Constipation

Constipation means having fewer than three bowel movements a week. The stool (poop) can be hard and dry. Sometimes it is painful to pass. At one time or another, almost everyone gets constipated. In most cases, it lasts a short time and is not serious.

There are many things you can do to prevent constipation. They include:

Eating more fruits, vegetables and grains, which are high in fiber
Drinking plenty of water and other liquids
Getting enough exercise
Taking time to have a bowel movement when you need to
Using laxatives only if your health care provider says you should
Asking your provider if medicines you take may cause constipation

It's not important that you have a bowel movement every day. If your bowel habits change, however, check with your provider.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Constipation FDA Approved Drugs

AMITIZA [Lubiprostone^{C₂₀H₃₂F₂O₅}]

24mcg (oral capsule)

8mcg (oral capsule)

Sucampo Pharma Llc^{Jan 31, 2006}

Method for relieving constipation in a human patient that comprises administering to the patient a dosage unit comprising (i) 24mcg+/- 10% of a drug substance and (ii) a pharmaceutically suitable excipient.
Method for relieving constipation in a patient with opioid-induced constipation that comprises administering to the patient a dosage unit comprising(i)24microg+/- 10% of a drug substance and (ii) a pharmaceutically suitable excipient.
Method for relieving or treating constipation in a human constipated patient.
Method for relieving or treating constipation in a patient with irritable bowel syndrome.
Method for relieving or treating constipation in a patient with opioid-induced constipation.
Method for the long term treatment of chronic constipation in a human subject with irritable bowel syndrome.
Method for the long term treatment of chronic constipation in a human subject.
Method for treating constipation by opening cic channels in a mammalian subject.
Method for treating constipation in a patient with opioid-induced constipation by opening cic channels.
Method for treating irritable bowel syndrome and method for treating abdominal discomfort associated with irritable bowel syndrome.
Method for treating opioid-induced constipation.
Method of relieving or preventing constipation in a human constipated patient.
Method of relieving or preventing constipation in a human patient with opioid-induced constipation.
Method of treating constipation in a patient with irritable bowel syndrome by opening chloride channels (cic).
Method of treating constipation in a patient with irritable bowel syndrome.
Use in relieving or preventing constipation in a human patient with a dosage unit comprising 24microg+/- 10% of a drug substance and a pharmaceutically suitable excipient.
Use in relieving or preventing constipation in a patient with opioid-induced constipation with a dosage unit comprising 24microg +/- 10% of a drug substance and a pharmaceutically suitable excipient.

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LINZESS [Linaclotide^{C₅₉H₇₉N₁₅O₂₁S₆}]

145mcg (oral capsule)

290mcg (oral capsule)

72mcg (oral capsule)

Forest Labs Llc^{Aug 30, 2012}

Method of treating chronic idiopathic constipation in adult patients..
Method of treating irritable bowel syndrome with constipation in adult patients..
Method of treating irritable bowel syndrome with constipation in adults.

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MOVANTIK [Naloxegol Oxalate^{C₃₄H₅₃NO₁₁C₂H₂O₄}]

eq 12.5mg base (oral tablet)

eq 25mg base (oral tablet)

Astrazeneca Pharms^{Sep 16, 2014}

Treatment of opioid-induced constipation.

efficacy
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0.0 (0)

RELISTOR [Methylnaltrexone Bromide^{C₂₁H₂₆NO₄Br}]

12mg/0.6ml (12mg/0.6ml) (subcutaneous solution)

150mg (oral tablet)

8mg/0.4ml (8mg/0.4ml) (subcutaneous solution)

Salix Pharms^{Apr 24, 2008}
Salix Pharms Inc^{Jul 19, 2016}

Treatment of opioid-induced constipation.

efficacy
0.0 (0)

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0.0 (0)

SYMPROIC [Naldemedine Tosylate^{C₃₂H₃₄N₄O₆C₇H₈O₃S}]

eq 0.2mg base (oral tablet)

Shionogi Inc^{Mar 23, 2017}

Treatment of opioid-induced constipation.

efficacy
0.0 (0)

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TRULANCE [Plecanatide]

3mg (oral tablet)

Synergy Pharms^{Jan 19, 2017}

Chronic idiopathic constipation.
Elevation of intracellular cgmp resulting in increased intestinal fluid and accelerated transit.

