Treatments for Constipation

Treatment

How do doctors treat constipation?

Treatment for constipation depends on

  • what’s causing your constipation
  • how bad your constipation is
  • how long you’ve been constipated

Treatment for constipation may include the following:

Changes in eating, diet, and nutrition

Changes in your eating, diet, and nutrition can treat constipation. These changes include

  • drinking liquids throughout the day. A health care professional can recommend how much and what kind of liquids you should drink.
  • eating more fruits and vegetables.
  • eating more fiber.

Read about what you should eat to help prevent and relieve constipation and foods to avoid if you are constipated.

Exercise and lifestyle changes

Exercising every day may help prevent and relieve constipation.

You can also try to have a bowel movement at the same time each day. Picking a specific time of day may help you have a bowel movement regularly. For example, some people find that trying to have a bowel movement 15 to 45 minutes after breakfast helps them have a bowel movement. Eating helps your colon move stool. Make sure you give yourself enough time to have a bowel movement. You should also use the bathroom as soon as you feel the urge to have a bowel movement.

Over-the-counter medicines

Your doctor may suggest using a laxative for a short time if you’re doing all the right things and are still constipated. Your doctor will tell you what type of laxative is best for you. Over-the-counter laxatives come in many forms, including liquid, tablet, capsule, powder, and granules.

If you’re taking an over-the-counter or prescription medicine or supplement that can cause constipation, your doctor may suggest you stop taking it or switch to a different one.

Bulk-forming agents. Bulk-forming agents absorb fluid in your intestines, making your stool bulkier. Bulkier stool helps trigger the bowel to contract and push stool out. Be sure to take bulk-forming agents with water or they can cause an obstruction or a blockage in your bowel. They can also cause bloating and pain in your abdomen. Brand names include

  • Citrucel
  • FiberCon
  • Konsyl
  • Metamucil
  • Serutan

Osmotic agents. Osmotic agents help stool retain fluid. Stools with more fluid increase your number of bowel movements and soften stool. Older adults and people with heart or kidney failure should be careful when taking osmotic agents. They can cause dehydration or a mineral imbalance. Brand names include

  • Cephulac
  • Fleet Phospho-Soda
  • Milk of Magnesia
  • Miralax
  • Sorbitol

Stool softeners. Stool softeners help mix fluid into stools to soften them. Doctors recommend stool softeners for people who should avoid straining while having a bowel movement. Doctors often recommend stool softeners after surgery or for women after childbirth. Brand names include

  • Colace
  • Docusate
  • Surfak

Lubricants. Lubricants work by coating the surface of stool, which helps the stool hold in fluid and pass more easily. Lubricants are simple, inexpensive laxatives. Doctors may recommend lubricants for people with anorectal blockage. Brand names include

  • Fleet
  • Zymenol

If these laxatives don’t work for you, your doctor may recommend other types of laxatives, including

Stimulants. Stimulant laxatives cause the intestines to contract, which moves stool. You should only use stimulants if your constipation is severe or other treatments have not worked. Brand names include

  • Correctol
  • Dulcolax
  • Purge
  • Senokot

People should not use stimulant laxatives containing phenolphthalein. Phenolphthalein may increase your chances of cancer . Most laxatives sold in the United States do not contain phenolphthalein. Make sure to check the ingredients on the medicine’s package or bottle.

If you’ve been taking laxatives for a long time and can’t have a bowel movement without taking a laxative, talk with your doctor about how you can slowly stop using them. If you stop taking laxatives, over time, your colon should start moving stool normally.

Prescription medicines

If over-the-counter medicines do not relieve your symptoms, your doctor may prescribe one of the following medicines:

Chloride channel activator. If you have irritable bowel syndrome (IBS) with long-lasting or idiopathic—meaning the cause is not known—constipation, your doctor may prescribe lubiprostone (Amitiza) . Lubiprostone is a chloride channel activator available with a prescription. Research has shown lubiprostone to be safe when used for 6 to 12 months. This type of medicine increases fluid in your GI tract, which helps to

  • reduce pain or discomfort in your abdomen
  • make your stool softer
  • reduce your need to strain when having a bowel movement
  • increase how often you have bowel movements

Guanylate cyclase-C agonist. If you have IBS with long-lasting or idiopathic constipation, your doctor may prescribe linaclotide (Linzess) to help make your bowel movements regular. Linaclotide is a guanylate cyclase-C agonist that eases pain in your abdomen and speeds up how often you have bowel movements.

