Treatment for Constipation
Most of the time, constipation is not serious and resolves with conservative treatment. Eating a high fiber diet (e.g., whole grain foods, fresh fruits and vegetables), increasing fluid intake, and exercising daily can help reduce constipation. Foods that can contribute to constipation, such as cheese, processed foods, and red meat should be avoided. Making time for bowel movements regularly also may be helpful.
When changes in diet and lifestyle modifications do not improve symptoms, over-the-counter or prescription medications (e.g., stool softeners, laxatives) and enemas may be used. An enema involves introducing a special solution into the rectum and colon to stimulate bowel activity and empty stool from the lower intestines. Medications and enemas should not be used longer than directed except under the supervision of a physician.
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.
Biofeedback sometimes can help improve the function of muscles that are used to control bowel movements. In some cases, complications from chronic constipation (e.g., rectal prolapse, anal fissure) may require surgery.