Ask the doctor: What medications are used to control constipation?

Because I suffer from chronic constipation, a doctor prescribed Bisacodyl in 1999. Although the medicine would provide relief then, it no longer does. Which other drug can I use? Anna

Dear Anna,

When someone takes long to pass stool (fewer than three times a week) and when they do, the stool is hard and difficult to pass, then they are said to have constipation.

Constipation can lead to a number of complications including painful defecation, swollen veins of the rectum and anus (haemorrhoids), bloody stool, anal fissure (a torn anus), anal prolapse (anus that may protrude outwards), swollen painful tummy, loss of appetite, and hard stool that may block the intestine (stool impaction with intestinal obstruction), among others.

Because of the many complications, it is important to take a lot of fluids, fruits and vegetables, exercise and avoid eating foods such as finger millet or drugs that cause constipation. These and other measures as advised by your doctor are better at treating constipation than drugs such as Bisacodyl, which after a long time may fail to work or require taking all the time to treat constipation. Otherwise, one may fail to pass stool at all (cathartic colon).

Constipation is more prevalent in older people and those who have reached menopause. This and many other reasons could be the reason why the drugs are failing to work and the cause might be something that has not yet been addressed.

Instead of self-prescribing, visit your doctor for a checkup and treatment to avoid complications.

How can I treat cracked soles on my feet?

I have cracks on my feet locally known as enkyakya. I was advised to wear gumboots often but this has not helped. What can I do? Latima

Dear Latima,

Feet have numerous sweat glands (as many as 250,000) that constantly produce about 500mls of sweat a day. Apart from helping in regulating body temperature, the sweat also keeps the feet moist. Without this moisture, the soles of the feet are likely to dry and crack, forming fissures (enkyakya), which mostly affect the heels of the feet.

Walking barefoot, especially on dry soil (including digging in dry fields) will rid the feet of moisture, causing one’s feet to crack, the reason why a doctor advised you to wear gumboots, especially while digging or walking on dry ground. Since the gumboots did not help you, it is likely that other causes, such as being obese, or having inactive sweat glands were not addressed.

Apart from not walking on dry ground barefooted, take adequate amounts of fluids to keep the body and feet well hydrated. You should also soak your feet in water mixed with salt and use a rough pumice stone to scrub off the hard skin around the cracks.

Cracks on soles of the feet do not only present a cosmetic problem but can also attract germs, leading to infection under the skin (cellulitis, locally called etalo). They can also attract jigger fleas, causing jiggers. So, any changes to your fissures requires you to visit your doctor, who will rule out any of the above and if present, provide treatment. 

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