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WARNING: Consult a licensed physician in the appropriate field for medical treatment and drug prescription. Do not self medicate.

WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Constipation

ÆSCULUS GLABRA
The bark and fruit of Aesculus glabra, Willdenow (Nat. Ord. Sapindaceae). A small fetid tree common to the central portion of the United... / ...gion, probably dependent most largely upon hepatic or portal congestion and associated with chronic constipation. Its chief value, however, lies in its power to relieve hemorrhoids due to faulty hemor... / ...Aesculus deserves further study to determine its status as a remedy for nervous disorders, and especially its control over visceral neuralgias. ¹

AGAR
A dried substance of mucilaginous character abstracted from several species of sea weeds (marine algae) growing along the coast of Asia. Most of... / ...as the property of absorbing moisture and swelling to a soft mass, and for this purpose is given in constipation as a mechanical laxative; rendering the best service when intestinal secretion is scant... / ...crackers are prepared from it and may be procured in the general trade. Agar is also used as a culture medium in making labaratory cultures. ¹

ALOE^ALOE
...oes, in 1/2 to 1 grain doses, is a gastric stimulant of value in atonic indigestion, with obstinate constipation. It has had a large vogue as an after-dinner pill, but is now little used for that purp......ll, but is now little used for that purpose. As a rule it is a good agent for use in atonic chronic constipation, but should never be exhibited in cathartic doses for this purpose. Aloes, or its deriv......oses of aloes or aloin. Aloes is a decidedly useful but much abused medicine in chronic or habitual constipation. As stated above only slightly laxative amounts should be used. When a purgative is nee...¹

APOCYNUM CANNABINUM
The root of Apocynum cannabinum, Linné (Nat. Ord. Apocynaceae) gathered in autumn after the leaves and fruit have matured. Grows throughout the... / ...ds wrinkled, as if parts had been recently swollen; feet full and edematous, pitting upon pressure; constipation, with edema; urine scanty and circulation sluggish; boggy, watery uterus; full relaxed ... / ...may be looked for. Under these circumstances we have removed enormous dropsical swellings with it, giving quick relief from dyspnea and¹

ARALIA HISPIDA
The bark of the root of Aralia hispida, Linné (Nat. Ord. Araliaceae). A perennial undershrub of the eastern section of the United States. Dose, 1... / ...unce to water, 16 ounces). Dose, 2 to 4 fluidounces. Specific Indications.Anasarca and edema with constipation. Action and Therapy.Sometimes a surprisingly effective agent for the removal of anasa... / ...the treatment of gravel. ¹

ASAFOETIDA (Ferula fetida)
A gum-resin derived from the rhizome and rootlets of Ferula Asafetida, Linné; Ferula foetida, Regel, and other species of Ferula (Nat. Ord.... / ... to disorders with nervous depression, more or less feebleness, and particularly if associated with constipation, flatulence, or tardy or imperfect menstruation. Asafetida is contraindicated by inflam...¹

ASCLEPIAS SYRIACA
The root of Asclepias syriaca (Asclepias Cornuti, in the original), Decaisne (Nat. Ord. Asclepiadaceae). Common in rich soils throughout the... / ...has been suggested as a useful remedy in muscular rheumatoid affections, acting much like macrotys. Constipation is said to be favorably influenced by it, and in full doses it is recommended to expel ...¹

CALUMBA (Jateorhiza palmata)^JAPA2
The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A climbing perennial, the Kalumb of the Southeast coast of Africa.... / ...f soda, senna, ginger, and aromatics, to meet special indications, particularly when flatulence and constipation are present. Calumba and the allied bitters should not be given in acute or subacute in... / ...local action, and indirectly, by favoring better digestion, the quality of the blood is improved, hence its value in anemia during convalescence.¹