Biofeedback

If you have problems with the muscles that control bowel movements, your doctor may recommend biofeedback to retrain your muscles. Biofeedback uses special sensors to measure bodily functions. A video monitor shows the measurements as line graphs, and sounds from the equipment tell you when you’re using the correct muscles. By watching the monitor and listening to the sounds, you learn how to change the muscle function. Practicing at home can improve muscle function. You may have to practice for 3 months before you get all the benefit from the training.

Surgery

You may need surgery to treat an anorectal blockage caused by rectal prolapse if other treatments don’t work. You may need surgery to remove your colon if your colon muscles don’t work correctly. Your doctor can tell you about the benefits and risks of surgery.

Source: NIDDK (NIH)1

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Back to: « Constipation

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How do doctors treat complications of constipation?

Doctors can treat or tell you how to treat complications of constipation. Hemorrhoids, anal fissures, rectal prolapse, and fecal impaction all have different treatments.

Hemorrhoids

You can treat hemorrhoids at home by

  • making dietary changes to prevent constipation
  • taking warm tub baths
  • applying over-the-counter hemorrhoid cream to the area or using suppositories—a medicine you insert into your rectum—before bedtime

Talk with your doctor about hemorrhoids that do not respond to at-home treatments.

Anal fissures

You can treat anal fissures at home by

  • making changes in your diet to prevent constipation
  • applying over-the-counter hemorrhoid cream to numb the area or relax your muscles
  • using stool softeners
  • taking warm tub baths

Your doctor may recommend surgery to treat anal fissures that don’t heal with at-home treatments.

Rectal prolapse

Your doctor may be able to treat your rectal prolapse in his or her office by manually pushing the rectum back through your anus. If you have a severe or chronic—long-lasting—rectal prolapse, you may need surgery. The surgery will strengthen and tighten your anal sphincter muscle and repair the prolapsed lining. You can help prevent rectal prolapse caused by constipation by not straining during a bowel movement.

Fecal impaction

You can soften a fecal impaction with mineral oil that you take by mouth or through an enema. After softening the impaction, a health care professional may break up and remove part of the hardened stool by inserting one or two gloved, lubricated fingers into your anus.

Source: NIDDK (NIH)2

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Eating, Diet, & Nutrition

How can your diet help prevent and relieve constipation?

You can drink water and other fluids, such as fruit and vegetable juices and clear soups, to help the fiber in your diet work better. This change should make your stools more normal and regular. Ask your doctor about how much you should drink each day based on your health and activity level and where you live.

Depending on their age and sex, adults should get 22 to 34 grams of fiber a day.3 Older adults sometimes don’t get enough fiber in their diets, because they may lose interest in food. If you are older and have lost interest in food, talk with your doctor if

  • food doesn’t taste the same as it once did
  • you don’t feel hungry as often
  • you don’t want to cook
  • you have problems chewing or swallowing

Talk with your doctor to plan a diet with the right amount of fiber for you. Be sure to add fiber to your diet a little at a time so that your body gets used to the change.

Use this table as a tool to help replace less healthy foods with foods that have fiber.

Portions of food for constipation

Examples of Foods That Have Fiber [3]

Beans, cereals, and breads

Fiber

½ cup of beans (navy, pinto, kidney, etc.), cooked

6.2-9.6 grams

½ cup of shredded wheat, ready-to-eat cereal

2.7-3.8 grams

  • cup of 100% bran, ready-to-eat cereal

9.1 grams

1 small oat bran muffin

3.0 grams

1 whole-wheat English muffin

4.4 grams

Fruits

1 small apple, with skin

3.6 grams

1 medium pear, with skin

5.5 grams

½ cup of raspberries

4.0 grams

½ cup of stewed prunes

3.8 grams

Vegetables

½ cup of winter squash, cooked

2.9 grams

1 medium sweet potato, baked in skin

3.8 grams

½ cup of green peas, cooked

3.5-4.4 grams

1 small potato, baked, with skin

3.0 grams

½ cup of mixed vegetables, cooked

4.0 grams

½ cup of broccoli, cooked

2.6-2.8 grams

½ cup of greens (spinach, collards, turnip greens), cooked

2.5-3.5 grams

Source: NIDDK (NIH)3

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What should you avoid eating if you’re constipated?

