This Popular Constipation Treatment Doesn’t Really WORK
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- čas přidán 28. 08. 2024
- Strange but true! Don't worry, there are plenty of other great options- subscribe to make sure you don't miss the video I'll make explaining constipation treatment options!
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As an IM resident and aspiring GI physician, I've had way more debates on constipation meds than I'd ever thought I'd have in my entire life 😬
If you have a sluggish GI system since birth, like I do, some of these meds. can actually cause "plugging" in the bowel, and can worsen symptoms!
Ooh, Dr. H., you didn't meet my mom!😩😂
I’ve tried to tell my surgical and PMR colleagues this for the last 10 years. Good luck Doc!
Polymyalgia rheumatica?
Physical Medicine and Rehabilitation Physicians : PMR
TELL THIS TO THE OB/L&D FLOOR! That’s EXACTLY what is given to postpartum patients to help with pooping after the trauma of childbirth. No wonder PP patients still complain so much about the after birth bowel movements 😢
I’ve had this convo with so many ppl but a lot of mums swear by docusate! If they like it I just let them keep it ¯\_(ツ)_/¯
Ugh. I jut made thi comment 😞 why women are getting tho post partum is beyond me. Jfc just tell me to go get something myself
Taking it now for PP. It sucks lol
@@valentinaa9916 see Doc Schmidt’s other video on laxatives he does recommend! PEG and senna work great!
This is what they use in the nursing homes on the old people to help their bowel movements.
You’ve changed my daily practice in this video. Palliative guidelines in my hospital is for docusate rather than lactulose/macrogol as it’s less bloating. I will reconsider this in future.
Can't wait until the next video! I work in palliative care where patients are often on multiple pain meds, so effective constipation treatment is important.
Senokot daily gummy laxatives. 5, 2x a day. It's not as cramping as other laxatives, and I have had chronic constipation for 13 years along with achalasia. Just my 2 cents. It works. I had one doctor having me take 4 ducolax every night. No real physical harm except the cramping and just saying it makes me want to throw up.
I take oxycodone for my chronic pain and doctors don't give a shit about constipation, so, so, so annoying and unprofessional, happy to know someone does care.
Second colloxyl and senna
Retired RN here. Senokot is wonderful for palliative care. Up to 8 tablets can be given over the course of a day. It can be titrated however needed. It also comes in a liquid. I did hospice care for 3 years. We also could use it in children.
I take a dulcolax chew daily to stay regular. It helps me didn’t even need the Linzess
As an almost pharmacist, this really interests me! Excited to see the video! I see docusate ALL the time so I'd love to hear what's more efficacious and how to present that info to docs who prescribe docusate!
In the same situation. Looking forward to this next video!
@@nayla9353 yeah, that doesn't sound sketchy at all. Nice try spam bot.
Lol, I also studied pharmacy, but in Germany, and I don't think we even have it here for constipation. I just know there's an ear wax liquidiser (which aren't recommended to use at home anyway, so the blockage doesn't settle down deeper in the ear canal).
I am a nurse and see colace ordered a lot for patients. Most of my folks are on meds that slow the gi tract way down and you really need a stimulant laxative. Either with or instead of colace. Only thing that works from what I’ve seen.
Pharmacy grad from last spring here. Giving the "mush" without the "push" doesn't do much to help you get rid of it. Stimulant laxatives +/- docusate does a lot better generally. Although, if the stool is especially hard (low end of the London scale) and potentially painful to get out, docusate may be more helpful. I'm sure Doc Schmidt will go into other options too.
Waiting on the edge of my toilet seat for that next video!
😩😆😆...
@@clarissar1528 xd
Me too.
Same here. Waiting on the toilet seat
Try coffee
Way to go doc! You’ve got the best no nonsense, informative, non-begging for likes and subscriber videos in the business! Keep on rockin’!
OMG!! Palliative care APRN here, thanks for saying what I have for a long time!