CANNABIS
The dried flowering tops of the female plant of Cannabis sativa, Linné, or the variety indica, Lamarck (Nat. Ord. Cannabinaceae). Asia, East... / ...er, restrain the secretions nor produce itching. If anything the urine is increased by cannabis and constipation does not occur. The keynote indication for cannabis is marked depression of the nervous...¹

CASCARA SAGRADA
...Aromaticum, Aromatic Fluidextract of Cascara Sagrada. Dose, 10 to 60 minims. Specific Indications.Constipation due to neglect or to nervous and muscular atony of the bowels; minor ailments, dependen......ue to neglect or to nervous and muscular atony of the bowels; minor ailments, dependent solely upon constipation, with intestinal atony. Action and Therapy.Cascara is a simple and practically non-gr...... stool. It has, moreover, a tonic action upon the stomach and bowels, and does not produce an after constipation. It is the most popular and most efficient agent for chronic constipation, and may be g...¹

COLLINSONIA
... with a painful contraction of the sphincter and perineum; sense of contraction in the rectum, with constipation due to vascular engorgement of the pelvic viscera; scybalous feces; sticking pains in t......ting the nervous system profoundly. There is weight, heat, and dull pain, with or without scybalous constipation, or sometimes with partly semifluid and partly scybalous feces. The only rational proce......tite. Indigestion, spasmodic pain, gastric catarrh, and irritative dyspepsia, all with more or less constipation, appear to be benefited by collinsonia. By increasing innervation and relieving irritab...¹

COLOCYNTHIS
The dried, peeled pulp of the fruit of Citrullus Colocynthis (Linné,) Schrader. (Nat. Ord. Cucurbitaceae.) Mediterranean basin of Europe, Asia,... / ...tting pain; colicky pains anywhere in the abdomen (minute doses); distressing accumulations of gas; constipation with dry scybala and griping pain in the lower bowel (larger doses). Action.Colocynt... / ...of the fifth nerve, when the characteristic cutting pain prevails. It should be given also when colicky pain precedes or accompanies amenorrhoea.¹

ERECHTITES
The entire plant and oil of Erechtites hieracifolia, Rafinesque (Nat. Ord. Compositae.) A rank weed throughout the United States. Common Name:... / ...al glands and pancreas, and causes free and full alvine evacuations, rendering it useful in chronic constipation, especially when acid fermentation and flatulence are present. Its ultimate effect upon... / ...edema. For this purpose the dose should not be over one drop of the oil, in emulsion, well diluted. Usually the oil is administered on sugar.¹

EUONYMUS
...onymus. Dose, 5 to 60 drops. Specific Indications.Yellow-coated tongue; anorexia; indigestion and constipation, due to hepatic torpor; prostration with irritation of the nerve centers; periodic dise......n due to faulty and torpid action of the liver. Many value it in so-called chronic ague, and in the constipation and gastric debility associated with or following it. Euonymus is a neglected bitter.¹

EUPHORBIA COROLLATA
The bark of the root of Euphorbia corollata, Linné (Nat. Ord. Euphorbiaceae). Dry fields and woods of Canada and the United States. Common Names:... / ..., long and pointed, and there is persistent vomiting. In moderate doses it may be used in obstinate constipation, with evidence of gastric irritation. Euphorbia is contraindicated by active inflammati... / ...from the pulmonic, gastro-intestinal, or urino-genital mucosa; or the tough, glutinous tracheo-broncho-pulmonic secretions, with irritation.¹

Physician's Materia Medica on Constipation

ALOES
The inspissated juice of leaves of different species of ALOE. Laxa tive or cathartic according to the dose. It acts especially on the lower bowel, and is particularly serviceable in chronic constipation. Dose as a laxative 0.06 to 0.3 Grm. (1 to 5 grs.).²

ASAFETIDA^FEAS2
Gum resin from FERULA FOETIDA, (Bunge) Regel. Antispas modic, carminative, nervine. Used in hysterial conditions, as a soothing remedy for infants, for relief of constipation and t ympanites and as a stimulant expectorant. Dose, 0.2 to 1 Grm. (3 to 15 grs.).²

BUCKEYE^AESCU
The bark of AEsCULUs GLABRA, Willd. Bitter tonic, antiperio die, in large doses narcotic. Prescribed as a remedy for portal con gestion, for chronic constipation attended with hemorrhoids and for dyspnea.²