If you’re constipated, try not to eat too many foods with little or no fiber, such as

  • cheese
  • chips
  • fast food
  • ice cream
  • meat
  • prepared foods, such as some frozen meals and snack foods
  • processed foods, such as hot dogs or some microwavable dinners

Source: NIDDK (NIH)4

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Treatment

There are a number of different reasons for experiencing constipation and so treatment will depend on the individual cause. In general, lifestyle changes will be recommended, including eating a varied diet with plenty of fibre (vegetables, fruit) and increasing fluid intake (1.5L a day). A gradual increase in dietary fibre up to 20 - 30 grams of fibre is recommended, which may include dietary sources as well as fibre supplements. Your pharmacist and doctor may be able to recommend some supplements which are appropriate for you. Increased fibre intake may initially be accompanied by excess bloating and gaseousness, however, this usually subsides over several days as the body adjusts.

Undertaking regular exercise, a minimum of three times per week for 30 minutes has also been shown to improve the symptoms of constipation by assisting with movement of the bowel.

Developing a routine for passing bowel motions has also been shown to be useful strategy for treating constipation. Attempting to defacate at the same each day, for example 30 minutes after breakfast, will encourage regular passage of bowel motions.

In addition to this, your doctor may wish to alter your medications or take some blood in order to make sure there is no medical problem responsible for the reduced bowel motions. Depending on your symptoms, your doctor may suggest further investigations with some medical investigations such as a colonoscopy or barium enema to get a better view of the gastrointestinal tract and rule out any serious causes.

A trial of stool softeners or laxatives may also be of benefit. There are a number of different types of these, including osmotic laxatives, which increase the amount of fluid retained within the stool and thereby soften the faeces, and stimulants such as senna, which may be used in the short term to treat an acute bout of constipation.

Source: Queensland Health5

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Help and Assistance

Your doctor or pharmacist will provide you with further information regarding possible management options. In an emergency situation your doctor may be able to assist with immediate emptying of bowels should this be required.

If you have any symptoms of or concerns about constipation:

  • please contact one of our registered nurses at 13 HEALTH by phoning 13 43 25 84 or
  • speak to your doctor.

Source: Queensland Health6

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Treatment

If you think you are constipated, talk to your doctor to rule out a more serious problem. If tests show no disease or blockage, and if your doctor approves, try these changes:

  • Add fiber to your diet by eating more fresh fruits and vegetables, either cooked or raw, and more whole-grain cereals and breads. Dried fruits, such as apricots, prunes, and figs, are high in fiber.
  • If your diet does not include natural fiber, you may need to add a small amount of bran to baked goods, cereal, and fruit. This may cause some bloating and gas in the beginning. Make diet changes slowly to allow your system to adapt. Look for fiber products such as psyllium seed in the grocery store.
  • Be sure to get enough fluids. Without fluids, constipation can get worse. Drinking enough water and juice can help you have regular bowel movements. Talk with your doctor about how much water you should drink.
  • Stay active. This is important for overall health, too. Do things that keep you moving and active. For example, go for walks. Find physical things that you enjoy doing, and make them a part of your everyday life.

If these changes don’t work, talk to your doctor about laxatives. There are different kinds of laxatives, and each has its pros and cons. Your doctor can help you decide which laxatives may be best for you.

Source: NIA (NIH)7

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How your bowel works

Your bowel is the organ for removing solid waste left over from what you eat. Fibre in the food you eat bulks out this waste and helps it move along your bowel more easily.

Source: New Zealand Health8

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Self-care

  • Drink more fluids, especially water.
  • Eat more wholegrain cereals, vegetables and fruit - including the skins, if they’re edible.
  • Prunes, broccoli, rhubarb, kiwifruit, corn, dried fruits and liquorice can all help move your bowels.
  • Be physically active.
  • Don’t delay bowel motions - go when you feel the urge.
  • Avoid straining or forcing a motion, as this can cause haemorrhoids (piles).

Source: New Zealand Health9

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Home treatment

If your child is well apart from constipation, you can treat them with the simple measures below.

All babies

You can try:

  • warm relaxing baths
  • gentle baby massage (eg, rubbing baby’s tummy gently in a clockwise direction).

Breastfed babies

  • Continue breastfeeding your baby.

