How Is Constipation Treated?
Although treatment depends on the
cause, severity, and duration, in most cases dietary and
lifestyle changes will help relieve symptoms and help prevent
A diet with enough fiber (20 to 35 grams each day) helps form
soft, bulky stool. A doctor or dietitian can help plan an
appropriate diet. High-fiber foods include beans; whole grains
and bran cereals; fresh fruits; and vegetables such as
asparagus, brussels sprouts, cabbage, and carrots. For people
prone to constipation, limiting foods that have little or no
fiber such as ice cream, cheese, meat, and processed foods is
Other changes that can help treat and prevent constipation
include drinking enough water and other liquids such as fruit
and vegetable juices and clear soup, engaging in daily exercise,
and reserving enough time to have a bowel movement. In
addition, the urge to have a bowel movement should not be
Most people who are mildly constipated do not need laxatives.
However, for those who have made lifestyle changes and are still
constipated, doctors may recommend laxatives or enemas for a
limited time. These treatments can help retrain a chronically
sluggish bowel. For children, short-term treatment with
laxatives, along with retraining to establish regular bowel
habits, also helps prevent constipation.
A doctor should determine when a patient needs a laxative and
which form is best. Laxatives taken by mouth are available in
liquid, tablet, gum, powder, and granule forms. They work in
People who are dependent on laxatives need to slowly stop using
the medications. A doctor can assist in this process. In most
people, this restores the colon's natural ability to contract.
Treatment may be directed at a specific cause. For example, the
doctor may recommend discontinuing medication or performing
surgery to correct an anorectal problem such as rectal
People with chronic constipation caused by anorectal dysfunction
can use biofeedback to retrain the muscles that control release
of bowel movements. Biofeedback involves using a sensor to
monitor muscle activity that at the same time can be displayed
on a computer screen allowing for an accurate assessment of body
functions. A health care professional uses this information to
help the patient learn how to use these muscles.
Surgical removal of the colon may be an option for people with
severe symptoms caused by colonic inertia. However, the
benefits of this surgery must be weighed against possible
complications, which include abdominal pain and diarrhea.
Can Constipation Be Serious?Sometimes constipation can lead to
complications. These complications include hemorrhoids caused
by straining to have a bowel movement or anal fissures (tears in
the skin around the anus) caused when hard stool stretches the
sphincter muscle. As a result, rectal bleeding may occur that
appears as bright red streaks on the surface of the stool.
Treatment for hemorrhoids may include warm tub baths, ice packs,
and application of a cream to the affected area. Treatment for
anal fissure may include stretching the sphincter muscle or
surgical removal of tissue or skin in the affected area.
Sometimes straining causes a small amount of intestinal lining
to push out from the anal opening. This condition is known as
rectal prolapse and may lead to secretion of mucus from the
anus. Usually, eliminating the cause of the prolapse such as
straining or coughing is the only treatment necessary. Severe
or chronic prolapse requires surgery to strengthen and tighten
the anal sphincter muscle or to repair the prolapsed lining.
Constipation may also cause hard stool to pack the intestine and
rectum so tightly that the normal pushing action of the colon is
not enough to expel the stool. This condition, called fecal
impaction, occurs most often in children and older adults. An
impaction can be softened with mineral oil taken by mouth and an
enema. After softening the impaction, the doctor may break up
and remove part of the hardened stool by inserting one or two
fingers in the anus.
Points to Remember
- Bulk-forming laxatives generally are considered the safest
but can interfere with absorption of some medicines. These
laxatives, also known as fiber supplements, are taken with
water. They absorb water in the intestine and make the stool
softer. Brand names include Metamucil®, Citrucel®, Konsyl®, and Serutan®.
- Stimulants cause rhythmic muscle contractions in the
intestines. Brand names include Correctol®, Dulcolax®, Purge®, Feen-A-Mint®, and Senokot®. Studies suggest that
phenolphthalein, an ingredient in some stimulant laxatives,
might increase a person's risk for cancer. The Food and Drug
Administration has proposed a ban on all over-the-counter
products containing phenolphthalein. Most laxative makers have
replaced or plan to replace phenolphthalein with a safer
- Stool softeners provide moisture to the stool and prevent
dehydration. These laxatives are often recommended after
childbirth or surgery. Products include Colace®, Dialose®, and Surfak®.
- Lubricants grease the stool enabling it to move through the
intestine more easily. Mineral oil is the most common
- Saline laxatives act like a sponge to draw water into the
colon for easier passage of stool. Laxatives in this group
include Milk of Magnesia®, Citrate of Magnesia®, and Haley's M-O®.
- Constipation affects almost everyone at one time or
- Many people think they are constipated when, in fact,
their bowel movements are regular.
- The most common causes of constipation are poor diet and
lack of exercise.
- Additional causes of constipation include medications,
irritable bowel syndrome, abuse of laxatives, and specific
- A medical history and physical examination may be the
only diagnostic tests needed before the doctor suggests
- In most cases, following these simple tips will help
relieve symptoms and prevent recurrence of constipation:
- Eat a well-balanced, high-fiber diet that includes beans,
bran, whole grains, fresh fruits, and vegetables.
- Drink plenty of liquids.
- Exercise regularly.
- Set aside time after breakfast or dinner for undisturbed
visits to the toilet.
- Do not ignore the urge to have a bowel movement.
- Understand that normal bowel habits vary.
- Whenever a significant or prolonged change in bowel habits
occurs, check with a doctor.
- Most people with mild constipation do not need laxatives.
However, doctors may recommend laxatives for a limited time for
people with chronic constipation.