Individual differences are very great here: whereas some people have bowel movements twice a day, for others just once every three days is completely normal. At any rate, daily bowel movements are not absolutely necessary. One does not speak of truly being constipated unless one has a bowel movement less often than once every three days. The resulting stools are then generally hard and low in volume.
Many people experience temporary constipation in certain situations, e.g. in an unfamiliar environment or when daily life is hectic and stressful. This sort of situational constipation is not dangerous, although it is unpleasant, since feeling overfull and having a bloated belly will affect our sense of well-being. Relief can be had by maintaining a high-roughage diet, drinking plenty of fluids or taking Duphalac® .
If constipation persists over weeks or months, one should consult a physician to determine whether the complaint has an organic origin.
I often suffer from constipation during hectic situations or when I am
travelling. What can I do?
Unfamiliar situations, tension and psychological stress also affect our intestine - constipation can be the response.
Try to activate your digestion by eating foods with high amounts of roughage and by drinking plenty of fluids. Sometimes it is enough when abroad on vacation to eat some robust whole-grain bread or pumpernickel brought from home rather than the local white bread. Drink plenty of fluids, get regular exercise and visit the toilet as soon as you feel the urge to do so.
If these measures are not sufficient, Duphalac® can help you restore a normal, regular digestion process. You would be better off avoiding drastic laxatives, since they damage the intestinal mucosa and can even lead to dependency.
Different drugs can have the undesirable side-effect of triggering constipation, e.g. certain anti-inflammation and anti-hypertension medications, iron preparations, painkillers and psychopharmaceuticals. If you believe that your constipation could be caused by a medication that you take, check the accompanying package insert to see if constipation is listed as a possible side-effect. Do not, however, simply discontinue taking the medication, but consult your physician to determine how best to treat the problem.
By the way: Duphalac® can also help you in those situations where these medications must continue to be taken.
Should one always consult a physician in cases of constipation?
Many different things can lead to constipation. Often it "only" has to do with a change of location, or with excitement or stress, during which our bowels react by becoming temporarily sluggish. In this case, there is a functional disorder present which can often be relieved by even such simple measures as high-roughage diet, plenty of fluid intake and physical activity.
Nevertheless, constipation can also be caused by various intestinal diseases (haemorrhoids, inflammations, polyps, tumours, etc.), by metabolic disorders or by neurological illnesses. Consult your physician in cases where your constipation is linked with severe complaints or pains in the abdomen or in the anal area or when you notice mucus or blood in a bowel movement or when the constipation continues for weeks or months.
There is a ring-shaped body of tissue with blood vessels located above the anal canal which swells and acts as a seal on the rectum to contain fluids and gases. A varicose vein-like enlargement of this tissue and/or its prolapse lead to haemorrhoidal illness:
This tissue is lined with a mucous membrane and when it prolapses into the anal canal, it disturbs the fine closure of the anal canal. As a result, moisture travels outwards, which leads to itching, dampness and a burning sensation on the skin around the anus. If a haemorrhoid - i.e. an enlarged vein - is physically damaged, it will bleed.
Various factors promote haemorrhoidal illness, among them constipation. This is because forced, repeated pressing during defecation causes a backflow of blood. This leads to an expansion of the blood vessels in the ring-shaped tissue body of the rectum, and haemorrhoids form which could eventually project themselves outside the anus. If you already suffer from haemorrhoids, Duphalac® will ease bowel movements.
How does a high-roughage diet regulate the digestion?
Roughage or vegetable fibres are constituents of plant foods which are indigestible for humans and which have a number of favourable effects. For example, they retain large amounts of water, increasing the volume of the stool and thus stimulating intestinal activity. The stool remains soft and pliable, allowing problem-free evacuation.
We should take in at least 30 g of roughage every day. We can increase the amount of roughage in our diet if we eat less meat, sausage and cheese and substitute them for whole-grain products, brown rice, fruit and vegetables. We also need to drink enough fluids to ensure that the plant fibres can be effective, namely two litres a day or more.
Cathartics (laxatives) are medications which accelerate defecation. Their effect is based on different mechanisms. Filling and swelling substances such as psyllium, wheat bran or linseed bind water and increase stool volume. This stimulates intestinal activity and a soft stool can be passed. Nevertheless, filling and swelling substances can only be effective when plenty of fluids are drunk at the same time (two litres per day or more).
Osmotic laxatives are substances which are difficult for the body to assimilate and which reduce the resorption of water from the bowels. Included in this group are such substances as Epsom and Glauber's salts, certain sugars and also the vegetable laxatives, such as senna, rhubarb and aloe, with their occasionally rather drastic effects.
Duphalac® has an especially gentle way of working. Duphalac® contains lactulose as its active ingredient, a special sugar which cannot be utilised by the human body. Lactulose travels undigested through the stomach and the small intestine to the large intestine where it is split up into small pieces by the intestinal bacteria. These fragments hold back the water in the bowel as roughage does, making the stool soft and voluminous. As a result, the bowel movement is stimulated in a very gentle and sure manner.
Certain laxatives may well be quite successful in the short term, but they are not able to restore the normal, regular functioning of the digestive process. This means that one has to keep taking them - often in ever-increasing dosages - which can lead to laxative dependency.
Consult your physician if you would like to stop using laxatives. Probably he or she will recommend a preparation for you which can be administered in individual dosages (e.g. lactulose). You reduce the amount of this preparation slightly every couple of days until you can eventually do without it completely. At the same time, you should switch over to a high-roughage diet, drink plenty of fluids and make sure you are physically active.
What is the difference between lactose (milk sugar) and lactulose?
Lactose (milk sugar), like lactulose, is used to treat constipation. However, milk sugar is not very effective and needs to be administered in relatively high dosages (40 g). In addition, one dose of milk sugar has a lot of calories (160 kcal), triggers feelings of hunger, affects body weight and is unsuitable for diabetics. Lactose (milk sugar) is mostly resorbed in the small intestine.
My four-year-old daughter suffers occasionally from constipation.
Could I give her Duphalac® ?
Duphalac® is also suitable for treating children. Scientific investigations show that they tolerate Duphalac® very well. The dosage for children is Duphalac® syrup once or twice daily (5 to 10 ml), corresponding to 3 to 6 g of lactulose.
For more on risks and side effects read the package insert and consult your doctor or pharmacist.
