How Constipation Is Treated – Verywell Health

Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.
Verywell / Zorica Lakonic
Constipation is a common problem for children and adults. In many cases, the treatment for uncomplicated constipation includes changes to diet, lifestyle, and bowel habits. Trying one or two of these strategies may help bring some relief. Occasional use of over-the-counter (OTC) treatments such as enemas or laxatives is the next step, although long-term use of these can be habit-forming.
Talk to your healthcare provider if your constipation doesn't respond to anything, or if you have severe pain and bloating. Some prescription medications and other therapies are available.
The first line of treatment for constipation is to make changes in your diet and some other elements of your lifestyle. Often, this is enough to get things moving again.
Ignoring the urge "to go" can lead to constipation. Instead, make time each day to have a bowel movement. Some people find it easier in the morning, while others may discover that later in the day, such as after dinner, may work better.
Taking the time to relax and allow the bowel movement to happen naturally is optimal.
Exercising can help keep your body working properly, both inside and out. Physical activity encourages the muscles in your intestines to keep the contents moving along (known as peristalsis). People who are bedridden or unable to move about because of disability or disease often experience constipation.
People who have chronic constipation report a better quality of life if they get regular exercise. Aside from encouraging bowel movements, regular exercise also helps relieve stress (which can be a cause of constipation). If you are able, getting regular exercise—even a daily walk—can help.
In Western countries (such as the U.S.), the lack of fiber in the diet is a frequent contributor to the problem of constipation.
Many people are unsure as to how to add more dietary fiber, or which kind of fiber would be most effective. Getting fiber through the foods you eat is best. Some foods, including prunes, figs, licorice, and rhubarb, have natural laxative properties and can be helpful in relieving constipation.
It's best to gradually add more fiber to your diet, as a sudden, large increase in fiber can cause abdominal bloating and gas.
OTC therapies are the next step in relieving constipation. While you can buy these without a prescription, it's best to talk to your healthcare provider before starting to use any of these options, especially if you are pregnant or nursing, or if the treatment is being considered for a child.
Though getting more fiber from foods is best, fiber supplements can be helpful as well. There are several different options that can help with constipation. These are collectively known as bulk-forming laxatives because they work to make stool soft and, therefore, easier to pass. These supplements can also help treat diarrhea by absorbing water and making the stool more solid.
Bulk-forming laxatives are not habit-forming, and most can be used every day and on a long-term basis. Your healthcare provider can help you choose the right type of fiber supplement for you.
There are a number of laxatives available in drugstores that can help in cases where constipation is not relieved by diet and lifestyle changes. It's especially important that you consult with a healthcare provider before starting one of these medications, especially if it's being used for a child under the age of 6.
Laxatives can help in relieving constipation on a short-term basis, but they are not a long-term solution because they can be habit-forming and actually worsen constipation when used improperly. The need to use a laxative for a long duration also hints at an underlying issue that may need unique management.
Some OTC laxatives can interfere with other medications, so be sure to discuss anything you are taking with your healthcare provider.
Enemas are used to help clean out the bowel before a diagnostic test, such as a colonoscopy, but can also help relieve constipation.
An enema is a short-term solution, and not appropriate for the treatment of chronic constipation. This is because using enemas regularly can impair the colon from working properly and eventually lead to a dependency on them to have a bowel movement.
If diet, lifestyle, and OTC treatments are not effective for your constipation, your healthcare provider may turn to some prescription medications. These include:
Your current prescription medications, OTC medications, or supplements could be the source of your constipation. Discuss these with your healthcare provider to see if there are substitutes that are less likely to make you constipated.
In some cases, bowel retraining may be helpful in learning how to have a bowel movement that is soft and easily passed. Retraining the bowel takes time and a conscious effort. The goal is to create a daily schedule and routine that helps make having a bowel movement an easier and more comfortable process.
This method takes patience and effort and should be undertaken with the help of a healthcare provider.​
If stool is impacted and not relieved with an enema, your healthcare provider may perform manual removal of the impacted stool with a gloved finger.
Surgery is rarely needed for constipation, but it can be used in certain circumstances. If your constipation is due to rectal prolapse, surgery may be performed. If constipation is due to problems with your colon muscles, your healthcare provider may remove your colon.
Antegrade colonic enema is another surgical intervention used in rare cases. A small opening is made in the side of the abdomen and the appendix or other section of the bowel are made into a conduit to the large intestine. A stoma is created on the surface and a catheter is used to flush the bowels daily.
Supplements and behavioral techniques have been used traditionally and in the modern era for constipation.
Biofeedback is a type of treatment that can help treat several conditions, including constipation. During biofeedback, your temperature, heart rate, and muscle activity are monitored with electrodes. The information provided through this monitoring can help you learn, through a specific targeted effort, to relax the muscles needed to have a bowel movement.
The benefits of this treatment are that it is non-invasive and can work long-term. The downsides are that it has not been studied extensively, it takes significant time and effort, and it may be difficult to find a practitioner to administer treatment, depending on where you live.
A variety of herbal remedies and supplements are used for their laxative or stool-bulking effects. The National Center for Complementary and Integrative Medicine notes research that might support some specific remedies. However, it is essential to discuss the use of any supplements with your healthcare provider to check for interactions and precautions with any medications you take and health conditions you have.
Flaxseed contains fiber that is beneficial as a bulk-forming laxative. It has had little research related to constipation, but it falls within the general guideline of bulk-forming OTC laxatives or adding more fiber to your diet.
Avoid raw or unripe flaxseed, as it contains some toxic compounds. Always take flaxseed with lots of water to prevent from making your constipation worse.
Some people use probiotics for constipation. More research is needed as to how well this approach works.
You may have also heard of using aloe latex for constipation. It has a strong laxative effect and has been used traditionally for this purpose. However, it can cause abdominal cramps and diarrhea, with additional risks for higher doses or long-term use.
Aloe latex was used in OTC laxative products until 2002 when the U.S. Food and Drug Administration (FDA) required they be reformulated or removed from the market. As well, the use of nondecolorized whole-leaf aloe extract and aloe latex is associated with a higher risk of cancer in animal studies. Given this, it is best to avoid such products.
In cases of uncomplicated constipation, some changes in diet and lifestyle are all that will be needed to meet the goal of a soft, well-formed, easily passed stool. When disease or medication is the cause of constipation, other treatments might be needed. Always consult with a healthcare provider regarding constipation that becomes chronic or if enemas or stimulant laxatives are needed to have a bowel movement.
Eating more fiber, drinking plenty of fluids, and staying active can help with pregnancy constipation. Taking a stool softener may also be helpful, but check with your healthcare provider first.
See your healthcare provider if constipation lasts more than three weeks. Constipation does not usually become dangerous, but you should also see a healthcare provider if you have any of the following: a history of colon cancer, bleeding from the rectum, bloody stool, constant abdominal pain, inability to pass gas, vomiting, fever, lower back pain, and unexpected weight loss.
High-fiber foods will help prevent constipation. These include whole grains, such as wheat bread and oatmeal; beans; fruits, such as apples, prunes, berries, and pears; vegetables, such as carrots, broccoli, and green peas; and nuts. Also, consuming plenty of water and other clear fluids, including broth-based soups, can help.

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