OMFG THANK YOUUUUUUUUU! FINALLY. I ALWAYS, ALWAYS REJECT THIS MEDICINE when i'm in the hospital. that shit does not work.
i knew i wasn't tripping. i'm saving this video.
As someone with chronic constipation thats tried every medication under the sun, i swear my doctor thought i was crazy when i said it wasnt working but its good to know im not
I’ve heard patients “switched” from docusate to colace, and it made a big difference for them. #placebo
LOL
🤣
That’s literally the same thing
Me, hearing him talk about this, getting a flashback of the time I didn't have a bowl movement at home for seven (7) days post cesarean section even tho I took the prescribed stool softening medicine..........
Right?!?!? I thought it was just me. And I felt like I was drowning in water. And no one wants to pee anymore than usual when they literally have a peeing/pooping/crying newborn to take care of.
LMFAO i was just about to write the same thing!! Stool softener my ass!! (Literally 😂) My second c section i said, "does that even work? I can honestly say from experience that it doesn't." I was given something different, don't remember what it was but i didn't have the same bad experience. Have a wonderful evening and thank you for that hilarious comment 😂😂
I delivered vaginally and also didn't have a bowel movement for 7 Days in spite of any medications given.
Yup. This explains so much.
Same 😅
Great PSA - I'd argue that Colace can hurt folks, by delaying appropriate treatment of constipation.
Same reason we use backboards all the time in EMS for everything. "200 years of tradition, unimpeded by progress"
It's not for every day but 99 cent over the counter bottle of magnesium citrate takes care of severe (and temporary) constipation within 2-12 hours.
Soooo true!
I agree! For tummies that are prone to cramping, ime Magnesium citrate is gentler than Magnesium sulfate, but supplements tend to use the latter, making the former sometimes hard to find. They're both fine, though, but for me, I can't even tolerate the pain of a half dose of Magnesium sulfate. My advice: check the label and go for the citrate if you're new to Magnesium supplements. And, if I may be so bold, also start with 1/2 the dose listed, if possible. [Don't open capsules or pierce softgels, for example.] But it may be easier than cutting pills, thanks to dodgy labelling. And that brings me to...
Please, read the labelling carefully! "Natural" supplement companies pull some sneaky moves, so be sure that you check the label and understand _exactly_ what is in the pills in the bottle (I mean _active_ ingredients; Magnesium stearate and titanium dioxide are harmless little helpers: binders, colorants, etc.) *and* how much is the _dosage_ - the mg per each pill. (And know that supplements usually contain far more than is recommended, sometimes more than is even safe; look it up, & ask your doctor if you have one). Here's what I mean: even on a bottle of "300mg Magnesium citrate", for example, you'll often find that the 300mg of Magnesium is in *2* pills, so each pill is actually just 150mg. (There's your half dose!)
...It's deceptive and annoying, but it's important to know. It does matter for most supplements, which overall I think most people (especially in the USA, Canada, and UK) take way too many of them, and in way too much. And Americans fall the hardest for chiropractic (note I didn't say _medicine)_ to the tune of billions of dollars per year. Look up its origins. It's not medical, and never was. It wasn't invented by doctors, but the grifters swore it could cure a whole panacea of disorders. And darkest of all, it does destroy lives. For hecc's sake, people do it on children & babies, and people have died.
I know I'm waffling. Just... please read your labels, dear readers, and stay safe out there. I worry about you. Have a nice day. ♡
You just have to be careful because it can throw some patients electrolytes out of whack.
@@grannyjann A good thing to note. Folks should also check other supplements they take to be sure of not "doubling up" accidentally.
Having nursed my mom post-op for 2 knee replacement surgeries, during which the pain meds caused constipation, the most consistent solution we found was... prune juice. She was prescribed Senna and docusate together, and still struggled to have daily bowel movements. Prune juice worked quickly and consistently
As a Crohn's patient with constipation and diarrhea this interests me. I feel like colace does help on occasion. As a nurse, I'm looking forward to seeing what's next!! Most people don't like miralax, don't want to mix the powder and liquid, don't use it correctly, and it's more expensive than most other meds. Help us doc!! We're all waiting on the edge of our (toilet) seats!!
