What Is The Best Treatment For Constipation?

Summary:

Lifestyle changes and dietary intervention can usually relieve occasional and mild constipation.
If they don’t work, over-the-counter laxatives stimulate the bowels and soften stool, making it easier to pass.
Prescription medications can help recurring constipation long term, or constipation caused by opioids.
Enemas can help relieve constipation quickly, but are considered a “last resort” due to possible complications.

Lifestyle changes

Changes to your lifestyle and diet are typically the first step when it comes to relieving constipation. Making some simple changes here and there can be enough to relieve occasional constipation, or help improve chronic constipation.

Regular exercise

It’s true that your diet can have a big impact on your digestive health, but there’s evidence that the amount of physical activity you do can also have an effect. A small study that compared how long it took food to move through the gut when running, cycling, and resting found that bowel transit time was increased by exercise. This means that regular physical activity could help improve the movement of food through your digestive system, and help prevent constipation.

But while mild-to-moderate intensity exercise can help protect against and relieve constipation, more strenuous exercise could cause or worsen gastrointestinal symptoms. This could be due to a lack of blood flow to your gut, or becoming dehydrated (more on that in a moment). So it’s usually best to stick to moderate-intensity exercise if you’re struggling with irregular bowel movements.

Hydration

Your digestion isn’t just affected by the foods you eat, but the liquids you drink, too. Increasing fluid intake is a common recommendation for constipation – and for good reason. Evidence suggests there’s an association between low fluid intake and intestinal constipation.

This is because water is essential for dissolving soluble fiber in your gut, which softens your stool and makes it easier to pass. Your intestine draws water out of your stool as it passes through – so if you’re dehydrated, you can end up with hard, dried out stools that are difficult to pass. While drinking more water won’t necessarily “cure” constipation, it can help make your bowel movements softer and easier to pass.

Stress management

But sometimes, the cause of digestive discomfort isn’t something we can control so easily. Gut-related responses to stress are really common, and can include nausea, vomiting, abdominal pain, and changes to your bowel movements.

These changes can be caused by corticotropin-releasing factor (CRF), a hormone that’s involved in regulating your response to stress. This hormone acts both directly on your bowel, and through your central nervous system, to cause constipation and gastrointestinal symptoms. Studies also suggest that CRF can alter your gut microbiota – the ecosystem of microorganisms that live in your gastrointestinal tract. Changes to this microbiota can result in a range of gastrointestinal disorders, including constipation.

Dietary adjustments

Fiber-rich foods

Upping the amount of fiber you eat is often the number one way you can help relieve constipation. A review of over 1300 scientific articles on dietary fiber intake and constipation proves that fiber plays a really big role in stool frequency. Across the studies, dietary fibre had a significant advantage over placebo in the amount of stools passed per week, but didn’t obviously improve stool consistency, laxative use, or painful defecation. This suggests that while increased fiber intake might help relieve cases of acute (short-term) constipation – it may not be as effective at relieving chronic constipation.

It’s also important not to go overboard on fiber, especially if you’re not currently getting a lot in your diet. Increasing your fiber intake by a lot when your body isn’t used to it can cause bloating, gas, stomach pain, and cramping. It can also increase your risk of intestinal blockages, making constipation even worse. It’s best to gradually increase the amount of fiber you eat over a few weeks, to give your body a chance to adjust to the change.

Probiotics

While the research is still relatively new, recent clinical studies report that some probiotic compounds could help treat constipation. Evidence suggests these compounds (including those produced by Limosilactobacillus reuteri, Lactiplantibacillus plantarum, and Lacticaseibacillus rhamnosus) can increase the rate at which food is carried through the gastrointestinal tract by improving the function and motility of your gut. They can also help shorten the time it takes for stool to pass through the colon and regulate fecal microbiota, lessening the symptoms of constipation

The research also found that probiotic compounds could still be detected in the gut even after the treatment intervention was over. This suggests probiotics can colonize the intestinal tract and relieve constipation even after you stop taking them.

Limiting processed foods

Scientific data shows that there’s a link between the amount of ultra-processed foods (UPF) a person eats and their risk of constipation. A cross-sectional study that calculated intakes of UPF and minimally processed foods (MPF) across 12,716 adults in the U.S. found that higher UPF consumption was linked with a greater risk of constipation.

So while reducing the amount of UPF in your diet won’t necessarily cure constipation, it can help reduce your risk of becoming constipated in the future. Swapping just 10% of your UPF intake with a similar portion of MPF could be enough to help lower your risk of constipation.

Medical treatment

But if making adjustments to your lifestyle haven’t worked, or you’re struggling with chronic constipation, there’s treatment available that can help.

Over-the-counter (OTC) laxatives

There are four main kinds of over-the-counter laxatives you can use to help relieve constipation.

Bulk-forming laxatives help add weight and size to your stool, which stimulates your bowel to pass it more quickly. They usually take two or three days to help relieve constipation. Psyllium husk, sold under brand names like Metamucil, and methylcellulose are two common types of bulk-forming laxatives.
Osmotic laxatives help draw water into your bowel from surrounding areas to soften your bowel movements and make them easier to pass. They also typically take two or three days to work. Types of osmotic laxatives include polyethylene glycol (sold under brand names like MiraLAX) and lactulose (available by prescription).
Stimulant laxatives do exactly what they say they do – stimulate the muscles that line your digestive tract to help keep your stool moving. These can work a little faster than other types of laxatives, taking around six to twelve hours to help relieve constipation. Common examples include bisacodyl (Dulcolax) and senna (Senokot).
Stool softeners help retain water inside your stool to soften it and make passing it easier. They’re not as effective as other options, but are gentle on your gut, so could be a good option for people with sensitive digestive systems with temporary constipation or mild chronic constipation. An example is docusate sodium (Colace).

