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Treatments and drugs
By Mayo Clinic staffIn most cases, simple changes in your diet and lifestyle will help relieve symptoms and manage constipation. Consider one or more of the following:
A high-fiber diet. A diet with at least 20 to 35 grams of fiber each day helps your body form soft, bulky stool. High-fiber foods include beans, whole grains and fresh fruits and vegetables. Limit foods that have little to no fiber, such as cheese, meat and processed foods.
Regular exercise. Physical activity will help stimulate intestinal activity.
Adequate fluid intake. Drinking plenty of water and other fluids will help soften your stool.
Take the time for bowel movements. Set aside sufficient time to allow for undisturbed visits to the toilet. And don't ignore the urge to have a bowel movement.
Laxatives. These over-the-counter medications should be considered as a last resort because they can become habit-forming. There are several different types of laxatives:
- Stimulants cause rhythmic contractions in the intestines. Examples include Correctol, Dulcolax and Senokot.
- Lubricants enable stool to move through your colon more easily. Examples include mineral oil and Fleet.
- Stool softeners moisten the stool and help prevent dehydration. Examples include Colace and Surfak.
- Fiber supplements, or bulk laxatives, are generally considered the safest of laxatives. Examples include FiberCon, Metamucil, Konsyl, Serutan and Citrucel. These agents must be taken with plenty of water.
- Osmotics help fluids to move through the colon. Examples include Cephulac, Sorbitol and Miralax.
- Saline laxatives act like a sponge to draw water into the colon for easier passage of stool. Examples include milk of magnesia and Haley's M-O.
Chloride channel activators. The agent lubiprostone (Amitiza) is available by prescription and increases fluid content of stool.
5-HT-4 agonists. These agents stimulate release of compounds in your body that increase fluid secretion in the intestines and decrease colonic transit time. Prucalopride is one such 5-HT-4 agonist.
If an underlying disorder is causing your constipation, treatment will be aimed at the specific cause. If pelvic floor dysfunction is the cause of your constipation, your doctor may suggest biofeedback as a treatment. This retraining technique may help you learn to better coordinate the muscles you use to have a bowel movement.
If you're pregnant and have constipation, try eating lots of high-fiber foods, such as fruits, vegetables and whole grains. Drink plenty of fluids and get as much exercise as you can. Swimming and walking may be good choices.
If your constipation doesn't respond to changes in lifestyle or medical treatment, surgical removal of part of your colon may be recommended. In this procedure, the problem segment or segments of the anal sphincter or rectum are removed.
Above all, recognize that a successful treatment program can take time and effort.
- Constipation. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/. Accessed Nov. 10, 2008.
- Wald A, et al. Treatment of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Wald A, et al. Etiology and evaluation of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Pohl D, et al. Pharmacologic treatment of constipation: What is new? Current Opinion in Pharmacology. 2008;8:724.
- Constipation. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/constipation. Accessed Nov. 10, 2008.
- Constipation. American Gastroenterological Association. http://www.gastro.org/wmspage.cfm?parm1=687. Accessed Nov. 10, 2008.
- Bharucha A. Constipation. Best Practice and Research Clinical Gastroenterology. 2007;21:709.
- Patel S, et al. Constipation. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://ww.mdconsult.com/das/book/body/113047217-6/780888909/1389/98.html?printing=true. Accessed Nov. 10, 2008.
- Culbert T, et al. Integrative approaches to childhood constipation and encopresis. Pediatric Clinics of North America. 2007;54:927.
