How Constipation Is Treated

Bowl of oatmeal with prunes

Verywell / Zorica Lakonic

Constipation is a common problem for children and adults. In many cases, uncomplicated constipation can be treated with changes to diet, lifestyle, and bowel habits. Trying one or two of these strategies may help bring relief.

The occasional use of over-the-counter (OTC) treatments like laxatives or enemas is the next step, for short-term relief. Prescription medications and other therapies tend to be reserved for more severe cases.

This article explores the different treatments used for constipation, including diet, exercise, lifestyle modifications, medications, and even surgery when all other options fail.

Home Remedies and Lifestyle

The first line of treatment for constipation is to make changes in your diet and lifestyle. Often, these little "fixes" are enough to get your bowels moving again.

Act on the Urge to Go

Ignoring the urge "to go" can lead to constipation by causing stools to impact and increase in size. To avoid this, make time every day to have a bowel movement.

Some people find it easier to go in the morning, while others find that later in the day (such as after dinner) works better for them.

Taking the time to relax and allow bowel movements to happen naturally is always best. Pushing and straining may only lead to hemorrhoids and rectal bleeding.

Exercise

Physical activity encourages the muscles in the intestines to contract and keep the contents moving (a process referred to as peristalsis). People who are bedridden or physically disabled often experience constipation due to the complete lack of physical activity.

Studies show that people with chronic constipation who regularly exercise report a better quality of life than those who are largely inactive. Aside from encouraging bowel movements, regular exercise also helps relieve stress (a contributing cause of constipation).

Eat More Fiber

In Western countries like the United States, the lack of fiber in the diet is a major contributor to constipation.

Many people with constipation are unsure as to how to add fiber to their diet or which type of fiber (soluble or insoluble) works best in maintaining regular bowel movements.

Although a fiber supplement can certainly help, getting fiber through food is always best. Foods like prunes, figs, and licorice all have natural laxative properties and can be extremely helpful in easing constipation.

Dietary Fiber Tips

Add fiber gradually to your diet as the sudden increase can cause bloating, gas, and even diarrhea. It also helps to eat high-fiber food with every meal, including snacks, to keep yourself regular.

Bowel Retraining

For people with constipation, bowel retraining is the practice of going to the bathroom at the same time every day to teach your body to have regular bowel movements. It also involves dietary changes to help soften stools.

During bowel retraining, many people will schedule bathroom visits 20 to 30 minutes after meals when the passage of food into the stomach and intestines triggers peristalsis. Others schedule bathroom visits after their morning coffee, which often triggers the same effect.

Bowel training requires time and persistence to put your bowels on a regular schedule.

Over-the-Counter (OTC) Therapies

Over-the-counter (OTC) therapies are the next step in relieving constipation. While you can buy these without a prescription, it's best to talk to your healthcare provider before starting any OTC treatment. This is especially true if you are pregnant or breastfeeding, have a digestive disorder, or are treating a child.

Fiber Supplements

While it's best to get fiber from food, fiber supplements can complement your treatment. These products are collectively known as bulk-forming laxatives because they add water-absorbing fiber to stools to make them softer and easier to pass. They can even help treat diarrhea by absorbing water and making stools more solid.

Bulk-forming laxatives are not habit-forming. Most can be used every day on a long-term basis. Your healthcare provider can help you select the right fiber supplement for you.

Laxatives

There are a number of OTC laxatives that you can turn to for occasional constipation. Some are stimulant laxatives that accelerate peristalsis, while others are osmotic laxatives that draw water from the intestines to make stools softer.

Laxatives can provide short-term relief of constipation and are not intended for long use. The overuse of laxatives can become habit-forming and make constipation worse as your body becomes increasingly less responsive to them. Some OTC laxatives can interfere with other medications you may be taking.

The one exception may be the osmotic laxative polyethylene glycol sold under the brand name Miralax and others. Studies suggest that it can be used safely on an ongoing basis for up to 12 months, even in children.

It is especially important to consult with a healthcare provider before using any laxative, especially in younger children.

Enemas

An enema is the introduction of fluid into the rectum, typically to clear out stool. It can be used to clean the bowel before a diagnostic procedure, such as a colonoscopy, but can also help relieve constipation. It is a short-term solution and not intended for long-term use.

Enemas are not appropriate for the treatment of chronic constipation.

Risks of Enema Overuse

The frequent use of enemas can cause the muscles in the colon to weaken. In time, you can develop a dependency on enemas to have a bowel movement. The overuse of enemas can also lead to hyponatremia ("water intoxication") due to the loss of sodium from the body.


Prescriptions

If diet, lifestyle, and OTC treatments fail to ease constipation, your healthcare provider may turn to prescription drugs that promote bowel movements in different ways.

Prescription drugs used for constipation include:

  • Amitiza (lubiprostone): This is an osmotic laxative that helps soften stools. The capsule is taken twice daily with food. Common side effects include nausea and dizziness.
  • Cholac (lactulose): This is an osmotic laxative approved for chronic constipation in adults. The capsule is taken by mouth once daily. Common side effects include burping, gas, bloating, stomach rumbling, and nausea.
  • Linzess (linaclotide): This is a drug used to treat irritable bowel syndrome with constipation (IBS-C) as well as chronic constipation without a known cause. The tablet is taken by mouth once daily. Common side effects include diarrhea, stomach pain, gas, and bloating.
  • Motegrity (prucalopride). This is a drug that stimulates peristalsis. The usual dose is one pill by mouth per day. Common side effects include headache, nausea, tiredness, stomach pain, gas, and bloating.
  • Pizensy (lactitol): This is a liquid osmotic laxative approved for the treatment of chronic constipation in adults. It is taken once daily, ideally with meals. Common side effects include gas, bloating, diarrhea, and an increased risk of upper respiratory infection.

