Lately you've been feeling a little -- to put it delicately -- backed up. You're not "going" as often as you should, and you feel bloated and uncomfortable.
A lot of Americans -- more than 4 million by some estimates -- deal with constipation on a regular basis. Women have constipation more often than men. This may have to do with the slower movement of food through a woman's intestines, as well as with the effects of female hormones on the GI tract.
There are a few effective constipation treatments.
What is Constipation?
If you can’t go, it's often because there isn't enough water in your stool, a problem that occurs when you don't drink enough fluids.
According to the National Digestive Diseases Information Clearinghouse, part of the National Institutes of Health, constipation is a condition in which you have fewer than three bowel movements in a week, and your stools are hard, dry, and small, making them painful and difficult to pass. Some people naturally have a bowel movement a few times a day, while others go just a few times a week. You don't need constipation treatments unless you're going to the bathroom a lot less often than usual.
You have a lot of options for treating constipation. What you choose will depend on why you’re blocked, and whether it’s a new or a long-term problem for you.
Constipation Home Remedies
You may be able to solve your constipation problem yourself, without your doctor’s help. It may seem obvious, but your diet has a big impact on how you poop.
Eat more fiber. Fiber makes stool bulkier and softer so it's easier to pass. Gradually increase the amount of fiber in your diet until you're getting at least 20 to 35 grams of fiber daily. Good sources include whole grains found in cereals, breads, and brown rice, beans, vegetables and fresh or dried fruits. Prunes and bran cereal are tried and true constipation remedies.
Stay hydrated. Water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day.
Try coffee. While caffeinated drinks and alcohol can make you dehydrated, there’s evidence a cup of coffee of tea in the morning may help you poop.
Limit high fat/low fiber food.Cheese and other dairy products, processed foods, and meat can make constipation worse.
Watch your FODMAPs.Certain carbohydrates cause digestive problems, including constipation, in some people. The names of the carbohydrates are abbreviated “FODMAPs.” Foods that contain them include dairy, apples, broccoli, wheat, and lentils. You might try cutting individual foods from your diet, but do it carefully. A lot of them are good sources of fiber and other nutrients you need.
Other things you can do to relieve constipation include:
Exercise regularly. Moving your body will keep your bowels moving, too.
Adjust your toilet posture. It may be easier to poop if you squat, raise your legs, or lean back.
Check your meds. Many prescription drugs can cause constipation. Ask your doctor if this might be the problem and if there’s an alternative.
Biofeedback. Some people get constipated because they unconsciously clench their muscles when they try to poop. A therapist can help you train your pelvic floor muscles to relax.
Massage. Massaging your own abdomen in a certain pattern can help encourage bowel movements.
Enemas. You can irrigate your colon with either tap water or an over-the-counter preparation to soften and flush out the contents.
Suppositories. Some over-the-counter constipation medications are meant to be inserted directly into the rectum. They typically work faster than laxatives you take by mouth.
Prebiotics and probiotics. You may have digestive issues, including constipation, because of an imbalance in the bacteria that live naturally in your intestines. Supplements or foods containing prebiotics, like bananas and oatmeal, and probiotics, like yogurt and fermented foods, may help.
Laxatives for constipation treatment
A box of laxatives shouldn't be the first place you turn to relieve constipation. Reserve laxatives for constipation that doesn't improve after you've added fiber and water to your diet.
If your doctor recommends laxatives, ask what type is best for you, and for how long you should take them. Laxatives are best taken short-term only, because you don't want to start relying on them to go to the bathroom. Also ask how to ease off laxatives when you no longer need them. Stopping them too abruptly can affect your colon's ability to contract.
Laxatives come in several forms:
Bulk-forming fiber supplements include calcium polycarbophil (Equilactin, Fibercon), methylcellulose fiber (Citrucel), and psyllium (Fiber-Lax, Konsyl, Metamucil), and wheat dextrin (Benefiber). Unlike other laxatives, you can take these every day. They make the stool bigger and softer. Although they are safe to use regularly, fiber supplements can interfere with your body's ability to absorb certain medicines, and they may cause bloating, cramps, and gas. Drink a lot of water with them.
Lubricant laxatives, including Zymenol, help the stool pass more easily through the colon. In general, doctors do not recommend using mineral oil or castor oil. Mineral oil can cause problems such as vitamin deficiencies, and castor oil can lead to long-term constipation.
Osmotic laxativessuch as lactitol (Pizensy), lactulose (Kristalose), magnesium hydroxide (Milk of Magnesia), polyethylene glycol (Miralax), and Sorbitol help fluids move through your intestines. If you have diabetes, ask your doctor before taking osmotics because they can cause electrolyte imbalances.
Stimulant laxativessuch as bisacodyl (Correctol, Dulcolax, Feen-a-Mint) and sennosides (Ex-Lax, Senokot) make the muscles in your intestines contract to help push stool out. These laxatives work quickly, but they can cause side effects, including cramping and diarrhea, so use them for as short a period of time as possible.
Stool softeners such as docusate calcium (Surfak) and docusate sodium (Colace) make stools easier to pass by adding fluid to them. Having softer stool can prevent you from having to strain during bowel movements. Your doctor may recommend one of these products if your constipation is due to childbirth or surgery.
Medical Treatment for Constipation
If over-the-counter treatments don’t do the job, your doctor may prescribe a different kind of medication.
Prescription laxatives such as linaclotide, (Linzess) lubiprostone, (Amitiza) and plecanatide (Trulance) work by increasing the amount of water in your intestines and speeding up the movement of stool. Note that Amitiza is approved for use only in women.
Serotonin 5-hydroxytryptamine 4 receptors. Prucalopride (Motegrity) is a powerful stimulant that’s used for chronic constipation without a known cause.
PAMORAs. This is a shorter way of saying “peripherally acting mu-opioid receptor antagonists.” These work on constipation that’s caused by opioid pain medicines. These drugs include methylnaltrexone (Relistor) and naloxegol (Movantik.)
Surgery for constipation treatment
Sometimes constipation is caused by a structural problem in your colon or rectum. Your colon may be blocked or unusually narrow, or you may have a partial collapse or a bulge in the wall of your rectum. In that case, surgery can correct the problem.
Surgery may also be a last resort if your colon just works too slowly and treatments haven’t helped. You may need to have a section of your colon removed.
When Constipation Is a Regular Problem
Regardless of what constipation treatment you use, give yourself enough time to sit on the toilet when you need to go. Holding in the urge can make your constipation worse. Set aside a regular time of the day when you know you'll be left undisturbed for several minutes.
Also, don't ignore the problem. Untreated constipation can lead to real problems, such as hemorrhoids and tears in the skin around the anus (called fissures) that make you bleed. If you strain too hard, you might even cause part of your intestines to push out through the anus -- a condition called rectal prolapse that can sometimes require surgery.
Call your doctor right away if you have any of these symptoms with constipation:
Blood in your stools
Unexplained weight loss
Inability to have a bowel movement
Also, call if you've been having trouble going for more than three weeks and constipation treatments aren't working. You may have a condition called Chronic Idiopathic Constipation (CIC) which means your constipation may be caused by something other than physical or physiological.