What can I do for severe constipation? How can I get relief from persistent bowel issues? Discover effective solutions to overcome stubborn constipation and restore regular bowel movements.

Understanding Constipation: Causes and Symptoms

Constipation is a common gastrointestinal issue that affects millions of people worldwide. It occurs when your bowel movements become infrequent, hard, and difficult to pass. The normal frequency of bowel movements can vary greatly from person to person, but going longer than 3 days without a bowel movement is usually considered a sign of constipation.

The primary symptoms of constipation include:

• Infrequent bowel movements (less than 3 per week)
• Difficulty having a bowel movement (straining, hard or small stools)
• A sense that the bowels haven’t completely emptied
• Abdominal bloating and discomfort
• The need to manually assist in the evacuation of stool

Constipation can be caused by a variety of factors, such as a lack of dietary fiber, dehydration, lack of physical activity, certain medications, and underlying medical conditions. Understanding the root cause is crucial for finding the most effective treatment.

Home Remedies for Constipation Relief

Before seeking medical intervention, there are several home remedies you can try to alleviate constipation:

Increase Fiber Intake

Fiber is essential for maintaining regular bowel movements. Gradually increase your intake of fiber-rich foods, such as whole grains, fruits, vegetables, and legumes, to reach the recommended 20-35 grams of fiber per day.

Stay Hydrated

Drinking plenty of water and other fluids can help soften stool and facilitate easier bowel movements. Aim for 1.5 to 2 quarts of fluid intake per day, unless your doctor has advised you to limit your fluid intake.

Exercise Regularly

Physical activity can stimulate the muscles in your intestines, promoting better digestion and regularity. Engage in at least 30 minutes of moderate exercise most days of the week.

Try Laxatives

Over-the-counter laxatives can provide temporary relief by softening stool or stimulating bowel movements. Consult your healthcare provider to determine the best type of laxative and the appropriate duration of use.

When to Seek Medical Attention

If home remedies fail to provide relief or if you experience any of the following symptoms, it’s important to consult your healthcare provider:

• Sudden-onset constipation accompanied by abdominal pain or cramping
• Inability to pass gas or have a bowel movement
• Blood in your stool
• Unexplained weight loss
• Severe pain during bowel movements
• Constipation lasting more than 2 weeks

Your healthcare provider may recommend additional tests, such as blood tests, anorectal function tests, or a colonoscopy, to determine the underlying cause of your constipation and develop a personalized treatment plan.

Preventing Constipation

While constipation can be a recurring issue, there are several steps you can take to prevent it from happening in the first place:

Maintain a Balanced Diet

Ensure that your diet includes a variety of fiber-rich foods, such as fruits, vegetables, whole grains, and legumes. This will keep your digestive system functioning optimally.

Stay Hydrated

Drink plenty of water and other fluids throughout the day to maintain proper hydration and support regular bowel movements.

Exercise Regularly

Engaging in regular physical activity, such as walking, swimming, or yoga, can help stimulate the muscles in your digestive system and promote better overall bowel health.

Establish a Routine

Try to establish a consistent time for bowel movements and respond to the urge to have a bowel movement promptly, rather than ignoring it.

Seeking Professional Help

If you’ve tried home remedies and lifestyle changes, but your constipation persists or worsens, it’s important to seek medical advice. Your healthcare provider can help identify the underlying cause of your constipation and develop a comprehensive treatment plan to restore your digestive health.

Remember, constipation is a common issue, but with the right approach, you can find relief and regain regular bowel function. Don’t hesitate to consult your healthcare provider if you have any concerns or experience severe or prolonged constipation.

What To Do For Severe Constipation

Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it at some point.

Although it’s not usually serious, you’ll feel much better when your body is back on track.

The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them just a few times a week.

Going longer than 3 or more days without one, though, is usually too long. After 3 days, your poop gets harder and more difficult to pass.

What Are the Symptoms?

You may have:

• Few bowel movements
• Trouble having a bowel movement (straining to go)
• Hard or small stools
• A sense that everything didn’t come out
• Belly bloating

You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.

Why Does It Happen?

Some causes of constipation include:

What Should I Do If I Am Constipated?

Take these steps:

• Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
• Try warm liquids, especially in the morning.
• Add fruits and vegetables to your diet.
• Eat prunes and bran cereal.
• Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
• Don’t ignore the urge to poop.