Medications That Cause Constipation

If struggling with constipation, tell your healthcare provider about any medications you are taking, some of which may cause constipation. These include:


Surgeries and Specialist-Driven Procedures

In rare instances, surgery and specialist procedures may be used if there is an underlying condtion preventing the normal moment of stool. This includes fecal impaction (in which the stool is so hard that it cannot pass with a normal bowel movement).

Some of the specialist procedures used in these instances include:

  • Digital disimpaction: This is the manual removal of stool from the rectum with a gloved finger. It is often used in people with spinal cord injuries or other nerve-related conditions that impair the movement of the bowels.
  • Antegrade colonic enema: This is a surgical procedure in which a small passage (called a stoma) is made between the abdomen and the colon. This provides a route through which the bowel can be flushed daily with a sterile saline solution.
  • Surgical repair or resection: Surgery may sometimes be needed to remove or repair an obstruction in the digestive tract. Examples include rectopexy (the surgical repair of a rectal prolapse) and a colon resection (the removal of a damaged section of the colon).

Complementary and Alternative Medicine (CAM)

Herbal supplements and alternative therapeutic practices have long been used to treat constipation. While many people swear by them, there is generally little scientific evidence to support their use. Even so, some have shown promise.

Acupuncture

Acupuncture is thought by some to be an effective treatment of constipation. It is an ancient practice of traditional Chinese medicine in which thin needles are placed at specific parts of the body to induce heal. Some studies suggest that acupuncture can relieve constipation due to changes it causes in the nervous system.

According to a 2013 review of studies in the American Journal of Chinese Medicine, acupuncture was as good as conventional medical treatments for the treatment of constipation and better than a placebo (sham) treatment. Even so, the authors stated that the conclusions were limited by the small size and generally poor quality of the studies.

Biofeedback

Biofeedback is a technique used to gain control over some of your body's functions, including bowel movements. During biofeedback, your temperature, heart rate, and muscle activity are displayed in real-time on a digital display. With practice, some people can learn to control these functions and relax the muscles needed to have a bowel movement.

Biofeedback is non-invasive and can use over the long term. With that said, the evidence is lacking as to whether it actually helps. Some studies suggest that is "possibly beneficial" for people with fecal impaction but less so with chronic constipation.

Herbal Remedies and Supplements

There are many herbal supplements and remedies marketed for their laxative or stool-bulking effects. While the evidence supporting these products is generally sparse, there are a few that have shown promise:

  • Rhubarb extract: Extracts made from the fleshy stalks of the rhubarb plant appear to increase peristalsis.
  • Senna leaf extract: A herbal medicine derived from a flowering plant, called Senna alexandrina, has plant-based compounds that work similarly to stimulant laxatives.
  • MaZiRenWan: A traditional Chinese medicine, also known as hemp seed pill, has been used for centuries to treat constipation.

Herbal Supplement Safety

Speak with your healthcare provider before using any herbal supplement. Some might interfere with the medications you take or cause liver toxicity if overused. To ensure purity, only buy supplements that have been certified by an independent body like the U.S. Pharmacopeia, NSF International, or Consumer Lab.

Summary

The treatment of constipation can vary by the cause and severity of the symptoms.

Uncomplicated constipation often responds well to changes in diet, routine exercise, fiber supplements, and the occasional stool softener or laxative. Certain complementary therapies such as acupuncture and senna leaf extract may also help.

If these fail to provide relief, your healthcare provider may prescribe medications that stimulate bowel contractions or increase water absorption in stools. In severe cases, surgery may be needed.

A Word From Verywell

As aggravating as constipation can be, it can often be treated with diet, exercise, and over-the-counter fiber supplements or Miralax. It should not be considered an "aging thing" or something you have to live with. If conservative treatments fail to provide relief, speak with your healthcare provider.

On the other hand, if you've not had a bowel movement in three days and are experiencing severe stomach pain, bloating, vomiting, and blood in the stool, see your healthcare provider immediately. These could be signs of a bowel obstruction that can turn serious if left untreated.

Frequently Asked Questions

  • What foods should I eat to avoid constipation?

    High-fiber foods will help prevent constipation. These include:

    • Whole grains, such as wholewheat bread and oatmeal
    • Fruits, such as apples, prunes, berries, and pears
    • Vegetables, such as carrots, broccoli, and green peas
    • Beans, legumes, and nuts

    Also, drink plenty of water (around 3.5 liters per day if you are male and 3 liters per day if you are female) to help keep you regular.

  • When should I see a healthcare provider about constipation?

    Call your healthcare provider if you:

    • Have not had a bowel movement in the days
    • Are bloated or have stomach pain
    • Have nausea or vomiting
    • Have blood in the stool
  • What is the best treatment for constipation in pregnant women?

    Drinking plenty of fluids, eating more fiber, and staying active can help ease pregnancy constipation. Taking a stool softener may also help, but check with your healthcare provider first to ensure that it is safe.

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