Constipation information and alternative treatment using natural remedies without the need for prescription medications
Natural therapy and remedy

Constipation is defined as difficult or infrequent passage of feces, hardness of stool, or a feeling of incomplete evacuation. Chronic constipation is harmful to the body and may possibly increase the risk for colon polyps.
   A person's diet should contain enough fiber to ensure adequate stool bulk in order to prevent problems with bowel movements. Some fibers are soluble in water and others are insoluble. Soluble fiber slows digestion and helps you absorb nutrients from food. Insoluble fiber adds bulk to your stool, helping the stool pass more quickly through the intestines. Most plant foods contain some of each kind of fiber. Foods containing high levels of soluble fiber include dried beans, oats, oat bran, rice bran, barley, citrus fruits, apples, strawberries, peas, and potatoes. Foods high in insoluble fiber include wheat bran, whole grains, cereals, seeds, and the skins of many fruits and vegetables.
   Vegetable fiber, which is largely indigestible and unabsorbable, increases stool bulk and reduces the risk for constipation; certain components of fiber also absorb fluid into the solid phase, making stools softer and facilitating their passage. Fruits and vegetables are recommended, as are cereals containing bran taken to tolerance.
   One of the most important steps we recommend in order to reduce the risk is to drink plenty of fluids. The most important time to drink water is upon awakening. Drink one or two glasses of room temperature or cold water to stimulate peristalsis, and hence reduce your risk for constipation the rest of the day.

Bulking agents that could be of benefit
Bulking agents include bran, psyllium, calcium polycarbophil, and methylcellulose. They provide fiber and are the only laxatives acceptable for long-term use. They act slowly and gently and are the safest agents for promoting elimination and preventing constipation. Proper use involves gradually increasing the dose--best taken tid or qid with sufficient liquid (by adding 20 oz/day of extra fluid) to prevent impaction -- until a softer, bulkier stool results. This approach produces natural effects and is not habit forming. Bulking agents normalize both constipation and diarrhea. You may also consider glucomannan. Flax seeds are a wonderful way to bulk up stools and reduce transit time.

Which supplements are helpful for constipation?
Consider cascara sagrada, psyllium and glucomannan fiber.

Laxatives
These should be used carefully. Some may interfere with absorption of various drugs by binding them chemically (eg, tetracycline, Ca, phosphate) or physically (eg, digoxin on cellulose matrices). Rapid fecal transit may rush some drugs and nutrients beyond their optimal absorptive locus.

Osmotic agents are used to prepare patients for some diagnostic bowel procedures and occasionally to treat parasitic infestations. They contain poorly absorbed polyvalent ions (eg, Mg, phosphate, sulfate) or carbohydrates (eg, lactulose, sorbitol) that remain in the bowel, increasing intraluminal osmotic pressure and drawing water into the intestine. The increased volume stimulates peristalsis, which moves the water-softened stool easily through the bowel. These agents usually work within 3 h.

Secretory or stimulant cathartics (eg, cascara sagrada, senna and its derivatives, bisacodyl, phenolphthalein, castor oil) are often used to cleanse the bowel for diagnostic tests. They act by irritating the intestinal mucosa or by directly stimulating the submucosal and myenteric plexus. Some are absorbed, metabolized by the liver, and returned to the bowel in bile. Peristalsis and intraluminal fluid both increase, with cramping and passage of semisolid stool in 6 to 8 h. With continued use, melanosis coli, neuronal degeneration in the colon, "lazy bowel" syndrome, and serious fluid and electrolyte disturbances may occur.

Prune juice helps
 Does prune juice really work for constipation. How many ounces are needed?
   Yes, prune juice is an excellent choice to help with constipation. Depending on the severity of the constipation, one to four ounces is beneficial. You may consider drinking about two ounces late in the evening and when you wake up in the morning drink a glass or two of cool water. This will help you eliminate. Some people notice a slight mood elevation by having an empty colon.

Female, 65 years, melanosis coli and celiac disease - my colon looks black! What do you suggest for this situation caused by nearly forty years of constipation not being treated properly? Would any type of fiber be helpful along with a laxative? Maybe acacia, salvia or glucomannan? Lactalose and Miralax have been suggested as a laxative?
    Specific suggestions have to be done by your doctor, but prune juice and drinking 2 glasses of water first thing in the morning are safe options for constipation.

Constipation help
Yoghurt containing galacto-oligosaccharides, prunes and linseed reduces the severity of mild constipation in elderly subjects.
Eur J Clin Nutr. 2007.
Constipation is a common problem in the elderly. Dietary fibre is recommended for its treatment. The aim was to examine whether yoghurt containing galacto-oligosaccharides (GOS), prunes and linseed relieve constipation in elderly subjects. A group of 43 elderly subjects with self-reported constipation (mean age 76 years, range 61-92 years, 32 females, 11 males). The study consisted of a 2-week baseline period and 2, 3-week dietary interventions, with a 2-week wash-out period between the interventions. During the interventions, the subjects ingested, in random order, 260 g/day of either control yoghurt or test yoghurt containing GOS (12 g/day), prunes (12 g/day) and linseed (6 g/day). The use of laxatives was controlled and only allowed after 2 days without defecation. Daily intake of yoghurt containing GOS, prunes and linseed reduced the severity of constipation in elderly subjects with mild constipation.

Children and Castor Oil.
Would giving a child or about 5 years of age castor oil (couple teaspoons a day) for constipation be appropriate? Wouldn't long term use of castor oil cause toxicity or depletion of probiotics in the gut? I understand Castor Oil is used as an "insecticide in 3rd world nations as a crop soil spray ! I would appreciate your opinion on this as I don't want to see a child cause "a lazy colon.
    Castor oil is a vegetable oil obtained from the castor seed. It is a triglyceride in which approximately ninety percent of fatty acid chains are ricinoleic acid. Oleic and linoleic acids are the other significant components. Occasional use of castor oil is acceptable but regular use is not necessary since other options are available to treat constipation.

Relistor for Opioid-Induced Constipation
FDA has approved Relistor (methylnaltrexone bromide) to help restore bowel function in patients with late-stage, advanced illness who are receiving opioids on a continuous basis to help alleviate their pain. Such patients include those with a diagnosis of incurable cancer, end-stage chronic obstructive pulmonary disease from emphysema, heart failure, Alzheimer’s disease with dementia, HIV/AIDS or other advanced illnesses. Opioids can interfere with normal bowel elimination function by relaxing the intestinal smooth muscles and preventing them from functioning. Relistor acts by blocking opioid entrance into the cells thus allowing the bowels to continue to function normally.

Use in children
Enemas and high-dose oral polyethylene glycol (PEG) are both equally effective treatments for rectal fecal impaction in children. Dr. Noor-L-Houda Bekkali, from the Academic Medical Center, Amsterdam, the Netherlands, believes that despite the lack of scientific data, rectal enemas have long been advocated as the best first-line treatment for severe rectal fecal impaction. Two recent studies showed that oral PEG had 95% successful disimpaction rate. Pediatrics 2009;124:

Does the herb tongkat ali cause constipation?
   No, it does not.