example)
b.
- Milk of magnesia (Philips Brand for example)
- Magnesium Citrate 300 mL
5. Stimulant Laxatives:

- Senna or Sennasoides (Ex-Lax®, Chinese teas, Swiss Kris®, Smooth Move®)
- Bisacodyl 5mg (Dulcolax® pills or suppositories)
6. Enemas
- Fleets brand Saline enema®

- Soap suds enemas
- Colonics with a colon hydrotherapist
7. Suppositories:
- Glycerin

- Bisacodyl
8. Mineral Oil Lubricant
- Kondremul® (Mineral Oil + Irish Moss Fiber)
9. Creams for Anal irritation:
- Balneol®
- Desitin®
10. Ayurvedic medicines:
Triphala
11. Anti-Bloating:
- Atrantil®
- IBgard®
- Simethocone (Gas-X®, Phazyme®)
- Digestive Enzymes
e
- Activated Charcoal


12. Prescription Medications:

- linaclotide (Linzess®)
- plecanatide (Trulance®)
- lubiprostone (Amitiza®)
- pruclaopride (Motegrity®, Resolor®)
- erythromycin

- tegaserod (Zelnorm®)
- Low Dose Naltrexone (LDN)

13. Bowel preparations
:
- SUPREP®

- MoviePrep®
- GoLYTELY®
- Plenvu®

Useful Links:
1. What is Pelvic Floor:
   • Pelvic Floor Muscles 101 | Pelvic Hea...  
2. American Gastroenterology Association handout for constipation:
https://aga-cms-assets.s3.amazonaws.c...
3. Dr. Rao explains dyssynergic defecation:
   • What is dyssynergic defecation, and w...  
   • Dyssynergic Defecation  

Visit us at:
www.treyzonmed.com
Twitter: @DrTreyzonGI

This video does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have seen on this site or video.