Question

I am 75 years old and have other health issues, but I want to know: Can I use a powdered supplement to stay regular?

Answer from internist Brandon Miller, MD

Before we start talking about laxatives, the number one thing would be to change what you eat. Eating more vegetables can keep you regular (and make you feel full). These fiber-filled veggies are what laxatives are trying to mimic anyway – by bulking up your stools. Good exercise or staying mobile will also help.

I like to tell my patients that if you want to stay regular, you should do something regularly. Training your body to have regular bowel movements can be hugely helpful. Make a routine of going to the bathroom early in the morning, right after you wake up. If you’re not having success, come back to it later.

If changing your diet or starting a routine isn’t helping, powdered supplements may be your next step. Powdered supplements include bulk-forming laxatives and osmotic laxatives.

Bulk-forming laxatives promote contractions of muscle and make your stools bulkier by pulling water into the GI tract. These laxatives can very rarely cause absorption issues with your other medications, so you need to talk with your doctor before taking them regularly. Also, you can get even more constipated if you don’t drink enough water. Drink at least eight ounces of water with these types of laxatives.

Osmotic laxatives change how tiny charged particles called electrolytes work in your GI tract. Electrolytes make it possible for muscles in your GI tract to function properly – and everywhere else in your body. Sometimes osmotic laxatives may cause electrolyte imbalance, triggering abnormal heart rhythms, confusion and seizures. So talk to your doctor about taking these as well.

As we get older, muscles and nerves in the GI tract can worsen, leading to constipation. Pain medications for chronic diseases often cause constipation as a side effect, but so can diet or acquired damage. The GI tract is a complicated organ. The cause of constipation affects how to treat it best.

In summary, there are many things to consider – especially if you’re taking other medications regularly. Your primary care provider can help find the best way forward.

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