Formula-fed babies

  • Check the formula is being made up correctly.
  • Check the volume markings on your baby’s bottles are accurate - if they aren’t, the formula may be over-concentrated. Over-concentrated formula can cause constipation.
  • If the bottle has the standard mark EN14350 on it (or on its packaging) it will be accurate.
  • If the bottle doesn’t have the standard mark, take it to your local pharmacy and ask them to check the volume marks for accuracy.
  • Try a different formula brand. Some formulas are easier to digest than others. Brands that are higher in casein may make your baby’s poos harder. A brand that is whey-based may make your baby less constipated.

Babies over 6 months old

If your baby is over 6 months old, try giving them more:

  • plain water
  • fruit and high fibre vegetables - kiwifruit, pear, plum, peach and apricots are particularly effective. Ensure that they are suitable for the stage of development (eg, soft, grated or cooked, depending on the age of the baby) to reduce choking risk.

Note that when you give your baby more fruit and vegetables, you need to give them more water as well. Otherwise the constipation could get worse.

Source: New Zealand Health10

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How you can treat constipation yourself

Simple changes to your diet and lifestyle can help treat constipation. It's safe to try these simple measures when you're pregnant.

You may notice a difference within a few days. Sometimes it takes a few weeks before your symptoms improve.

Source: NHS Choices UK11

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Make changes to your diet

To make your poo softer and easier to pass:

  • drink plenty of fluids and avoid alcohol
  • increase the fibre in your diet
  • add some wheat bran, oats or linseed to your diet

Source: NHS Choices UK12

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Increase your activity

A daily walk or run can help you to poo more regularly.

Source: NHS Choices UK13

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Improve your toilet routine

Keep to a regular time and place and give yourself plenty of time to use the toilet. Don't delay if you feel the urge to poo.

To make it easier to poo, try resting your feet on a low stool while going to the toilet. If possible, raise your knees above your hips.

Source: NHS Choices UK14

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Babies and toddlers: treating constipation

Simple changes to your child's diet and potty training can help treat constipation.

You may notice a difference within a few days. Sometimes it takes a few weeks before their symptoms improve.

Source: NHS Choices UK15

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Make changes to your child's diet

Give your baby extra water between their normal feeds if they haven't started to eat solid food yet. If you're using formula milk, don't add more water to the mixture.

Try gently moving your baby's legs in a bicycling motion or carefully massaging their tummy to help stimulate their bowels.

Give older children plenty of fluids and encourage them to eat fruit. Chop or purée it if it's easier for them to eat. The best fruits for constipation include apples, grapes, pears and strawberries.

Don't force your child to eat as this can make mealtimes stressful.

What to feed young children

Source: NHS Choices UK16

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Helping your child with potty training

Some children feel anxious or stressed about using the toilet. This can cause them to hold in their poo and lead to constipation.

This usually happens during potty training or if their usual toilet routine has changed. For example, after moving house or starting nursery.

Give your child plenty of time to use the toilet while they are still learning. Encourage them when they do use the toilet. Some parents find a reward chart works.

Source: NHS Choices UK17

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A pharmacist can help with constipation

Speak to a pharmacist if diet and lifestyle changes aren't helping. They can suggest a suitable laxative. These are medicines that help you poo more regularly.

Most laxatives work within 3 days. They should only be used for a short time.

Laxatives are not recommended for children unless they are prescribed by a GP.

Different types of laxatives and how they work.

Source: NHS Choices UK18

Treatments for Constipation

Laxatives: Taking laxatives

Taking laxatives is generally not recommended without medical supervision, but if you do try them, try to avoid using them on a regular basis.

Once your constipation has cleared, stop taking the laxatives and try other remedies, like diet and physical activity, to prevent the constipation from returning.

Source: New Zealand Health19

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References

  1. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ digestive-diseases/ constipation/ all-content
  2. ibid.
  3. ibid.
  4. ibid.
  5. Source: Queensland Health: conditions.health.qld.gov.au/ HealthCondition/ condition/ 9/ 46/ 31/ constipation
  6. ibid.
  7. Source: NIA (NIH): nia.nih.gov/ health/ concerned-about-constipation
  8. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ constipation
  9. ibid.
  10. ibid.
  11. Source: NHS Choices UK: nhs.uk/ conditions/ Constipation/ 
  12. ibid.
  13. ibid.
  14. ibid.
  15. ibid.
  16. ibid.
  17. ibid.
  18. ibid.
  19. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ constipation

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.