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Type 2 diabetic. On oral metformin and glimapride. Good Constipation medication would be?

My Mother is type 2 diabetic since last 15 years, and since last 6 years is on oral metformin and glimapride medicines, also she takes 1 tab of amitryptiline -25 mg at night almost around daily. Since last 2-3 days she is facing the problem of constipation , and very hard stools . Please could you advice some good medicine for constipation taking into account that she is a diabetic patient and 43 yr old. Thank advance.
Asked On : Mon, 24 Dec 2012
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General & Family Physician 's  Response
Hi there,
Thank you for writing to us.
I am sorry to know that your mother is going through a hard time.
Constipation in a person who has been a diabetic for more than a decade and a half could be due to what is called as "autonomic neuropathy", which is a condition in which the nerves coming to the gut do not function very well and are damaged by long-standing diabetes.
To overcome this problem she needs to make a few changes in the diet.
She should take a diet that is high in fiber with lots of fluids.
A high fiber diet would include things such as:
Whole grain cereals
Over the counter fiber supplements like isphaghula husk or metamucil or benefiber
In addition to the diet there are medications that can help by softening the stool which include:
Milk of magnesia
Olive oil
Castor oil
Sulfolax drops (skilax drops)
Dulcolax (bisacodyl)
Additionally the blood glucose should be kept under control and she should drink lots of fluids as well.
Kindest Regards
Answered: Mon, 24 Dec 2012
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