With thanks to http://www.quickcare.org/gast/constipation.html – their site is great for general info – though laxative dependency isn’t something we really see – their site shows a fantastic animated version of this diagram.
this is by far my most asked question!
FAQs? No – wordpress tells me this is almost the only question people search for that finds my blog
So, Movicol, how fast does it work, or at least how long does Movicol take to work?
Problem with constipation is that by the time anyone realises, there’s already some build-up. It’s that that makes people feel so – yuk!
This is because the amount of stool inside makes you feel sluggish and bloated. If you drink clear fluids that often helps, but eating fibre at this stage seems to just make you feel more bloated. This is why people who feel constipated eat simple carbs like bread and rice as these tend to be almost fully absorbed so they don’t add any more to the bloated feeling.
We forget this when trying to treat it. Movicol is like dynamite – if you give enough for the job it will work (though in most cases you should be in close liaison with your healthcare provider).
When to try it – relax!
When you know it will work, relax, find a time when you won’t need to worry too much how it affects you – time off or school holidays or Bank Holiday weekends. You never know if you’re going to be quite sensitive to it, or need bucket loads. Nobody does until you try it.
Bowel transit times and other ‘medical’ factoids
The normal bowel transit time in adults is a couple of days, in toddlers only about 12 hours. For this reason, it doesn’t work straight away. Because it is a starch attached to water it is a bit like food rather than fluid and it takes time to work through. If you think of cooking rice when there is the gloopy rice water before you rinse it – Movicol works like this – you couldn’t squeeze the water out of it even if you tried. But equally, the bowel doesn’t absorb it. While you always think of the bowel as your ‘insides’ ironically it sort of outside. It is open at the top and open at the bottom. If something goes in at the top and is not absorbed, it will come out at the bottom. This is how it works. When you make up the sachet, that minimum volume will all reach the end of the bowel, you can add more fluid, but that original amount all reaches the end.
Now the less lovely part – what happens then?
Ok, deep breath, here goes!
The food & drinks you eat all mix with fluids in the stomach. The clear fluids are absorbed quickly there as are simple sugars like glucose, most of the rest pushes along to mix with more enzymes to help absorb it. At this stage each Movicol molecule is still attached to its water.
They continue like that through the small bowel and enter the large bowel at the same level as the appendix (the caecum). This is inside your abdomen (of course) just above your right hip. It then passes in an inverted ‘U’ shape along to the end of the large bowel. Some nutrients are absorbed here but generally water is absorbed so that the stools get drier and drier as they get to the end.
Now the action bit!
The Movicol molecules continue being pushed along attached to the same water molecules. When it reaches the impacted stool (the stool that’s backed-up) it can do a number of things:
1) form a normal stool and by weight of this push that ahead of it out (‘rocks’)
2) remain loose and build-up a head of pressure sufficient to push that ahead of it out
3) remain loose and effectively break-up the stool ahead of it out as small bits or loose stool rather than expected ‘rocks’
It seems to be a variable proportion of these which varies from person to person.
I hope that this makes some sense – and makes taking this medicine easier.
It is hard to remember now, but in the days of lactulose and senna alone, treatment was much more difficult.