BUTTERNUT (Juglans)^JUCI
The bark of the root of JUGLANs CINEREA. Lin. Tonic laxative or mild cathartic. Used especially in chronic constipation.²*Slight

CALABAR BEAN (Physostigma).^PHVE11
The seeds of PHYSOSTIGMA VENENOSUM, Bali. Deprossant of motor tract of spinal cord; used in tetanus and in strychnine poison ing to control spasms, in constipation, and to counteract the effect of atropine on the eye.²

CASCARA SAGRADA
The well seasoned bark of RHAMNUS PURSHIANA, DC. Tonic laxative. The remedy par excellence in chronic constipation.²

MANDRAKE^MANDR
The rhizome of PODOPHYLLUM PELTATUM, Lin. Cholagogue, laxative or purgative according to dose. Much used as a laxative in chronic constipation and as a hepatic stimulant, g.'ncr;ll1y in the form of the resin, commonly called podophyllin. The active principle is belived to be Podophyllotoxin, q. v.²

NEUTRALIZING CORDIAL (Compound Syrup of Rhubarb and Potassa. N. F.)
Stomachic, laxative, antacid. A favorite remedy with many for certain dyspeptlc conditions, in which constipation and acidity of the stomach are prominent symptoms. Each fluidrachm repre sents; Rhubarb, 2 1/4 grs.; Cinnamon 1 1/8 grs.; Golden-seal, 1 1/8 grs.; Potassium Bicarb., 2 1/4 grs-; Oil Peppermint, 3-50 M Dose, 4 to 8 c. c. (1 to 2 fluidrachms) when distress is felt after eating. It is best taken as much as two hours after a meal.²

NUX VOMICA
The seeds of SrnYCrmos NUX-VOMICA. Lin. A tetanizing pois on; a powerful stimulant to spinal nerve centers. Prescribed often with laxatives in chronic constipation to stimulate peristaltic action; more used than any other tonic in nervous debility, associated often with iron and quinine. The active principle, Strychnine, q. v., is largely used in preference to preparations of the crude drug.²

OPIUM
Concrete milky exudation obtained from the capsules of PAPAVER SOMNIFERUM, Lin. A type of narcotics; anodyne, hypnotic; dimin ishes secretions, except that of the skin; tends to cause constipation. Its effects are modified by combination with Atropine, which antago nizes some of its unpleasant effects and Ipecac, whose diaphoretic action it notably increases. Average sedative dose for an adult, 0.06 Grm. (1 gr.).²

Physician's Therapeutics Memoranda on Constipation

ACNE
Ascertain whether constitutional... / ...disease or disordered dhrestion is present and modify treatment accordingly. Arsenic is generally indicated. especially in combination with iron. For constipation. if present, Compound Liquorice Powder, prelerably in lozenges, or Fluid Cascara Aromatic, N., B. & Co. Locally, lotions containing milk ...²

ANEMIA
Nourishing and easily digested food with remedies for promoting digestion and overcoming a tendency to constipation may... / Nourishing and easily digested food with remedies for promoting digestion and overcoming a tendency to constipation may often ac complish more than hematinics. Of these iron (as reduced iron or ferrous carbonate) is most often prescribed, but in many ca...²

CONSTIPATION
Medicate no more than is necessary. Prescribe regular open air exercise, regularity in going to stool; correct the diet; advise a large glass of Apolinaris before breakfast; if necessary prescribe general tonics. The laxatives best suited for habitual use are; 1, glycerin sup positories, when there is simply inertia of the rectum; 2, senna (particularly a cold infusion, or the oflicial compound liquorice pow der) or cascara sagrada (fluid extract aromatic or jellules); 3, com binations of aloin,...²

TYPHOID FEVER
Medication except to meet special indications is probably useless, although the Woodbridge treatment has its... / .... Cold sponging or cold baths serve to reduce temperature. Danger of perforation must always be borne in mind, and will govern choice of remedies for constipation. In later stages, oil of turpentine becomes the most important remedy, to be used both internally and externally.²

References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.

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