There are a lot of medicines to choose from if you're looking for relief from chronic constipation. Some are over-the-counter treatments, and others need a doctor's prescription.
Your doctor can help you choose the right product for you. One thing to keep in mind: Some of these over-the-counter medicines might be covered by your insurance plan. Check with your doctor and your health insurance company to see if you need a prescription to get the best deal.
Some products that you can take in pill form are:
Fiber supplements. They add bulk to your stool to get your bowels going. Make sure to drink lots of water with fiber so it doesn't block you up instead. For some people, it may cause bloating and pain in your belly. Common choices include:
- Calcium polycarbophil (FiberCon)
- Methylcellulose fiber (Citrucel)
- Psyllium (Metamucil, Konsyl)
- Wheat dextrin (Benefiber)
Osmotics. These help your stool hold on to more fluid, so it's softer. They can throw off levels of electrolytes in your body. If you're an older adult or have heart or kidney failure, check with your doctor first. At the drug store, look for:
- Magnesium citrate
- Magnesium hydroxide (Milk of Magnesia)
- Polyethylene glycol (Miralax)
Stimulants. You'd only try these if your constipation is severe and other drugs haven't worked. They cause your intestines to squeeze so things get moving. Two of the more common ones are bisacodyl (Correctol, Ducodyl, Dulcolax) and senna (Senexon, Senokot). Some people overuse stimulant laxatives. If you take them regularly or in large amounts, you can get side effects, including low potassium levels.
Stool softeners. You might get these if you need to avoid straining when you have a bowel movement, like after surgery. They're best for short-term use. They work by pulling in water from your intestines to soften your stool. Docusate sodium (Colace) is one you can find easily.
Besides constipation treatments that come in pill form, your doctor may also suggest suppositories or enemas:
Suppositories. These go directly into your rectum. They typically work by making your intestines squeeze so you have a bowel movement. Some also soften your stool. Glycerin and bisacodyl (Dulcolax) are typical choices.
Enemas. With these, you push fluid directly into your rectum. Sometimes you use plain tap water, but it's often mixed with sodium phosphate (Fleet Phospho-Soda) or soap suds. The added fluid softens your stool and makes for an easier bowel movement.
There are a variety of Rx medicines that work in different ways. Work with your doctor to figure out which type is the best one to try for your situation.
Linaclotide ( Linzess) . This a capsule you take once a day on an empty stomach, at least 30 minutes before your first meal of the day. It's used to treat chronic constipation and irritable bowel syndrome with constipation (IBS-C). Linaclotide may ease your constipation by helping bowel movements happen more often. The most common side effect is diarrhea. Doctors may suggest it if your other treatments don't work.
Lactulose ( Kristalose, Cephulac). This drug is an osmotic that draws water into the bowel to soften and loosen the stool. Side effects include gas, diarrhea, upset stomach, and stomach cramps.
Lubiprostone (Amitiza). Your doctor may suggest this drug if you have chronic constipation, IBS-C, or constipation brought on by opioids. The drug softens the stool by putting more fluidinto it, so the stool can pass easily. You take this medicine twice a day with food. Some possible side effects are headache, nausea, diarrhea, abdominal pain, and vomiting.
Plecanatide (Trulance). It's a tablet you take once a day. It helps your body make fluids in your intestines and speeds up intestinal transit, which helps your stool move through the bowel. Your doctor may suggest it if your other treatments aren't working. The drug is made specifically for people who have chronic idiopathic constipation, (CIC) or IBS-C. Diarrhea is one of the possible side effects.
Prucalopride (Motegrity). It is a once a day tablet prescribed specifically for CIC who have not been able to get relief from other medications. It works by increasing the muscle contractions in your colon which are needed for your stools to pass.