Constipation

Constipation Treatment

There are five major types of treatment^[17] for constipation. What type of treatment you will use will depend upon the severity, duration, and underlying cause of your constipation. Most mild-to-moderate cases of constipation can be managed with lifestyle changes or over-the-counter treatments like laxatives, enemas, and suppositories. Few patients require prescription medication, and fewer still end up needing surgery. Lifestyle changes are usually the first line of treatment for mild-to-moderate constipation. These may include^[18]:

• Consuming more fiber: Eating whole-grain cereals, fruits, vegetables, and foods with roughage can help increase your daily fiber intake and promote regular bowel movements. Fiber supplements are also an option, but most people are able to get enough fiber in their diets if they make a conscious effort to do so.

It’s generally recommended to consume between 25 and 30 grams^[19] of fiber per day. Some of the highest-fiber foods include cooked split peas (16.3g), black beans (15.0g), artichokes (10.3g), raspberries (8.0g), bran cereal (5.3g), oatmeal (4.0g), apples (4.4g), brussels sprouts (4.1g), and dried figs (1.6g). Keep in mind, however, that eating too much fiber can actually cause or worsen constipation.

• Other dietary changes: It’s often recommended to limit high-fat foods, like cheese and meat, to prevent constipation. Many people also experience constipation after eating a high volume of dairy products. Keeping a food diary can help you gain insight into the foods that trigger your constipation. Ultimately, everyone’s digestive systems are different. Certain foods that may be fine for others may make you constipated.
• Hydrate: Staying hydrated is one of the best ways to prevent and help relieve constipation. Drinking eight 8-ounce glasses of water a day is the general recommendation. It’s also a good idea to avoid drinks that can dehydrate you in large quantities, such as coffee and alcohol.
• Squat on the toilet: It can be easier to have bowel movements if you lean back or squat while using the toilet. There are many devices available that can elevate your feet and help keep you in a squatting position.
• Exercise: Getting regular exercise, especially cardio, can help keep food moving smoothly through the digestive tract and prevent constipation.
• Reduce stress: Stress has been linked to constipation in two ways^[20]. For one, stress can have a direct impact on bowel function. Additionally, people with high levels of stress are often less likely to exercise and eat well, both of which can help prevent constipation.

Typically, all of the above are approved for pregnant women dealing with constipation. However, it’s always best to speak with your healthcare provider before making changes to your diet, exercise routine, or lifestyle.

Over-the-counter constipation relief

If standard lifestyle changes don’t help relieve constipation, people often turn to non-prescription treatments like laxatives, enemas, and suppositories. These treatments are generally not recommended for pregnant women. It’s also important to note that these over-the-counter solutions should not become part of your daily routine. At most, they should be taken for no more than two weeks (although it’s always best to consult your healthcare provider beforehand). This is due to the fact that relying on these treatments can lead to physical dependence^[21]. Habitual use of these treatments—especially stimulant laxatives—can cause you to be reliant on laxatives in order to have bowel movements (in other words, being constipated all the time). That said, over-the-counter solutions can help relieve constipation in the short term. Here are some commonly used options:

• Laxatives: Laxatives refer to any medications that facilitate bowel movements. If you decide to use laxatives, it’s often recommended you use osmotic laxatives, which add water to your intestines. These can help soften hard stool and make it easier to have bowel movements.

Stimulant laxatives, on the other hand, work by forcing the bowels to move. These more commonly lead to physical dependence than osmotic laxatives.

• Enemas: An enema is a liquid-filled bag that is inserted into the anus. The liquid, often a sterile saline solution, travels into the rectum. This can help loosen stool and make it easier to have bowel movements.
• Suppositories: Similar to both laxatives and enemas, suppositories are laxatives that are inserted rectally.

Constipation medication

If your constipation is chronic or severe, your healthcare provider may recommend that you take a prescription medication^[22]. This is often recommended for those whose constipation is caused by irritable bowel syndrome (IBS). Some common prescription medications for constipation include:

Surgery for constipation

In some rare cases, surgery is required to treat constipation. This usually is only an option if a patient’s constipation is caused by a serious problem with the colon (a blockage, rectocele, or stricture) and other treatments have failed. Some constipation-causing conditions that may necessitate surgery include:

• Intestinal stricture: The narrowing of a portion of the intestines.
• Outlet dysfunction constipation: A condition that causes constipation that doesn’t respond well (or at all) to typical treatments, such as fiber, laxatives, and medication.
• Anal fissure: Tiny tears that form in the skin of the anus.
• Rectocele: A herniation (bulge) of the front wall of the rectum through the back wall of the vagina.
• Rectal prolapse: Occurs when a portion of the rectum protrudes outside of the body from the anus.
• Intestinal obstruction: A blockage in the intestinal tract.
• Certain cancers: Colon cancer, rectal cancer, and other abdominal cancers may all require surgery.

One surgical option for patients whose constipation is caused by the abnormally slow movement of stool through the colon is the removal of part of the colon (partial colectomy). Surgery to remove the entire colon (colectomy) is rarely necessary.