The best laxative for constipation will vary from person to person. Bulk-forming laxatives are usually the first treatment recommended to relieve constipation. If this doesn’t relieve your constipation, an osmotic laxative can help to soften your stool so it’s easier to pass. If your stool has softened but you’re still having difficulty passing it, taking a stimulant laxative alongside a bulk-forming laxative can help.

Prescription medication

If over-the-counter treatments haven’t helped relieve your constipation, a doctor may be able to recommend a prescription medication.

Prescription treatments are usually the best medication for constipation if it’s chronic, or if you also have irritable bowel syndrome, because they’re designed for long term use. While they can help encourage bowel movements in the first 24 hours of treatment, it usually takes a couple of weeks before they take full effect. When they do, you should notice more frequent bowel movements, and the number of weekly bowel movements you have should go up.

Prescription constipation medications include:

Linaclotide (also known as the brand name Linzess) is a prescription treatment for chronic constipation and irritable bowel syndrome. They help increase and regulate the amount of fluid in your intestines, and speed up the time it takes for stool to pass through.
Lubiprostone (sold under the brand Amitiza) ups the amount of fluid secreted by your intestines, softening your stool and helping it pass through your intestines more easily.
Methylnaltrexone (Relistor), Naloxegol (Movantik), and Naldemedine (Symproic). These medicines work by stopping certain pain relievers from binding to receptors in your gut and intestines, preventing their constipation-causing side effects while still allowing for pain relief.

Enemas and suppositories

While a combination of lifestyle changes and laxatives or prescription medicine should help relieve occasional or chronic constipation – sometimes the problem can persist. Suppositories and enemas can be used as a last resort option for stubborn cases of constipation.

Suppositories are a type of medicine you insert into your rectum. Two types of suppositories for constipation are glycerin (glycerol) suppositories and lecicarbon A suppositories. Glycerol suppositories help lubricate and soften your stool, and also stimulate your digestive tract to pass the bowel movement along. Lecicarbon A suppositories produce carbon dioxide after being inserted, which gently stimulates the bowel.

An enema is where fluid is used to “flush out” your digestive tract through your rectum, which can help soften and break up stool so you’re able to pass it. Tap water enemas are usually recommended, as they’re the least messy and come with fewer side effects.

But you shouldn’t use enemas regularly, as they come with some risks and aren’t meant to be used frequently. You might experience pain, damage the tissue in your intestines or bowels, or put yourself at risk of infection if the enema isn’t carried out properly. It’s usually best to try other methods of constipation relief first, and only try an enema after speaking with your doctor or healthcare provider about your options first.

When to seek medical advice for constipation

While constipation isn’t usually a serious health issue, if you get constipated regularly it could be a sign of another underlying issue. This is known as secondary constipation, where your disrupted bowel movements are a side effect of another condition.

Severe constipation symptoms

Serious conditions that can cause secondary constipation include diverticular disease or bowel cancer – but this is rare. If you experience any of the following symptoms as well as regular constipation, speak to your doctor:

Blood in your stool (red or black)
Bleeding from your rectum
Feeling like you need to have a bowel movement, even after just using the toilet
Stomach pain (particularly in the lower left side of your stomach)
Stomach pain that gets worse after you eat, and gets better after you pass stool or gas
A lump in your stomach
Bloating
Unexplained weight loss
Unexplained fatigue
Fever
Passing mucus from your rectum

Risk factors

But regular constipation isn’t necessarily a sign of a more sinister condition – and some people may be at a higher risk for it naturally. Risk factors that may increase your risk of becoming constipated include:

Low calorie intake
Low fiber diet
Difficulty accessing a toilet
Changes in your daily routine
Lack of physical activity
Family history of constipation
Anxiety or depression
Eating disorders
Old age
Dehydration
Reduced or a lack of mobility
Fever
Pregnancy
Medications like antidepressants, antihistamines, etc.
Health conditions like irritable bowel syndrome, diabetes, hyperthyroidism, etc.

How to avoid getting constipated

There’s no guaranteed way to avoid constipation, but there are plenty of things you can do to minimise your risk, and to help if you do have disrupted bowel movements. Gradually increasing your fibre intake, making sure you get regular physical exercise, and drinking plenty of fluids are the most effective lifestyle changes you can make to reduce your risk of constipation (or to get things moving again).

But if lifestyle interventions aren’t helping relieve your constipation, over the counter laxatives can soften your stool and stimulate your digestive muscles to help you pass it on. And if your constipation is a recurring problem (or caused by another medication or condition), prescription medication can help provide more long-term relief. Enemas are another option if other methods of constipation relief haven’t worked for you, but they’re typically used as “last-resort” due to possible side effects.

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What are the best treatments for constipation?

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Summary:

Lifestyle changes

Regular exercise

Hydration

Stress management

Dietary adjustments

Fiber-rich foods

Probiotics

Limiting processed foods

Medical treatment

Over-the-counter (OTC) laxatives

Prescription medication

Enemas and suppositories

When to seek medical advice for constipation

Severe constipation symptoms

Risk factors

How to avoid getting constipated

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What are the best treatments for constipation?

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Summary:

Lifestyle changes

Regular exercise

Hydration

Stress management

Dietary adjustments

Fiber-rich foods

Probiotics

Limiting processed foods

Medical treatment

Over-the-counter (OTC) laxatives

Prescription medication

Enemas and suppositories

When to seek medical advice for constipation

Severe constipation symptoms

Risk factors

How to avoid getting constipated

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