Constipation is common.

At any given time, as many as 1 in 3 of us have missing or difficult bowel movements. It might be easy for health care “professionals” to quickly pass it off, but that doesn’t mean it isn’t serious enough for concern. Once the basics are covered (diet, adequate fiber and water, and routine exercise), it’s time to look for things on the outside that may be constipating;  “stuff out there” that may interfere with normal bowel movements, primarily drugs and alcohol. This is where this conversation can stall because there isn’t a single area I can focus on that would help a majority of people. I’m in the same predicament as the doctor, except that the doctor can work with the individual to discover and resolve the causes of constipation – especially when changing or stopping certain drugs. While pharmacists can offer help in identifying possible causes, it is out of our scope of practice to directly intervene.We’re fundamentally are on our own when it comes to resolving  health issues, and a big problem for someone with constipation. It isn’t generally a topic brought up “at the dinner table” and the professionals who should be able to step in and help are stretched to their limit. Clearly, doctors are too busy, and pharmacists are also no longer in a place where they can spend time step up and offer suggestions.  In my earlier days, filling 100 prescriptions in a day was monumental. Today, I often hear numbers that are two to three times that many – in a single shift. High prescription volumes demand extraordinary concentration by those who work “behind the counter”.

Too many drugs being prescribed. Someone should be available to help people avoid debilitating side effects, like constipation. If not the doctor, nor the pharmacist, then who? Sadly, a simple answer isn’t “out there”. As much as health professional may want to advise, there just isn’t time or compensation enough to meet the need. That leaves the responsibility for a solution in our individual hands. We have to decide to do it ourselves.

While it may seem impossible, it really isn’t. However, it is time consuming. It can be done without a computer, but it is much more difficult. I suggest using Google and searching for “side effects  xxxxxx”, where xxxxxx is the name of a drug. www.Drugs.com is usually very good. So is Wikipedia. You could even use information published by the company that makes the drug. They usually publish facts because they’d be in deep trouble if they got caught lying.

Pick one or two of the references and read through the side effects and interactions. Write them down. Do this for every drug you use. Take particular note when there is mention of dry mouth, itchy eyes, infrequent or painful urination, and, of course, constipation. These are keys. If you see these words in one drug, they may be important. If you see one or more pop up in a second drug you can be assured that you’re onto something important.

When it comes to side effects, it is common for 1 + 1 to equal something more that 2. This is called synergy. The average person takes many drugs throughout the year so the problem of side effects is likely.

Accumulate your information and prepare a written statement for your doctor. Explain the difficulties you’re experiencing and how your research suggest that “such-and-such” may be responsible. The doctor is busy. Respect that. Be brief and demand help adjusting your medications.

Of course, increase water intake and avoid substances that can make constipation worse. Tea, and other beverages, can be part of the problem. Drinking water means just that, water. When appropriate, non-prescription stool softeners with laxatives can help. Ones that contain senna and/or docusate are usually very helpful. Follow package instructions. If they’re printed too small to read, use a magnifier or look online.

I understand how frustrating it can be when there isn’t someone ready with answers.  Regardless of what we may prefer, nobody can care about our health as much as we can.