Options for Treating Constipation

The first therapies your doctor will recommend if you have constipation are diet and lifestyle modifications. One of these is an increase in fiber consumption. The average American consumes 5 to 20 g of fiber a day; however, the Institute of Medicine recommends that men over age 50 get at least 30 g of fiber daily and that women over age 50 consume at least 21 g. (Younger men and women should aim for 38 g and 25 g of fiber daily, respectively.)

Although a 2006 review concluded that a lack of dietary fiber probably does not contribute to chronic constipation, fiber may help treat constipation by adding bulk (increased volume) and softening the texture of your stools. Fresh fruits and vegetables, whole grains, and beans are examples of fiber-rich foods that you should add to your diet.

Avoiding foods with a high-fat and low-fiber content, including meat and full-fat dairy products, also may be helpful. In addition, don't ignore the urge to have a bowel movement or delay a trip to the bathroom when the urge develops.

Fiber supplements that act as laxatives (such as Citrucel, Fiberall, Konsyl, or Metamucil) are useful for some people with constipation. These laxatives add bulk to the stool and are generally safe to use for a week at a time. If you need to use them for longer than that, you should consult your doctor.

You should also slowly increase the amount of fiber you take to avoid problems with gas, and be sure to drink plenty of water or other fluids every day.

If bulk-forming laxatives fail to help, your doctor may recommend an enema or a nonbulk-forming laxative, including stimulants, stool softeners, lubricants, and osmotic laxatives. Stimulants such as bisacodyl (Correctol, Dulcolax) cause rhythmic muscle contractions in the intestines. Stool softeners such as docusate sodium (Colace, Dialose, Surfak) add water to the stool which makes it easier to pass. Lubricants such as mineral oil (Fleet) allow stool to move more easily through the colon. Osmotic laxatives such as magnesium hydroxide (Milk of Magnesia) and polyethylene glycol (Miralax) draw water into the colon which provides a flushing action.

Even though these laxatives are available without a prescription, they should be used for only a week at a time. If you need them for longer than that, ask your doctor for guidance.

If constipation results in fecal impaction, your doctor may recommend a stool softener or enema. Then he or she will manually remove the hardened stool.

If a drug you are taking for another health problem is the suspected cause of your constipation, your doctor may be able to lower the dosage of the medication or switch you to another drug that does not have constipation as a side effect. (Never stop taking a medication or change the dosage without first consulting your doctor.)

In January 2014, the U.S. Food and Drug Administration (FDA) issued a warning against exceeding the recommended dosage of over-the-counter (OTC) oral solutions and enemas containing sodium phosphate. In rare cases, taking a larger-than-recommended single dose of these medications, or taking more than one dose in a day can lead to severe kidney or heart damage. According to the FDA, OTC constipation remedies should only be used as directed. Children, adults over the age of 55, people who are dehydrated, and those who have kidney or bowel disease or are taking certain other medications (e.g., NSAIDs, diuretics, ACE inhibitors, ARBs) are at higher risk for these serious complications.

When a medical condition is the source of the problem, treating that condition may relieve the symptoms.

Biofeedback—in which you learn to strain more effectively, coordinate your breathing, and properly relax and contract the muscles involved in a bowel movement—may help a small number of people with constipation, particularly the type caused by an inability to relax the pelvic floor muscles.

Updated by Remedy Health Media

Publication Review By: H. Franklin Herlong, M.D.

Published: 24 Mar 2011

Last Modified: 23 Jul 2015