OBSTipation  = Severe constipation. Obstipation is really what you treat with the meds. An internal medicine doctor, Dr. Eivas, uses the mnemonic, BOSS to remember the different medications for constipation. Bulk forming agents, Osmotic agents, Stimulants, and Surfactants. I love the idea of a mnemonic but because BOSS doesn’t mean anything to me – except that a BOSS might be constipated, I came up with my own. OBSTipation. If you remember that the kind of constipation that needs serious treatment is usually intractable constipation  which is called OBSTipation, then you remember easily the four classes of medications.

  • Osmotic agents: Polyethylene glycol – Macrogol / Miralax; Golytely; MOM, Mg Citrate, Mg Sulfate, Lactulose, Sorbitol, Glycerin suppository
  • Bulking agents: E.g. Psyllium (Metamucil), Wheat dextrin (Benefiber)
  • Stimulants: Bisacodyl, Senna (Sennosides)
  • Tension-lowering agents. Surfactants lower the surface tension of water so that it mixes easily with stool. E.g. Docusate sodium, Docusate calcium
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