Constipation : Constipation refers to infrequent or hard stools, or difficulty passing stools. More specifically, constipation may involve pain during the passage of a bowel movement, the inability to pass a bowel movement after straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days.
Treatment
Laxatives like aloe, cascara, senna compounds, bisacodyl, and castor oil. Bisacodyl (Dulcolax, Correctol) is available OTC in oral pill form and as a suppository or enema. The oral form takes 6 to 10 hours to work. Bisacodyl is commonly used in cleansing the colon for colonoscopies,barium enemas, and intestinal surgeries. While effective for occasional constipation, bisacodyl should not be taken for more than a week, and a doctor should supervise repeated use.
Other stimulant laxatives include senna (Ex-Lax, Senokot), cascara sagrada (Nature's Remedy), and casanthranol. These laxatives are converted by the bacteria in the colon into active compounds which then stimulate the contraction of colon muscles. After taking these products orally, bowel movements occur after 8 to 24 hours. Prolonged, chronic use of these laxatives can cause the lining of the colon to become darker than normal (melanosis coli) due to the accumulation of a pigment (melanin).
Castor oil (an ingredient of Purge Concentrate) is a liquid stimulant laxative that works in the small intestine. It causes the accumulation of fluid in the small intestine and promotes evacuation of the bowels. Castor oil should not be taken with food, although juice or other flavored liquids can help hide its unpleasant taste.
• Fiber supplements. Fiber supplements add bulk to your stool. Common ingredients include methylcellulose, psyllium, calcium polycarbophil and guar gum. Brand names include FiberCon, Metamucil, Konsyl and Citrucel.
• Stimulants.
• Osmotics. Osmotic laxatives help fluids move through the colon. Examples include milk of magnesia, magnesium citrate, lactulose, polyethylene glycol (MiraLax) and sodium phosphate enema (Fleet Enema).
• Lubricants. Lubricants enable stool to move through your colon more easily. One example of a lubricant is mineral oil.
• Stool softeners. Stool softeners moisten the stool by drawing water from the intestines. Examples include Colace and Surfak
Irritable bowel syndrome (IBS, or spastic colon) : Irritable bowel syndrome (IBS, or spastic colon) is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits
TREATMENT
Diet
Reduction of fructose and fructan has been shown to reduce IBS symptoms in a dose-dependent manner in patients with fructose malabsorption and IBS.
Fiber
Some evidence suggests that soluble fiber supplementation (e.g., psyllium/ispagula husk) is effective in the general IBS population.
Medication
Medications may consist of stool softeners and laxatives in constipation-predominant IBS and antidiarrheals (e.g., opiate, opioid, or opioid analogs such as loperamide, codeine, diphenoxylate) in diarrhea-predominant IBS for mild symptoms and stronger opiates such as morphine and oxycodone for severe cases.
Drugs affecting serotonin (5-HT) in the intestines can help reduce symptoms. 5HT3 antagonists such as ondansetron are effective in postinfectious IBS and diarrhoea-dominant IBS due to their blockade of serotonin on 5HT3 receptors in the gut.
Laxatives
For patients who do not adequately respond to dietary fiber, osmotic laxatives such as polyethylene glycol, sorbitol, and lactulose can help avoid "cathartic colon" which has been associated with stimulant laxatives
Antispasmodics
The use of antispasmodic drugs (e.g., anticholinergics such as hyoscyamine or dicyclomine) may help patients, especially those with cramps or diarrhea
Serotonin agonists
Tegaserod (Zelnorm), a selective 5-HT4 agonist for IBS-C, is available for relieving IBS constipation in women and chronic idiopathic constipation in men and women.
Other agents
Magnesium aluminum silicates and alverine citrate drugs can be effective for irritable bowel syndrome.