Lactulose? comes premixed, only needs a small volume (10-20ml) per dose.
Colace is “all smush and no push” per a GI attending at BIDMC.
As an internist I knew this since I was 12 because I have chronic Constipation since childhood and I tried docusate and I never thought it ever worked so I always avoided this in my practice and I used to cancel it as an order if it was prescribed by another provider X-D
As an Aussie pharmacist I’m very interested in the next video we use docusate all the time!
Interesting! Many of my pain patients are on OTC colace as a matter of habit. I'll be looking forward to your "better options" video!
im in pharmacy school and they still tell us to recommend docusate for patients… had no idea, thank you!
Yes please let us know. I used to order this all the time as well.
I almost felt click-baited but then I realized this was a short lol hard to explain literally everything in less than 60 seconds
Don’t worry there’s more where that came from!
That's really useful knowledge. Thank you for sharing.
Great info as always ! STAY SAFE ALL !!!
Thank you for saying this!! Docusate has never worked for me for anesthesia-induced constipation, but every time I've had surgery they've prescribed it anyway.
I’m a pharmacy tech and I think about this video every time we get a prescription in for docusate
Just learned this in pharmacy school yesterday so I knew the answer. Really good timing!
That makes so much sense! After the birth of my daughter they gave that to me. I told them it wasn't helping and nobody believed me. A few days later I'm at home after not pooping for close to a week in massive pain because I couldn't pass the giant rock hard stool. It took a lot of crying, multiple enemas, and the use of my hand. It was an awful experience. I've been put on that med other times for constipation and it never worked. I just figured it was me. This video explains so many things. Thank you!
this dietitian would love a tell all about your favorite constipation meds!!
My OB-GYN advised me to eat kiwi to help relieve constipation. It was miraculous.
@@brennasimondswhipple5777
Worked for me after giving birth as well.
Kiwis really?
Looking forward to the followup video! Crossing my fingers Miralax is on your list.
Miralax is my best friend in the world
as a pharmacy tech, this makes soooo much sense! i can't tell you the amount of times we get patients asking for alternatives to docusate because it hasn't worked for them, especially when they're on opiods and the docusate was actually prescribed by their doctor! thanks for the info!
Never thought I'd be so interested in learning about constipation
Hi there! I’m a retired nurse that worked for a Colo-rectal surgeon, both in office and during surgical procedures (RNFA). Would you address the whole fiber as a laxative bs, please?? That’s the one I have the most arguments over😉 Love your channel ✌🏽
Am i right that fiber helps prevent constipation though? Just not treat it?
@@nikolausengh6630 It’s a binding agent, an absorber. It does help to keep things moving along, but if you’re constipated it just “adds to the clog”, if that makes sense. Most people don’t get enough fiber in their diets, so added fiber aids in colon motility 💜
@@twoofakindOGDC yes I like to say it's like adding stone to cement makes concrete.
Most people need more actual fiber from diet, not tablets. If your stool is dry, the fiber won't help, it just increases the caliber and pain.
Fiber MUST be taken with adequate water which a lot of people do not take. Fiber without water can be bad.
Thank you so much for sharing this! Been a geriatric nurse for years and more docs need to knew this. I actually tried solace a couple times myself and after I stopped it the constipation seemed worse. I see we are almost all getting orders for metamucil or miralax now, but when a doctor prescribes Colace and zi know it's not going to work I feel so bad for my residrnts. We end up calling their offices and asking for something stronger like MOM to get things going and then if we get them over to Psyllium or Polythylene Glycol it helps. Diet change isnt usually an option and most of them dont feel thirsty so they dont drink enough water. But the Psyllium powder in the morning works well or if they cant swallow that the Miralax usually works well.
This makes perfect sense now. Been taking collace for who knows how long and I find myself struggling on the toilet- a lot!
