Go naturally. Generally, Ayurvedic remedies are very similar to what's prescribed in other healing systems. But Ayurvedic practitioners also prescribe herbal laxatives such as senna, rhubarb, aloe, and cascara sagrada. These herbs are potent chemical stimulants, and they must be used carefully, Dr. Pizzorno says. Otherwise, they may cause cramping, diarrhea, and bloody stools. So check with a knowledgeable Ayurvedic practitioner for the proper herb and dosage.
Over-The-Counter Drugs
Head for the drugstore. If none of the above approaches relieves your constipation within a few days, consider taking an overthe-counter laxative. In addition to the bulk formers described earlier, you can choose from lubricants, saline laxatives, and stool softeners. All of these products are gentle and safe, but be sure to use them only as directed.
Lubricants contain mineral oil, a petroleum product. Like olive oil, mineral oil coats stool to promote easier passage. Lubricants usually work within 6 to 8 hours.
Saline laxatives change the salt balance in your digestive tract. They draw water into stool, which adds bulk and stimulates peristalsis. Milk of magnesia is the best-known saline laxative. It produces results within 1 to 6 hours.
Stool softeners draw more water into stool, making it softer and easier to pass. These products usually work within 12 to 72 hours. For best results, Dr. Simons says, they should be taken with plenty of nonalcoholic fluids.
Medical Measures
Among over-the-counter laxatives, those classified as chemical stimulants should be considered last resorts and only taken for a short period of time. Among the active ingredients listed on the back of the package, you're likely to find chemicals such as bisacodyl, senna, and cascara sagrada.
The gentlest stimulant laxatives contain the medicinal herb cascara sagrada (Nature's Resource). Other, more powerful laxatives have bisacodyl (Dulcolax), buckthorn (Herbal Laxative Tablets), or senna (Senokot). Most have side effects. If you find that you need to use stimulant laxatives, it's best to consult your physician first.
In addition to their possible side effects, stimulant laxatives can actually cause a form of constipation known as lazy bowel syndrome. In this condition, bowel movements no longer occur without chemical stimulation. Lazy bowel syndrome is one reason why physicians discourage using stimulant laxatives more than once or twice a month.
Besides laxatives, some people rely on enemas to relieve constipation. Enemas irrigate the bowel and act as lubricants and stimulants. But frequent enemas can damage the colon and disrupt the balance of key minerals called electrolytes. For these reasons, the American Pharmaceutical Association advises against using enemas as a treatment for constipation.
Red Flags
While constipation is bothersome, it's usually not a cause for concern. But it can be a symptom of other, potentially serious conditions such as diabetes, thyroid problems, uterine fibroids, and certain types of cancer. So if your constipation does not clear up after a week of self-care using the approaches described in this chapter, or if it is associated with vomiting, abdominal pain, or fever, consult your physician.