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.
Don't be embarrassed. A lot of Americans -- more than 4 million by some estimates -- deal with constipation on a regular basis. Women are the most frequent constipation sufferers. 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.
So what do you do when you just can't go? Here are a few effective constipation treatments.
If you're constipated, 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 women 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.
Constipation Treatments -- Starting With Good Habits
One way to keep things moving is by getting enough fiber in your diet, which 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 fiber sources include:
- Bran and other whole grains found in cereals, breads, and brown rice
- Vegetables such as Brussels sprouts, carrots, and asparagus
- Fresh fruits, or dried fruits such as raisins, apricots, and prunes
While you're having an issue with constipation, limit foods that are high in fat and low in fiber, like cheese and other dairy products, processed foods, and meat. They can make constipation worse.
And on the subject of diet, water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day.
Also, exercise regularly. Moving your body will keep your bowels moving, too.
What About Laxatives?
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.
See your doctor for long-term constipation, because a medicine you're taking or a medical condition could be the cause. In that case, stopping the medicine or treating the problem should relieve your constipation.
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 laxatives such 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 laxatives such 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.
- Prescription medications such as linaclotide (Linzess) and lubiprostone (Amitiza) work by drawing water into your intestines and speeding up the movement of stool. Plecanitide (Trulance) changes stool consistency by increasing the amount of water into the GI lumen and increases gastrointestinal movement. Note that Amitiza is approved for use only in women.
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:
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.