If you've been on docusate for long and are having difficulty in your bowel movements, you should definitely consult a physician. Something is wrong somewhere.
I was prescribed this for years until they realized I had gastroparesis
From Diabetes?
Hypothyroidism?
YES. Palliative care doctors everywhere thank you for this PSA.
We use colase in hospice all the time. Looking forward to his next video.
I’m on my last semester of nursing school and this is so interesting to hear considering like 80% of the patients I’ve had were on docusate
This is SOOOO helpful!!! I wish I could have a series of these from every specialty!
I'm holding my poop with anticipation to find out the cliffhanger on this one.... Don't leave me hanging!!!
Yasssss! I have so many patients who tell me they’ve been on colace for their constipation! 🙅🏼♀️ let’s try something else!
Pharmacist here! Love seeing these short educational videos, please continue to make more :))
Thanks friend. I didn’t know that and have rx it as well.
Thank you, thank you thank you as a pharmacist I can tell you thank you enough. Docusate works really well as breaking up ear wax though.
I always think of Girl Interrupted when I hear Colace.
It’s a lovely new house. It has an eating chicken…
GI Interrupted
And now I need to rewatch the movie
Preach it doc!!! Evidence based practice all the way!!!!
My favorite is when someone in the hospital with constipation has a "1st line docusate" PRN order.
Nurse here. Colace was ordered BID post cardiac surgery for all patients at my old job. Transferred to work in ICU and we used everything but Colace, and from experience, Colace never did anything. I never looked into actual studies, good to know my experience is backed by science.
As someone with IBS-C this....makes so much sense
In pharm school I was taught that docusate good to make stool “mush” and senna is best to give with it to help the patient “push”! I hope this holds true or else I’d love to help physicians de-prescribe docusate and leave the senna 😅
Yes, I was just taught this as well in PA school with the exact same verbiage!
Thank you for the video. my dad has used it twice on medical advice and it has worked wonders for him.
Whaaaaaat? I’m tempted to send this to my pharmacology Professor now because we literally just leaned about laxatives a few weeks ago and Colace was one of them I think!
Coffee is my laxative I drink 16oz and it works 💕
That review actually specifies for a "stool softening" effect and doesn't take into consideration docusate's stimulant effects
I was prescribed docusate years ago and it never worked. I've tried so many things, and the only one that consistently works and doesnt make my gut feel over stimulated (caused by stimulant laxatives) is restoralax. I'm so glad to have finally found something that works after suffering from constipation for years.
That's crazy...nurse here at snf. Every pt comes in on docusate from hospital. And so many pts hate taking meds and constantly refuse. Good info thanks doc
Retired RN here. I've said that for years. When I was doing Hospice nursing, we often had our patients on Senokot. Up to 8 tablets a day can be given and it even comes in liquid. It can be titrated as needed to keep the patient regular. It's also safe in children. Not sure of your thoughts on it, but it worked miracles for many of my patients.
As an EMT who does half 911 and half transfers, I HAVE noticed constipated patients stay constipated on docusate! It makes sense.
Please let us know what you use. I have chronic constipation my whole life. Great video
I was prescribed colace in Europe because I had issues with my Crohn's when I was on vacation....it made stuff way worse! I am glad in the US they have a better understanding of IBD!
Try recommending plain old magnesium supplements.
Preach!
I’m going to guess Miralax…!
I'm a nurse, and I didn't know this until I had surgery this past fall. My surgeon said to take a stool softener post surgery. When I told her that I had Dos on hand for post-op, she said it didn't really do anything and to use [name] instead.
As a GI nurse this is so great to know!!!!
Excited to see what you do recommend. My almost 3 year old struggles bad with constipation. It wasn’t an issue prior to chemo. During chemo it made sense but now it’s been over a year since chemo stopped and she still struggles with constipation. We’ve had a lower and upper gi study and found no answers. I believe we are redoing the upper gi study soon to see what’s going on because the things we have tried don’t work or only work for a bit then stop working.
Omg thank you! I always wondered why it didn't work when I was prescribed it!
The suprised Pikachu face I got from residents when I told them this would be hilarious!
I need to my hospitalitsts this!! They all prescribe this for people on opioids. Thanks for the info Doc!!!!
Yes! Thry always prescribed this with surgeries. It never does anything. I have wasted so much money on this. If I’m ever constipated, i just use foods to get everything moving. Lentils is my personal plumber 😂😂. I’ve learned along the way. Also, acupuncture is another immediately effective solution. Used this going through cancer.
I'm shook!! We use this so much in the hospital!
As a pharmacist, I instantly guessed it was Docusate. Spoiler alert ⚠️ The medication he is gonna say he prescribes is probably Lax A Day. But it might also be fiber supplements because it is the first recommended option. But as a laxative, Lax A Day is one of the best.
Wow thank you!!! This is really good to know
I just finished my GI unit in school and we were taught that docusate is not sufficient by itself but when combined with another laxative (e.g. a stimulant or osmotic laxative such as miralax), then it is effective as it augments the 2nd agent.
Question: when are you going to start posting CME videos? Because I would definitely listen to your presentations on GI medicine with how well you present
Can’t wait for the next video. I’ve noted anecdotally that laxsol doesn’t really do much of anything. I’d like to be able to go back to work with evidence.
Will love to read that article. Please share.
Seriously so excited to have my GI consult…feel like I’m blindly taking meds!!!
Soooo I should have my hospitals remove this from our inpatient formulary?
Yup! I switched from docusate to miralax and it’s lifechanging
Please enlighten me so I can do more research before presenting to my group home managers
Share this with gynecologists and midwives! Anyone who works in L&D!!! I was given colace after having both my kids and I had stitches each time. I CRIED every time I had to go poop (this part is tmi and possibly triggering) bc it literally felt like I was pooping knives!! Please share this with L&D Dr's and nurses!
As a pharmacist I think of docusate as a stool softener, but you still need to combine it with a laxative to help relieve constipation.
The stool softener is what that gave me after having a baby and it really helps
Thank you! I always thought it didn't work!
I have MS and I’ve been given Colace all the time. It doesn’t work.
I can safely say that Linzess does work.
Yessss!!!! I had digestive surgery last year and they reccomended smooth move tea. Works better anyway!
Please talk about opioid induced constipation in this upcoming video!!
Pregnant woman here! Tired of taking psyllium husk daily, so I'm not so patiently waiting for your follow up video.
A nurse officially obsessed with this channel
I’ve said this for years! Colace doesn’t work
Thanks dr schmidt!! Dr can you do a segment on medication that doctors prescribe all the time but thats no similar to placebo?? Am an intern, currently applying to IM, thought it might be helpful in the future, because docusate is still being used in clinical practice where I work..
3-5 tablespoons of chia seeds a day. Can put them in water and mix them with juice, for a drink. or put them in food. Also fairly high in protein along with fiber. The best natural digestive / constipation help I found.
Had three brain surgeries within a year and a back procedure. I had to switch to more effective stuff over the long run.
Placebos work. The mind is powerful. The placebo allows the person you relax. I bet most medications for constipation have a huge placebo function.
WELL JUST GREAT!! I just sent my husband to Walmart for this after gallbladder surgery. Praying it works because he’s about to start 4 12hr overnight shifts. I’m taking it anyway lol 😂.
Ahhhhh i want to see the next vid! I give colace on a daily basis on my post-op ptes.
I’m always excited to see your videos, but I’m really looking forward to this next video! I’ve used Miralax for a long time and would love to know what your thoughts are! Thanks!!!
The gi doctors give Miramax prior to colonoscopy to empty your bowels. So my take is that it works well
As a psychiatry resident, i can tell you that clinically senna, then miralax then magnesium citrate for constipation seem to bring relief to patients. Would be interested if you could discuss them in your videos too.
I knew it! Our oncology team love using it.