Continued

You can try taking a laxative, too. There are several types of laxatives, and you can buy many of them over the counter. Each of them works in a different way to ease constipation. Ask your doctor or pharmacist which kind might work for you and how long you should take it.

When Should I Call My Doctor?

Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.

Also, make the call if:

• Constipation is a new problem for you, and lifestyle changes haven’t helped.
• You have blood in your stool.
• You’re losing weight even though you’re not trying to.
• You have severe pain with bowel movements.
• Your constipation has lasted more than 2 weeks.
• The size, shape, and consistency of your stool has changed dramatically.

Your doctor may recommend some tests to find the cause of your constipation:

• Blood tests to check on hormone levels
• Tests that check the muscles in your anus
• Tests that show how waste moves through and out of your colon
• Colonoscopy to look for blockages in your colon

Can I Prevent Constipation?

In many cases, you can. These things can help:

Eat a well-balanced diet with plenty of fiber. Good sources are fruits, vegetables, legumes, and whole-grain bread and cereal (especially bran).

Drink 1 1/2 to 2 quarts of water and other fluids a day (unless your doctor has you on a fluid-restricted diet). Fiber and water work together to keep you regular.

Avoid caffeine. It can be dehydrating.

Cut back on milk. Dairy products can constipate some people.

Exercise regularly. Do something active for at least 30 minutes a day, most days of the week.

Go to the bathroom when you feel the urge.

How To Get Rid of Constipation

Lately you’ve been feeling a little — to put it delicately — backed up. You’re not “going” as often as you should, and you feel bloated and uncomfortable.

A lot of Americans — more than 4 million by some estimates — deal with constipation on a regular basis. Women have constipation more often than men. This may have to do with the slower movement of food through a woman’s intestines, as well as with the effects of female hormones on the GI tract.

There are a few effective constipation treatments.

What is Constipation?

If you can’t go, it’s often because there isn’t enough water in your stool, a problem that occurs when you don’t drink enough fluids.

According to the National Digestive Diseases Information Clearinghouse, part of the National Institutes of Health, constipation is a condition in which you have fewer than three bowel movements in a week, and your stools are hard, dry, and small, making them painful and difficult to pass. Some people naturally have a bowel movement a few times a day, while others go just a few times a week. You don’t need constipation treatments unless you’re going to the bathroom a lot less often than usual.

Constipation Treatments

You have a lot of options for treating constipation. What you choose will depend on why you’re blocked, and whether it’s a new or a long-term problem for you.

Constipation Home Remedies

You may be able to solve your constipation problem yourself, without your doctor’s help. It may seem obvious, but your diet has a big impact on how you poop.

• Eat more fiber. Fiber makes stool bulkier and softer so it’s easier to pass. Gradually increase the amount of fiber in your diet until you’re getting at least 20 to 35 grams of fiber daily. Good sources include whole grains found in cereals, breads, and brown rice, beans, vegetables and fresh or dried fruits. Prunes and bran cereal are tried and true constipation remedies.

• Stay hydrated. Water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day.

• Try coffee. While caffeinated drinks and alcohol can make you dehydrated, there’s evidence a cup of coffee of tea in the morning may help you poop.

• Limit high fat/low fiber food.Cheese and other dairy products, processed foods, and meat can make constipation worse.

• Watch your FODMAPs.Certain carbohydrates cause digestive problems, including constipation, in some people. The names of the carbohydrates are abbreviated “FODMAPs.” Foods that contain them include dairy, apples, broccoli, wheat, and lentils. You might try cutting individual foods from your diet, but do it carefully. A lot of them are good sources of fiber and other nutrients you need.

Continued

Other things you can do to relieve constipation include:

• Exercise regularly. Moving your body will keep your bowels moving, too.

• Adjust your toilet posture. It may be easier to poop if you squat, raise your legs, or lean back.

• Check your meds. Many prescription drugs can cause constipation. Ask your doctor if this might be the problem and if there’s an alternative.   

• Biofeedback. Some people get constipated because they unconsciously clench their muscles when they try to poop. A therapist can help you train your pelvic floor muscles to relax.

• Massage. Massaging your own abdomen in a certain pattern can help encourage bowel movements.

• Enemas. You can irrigate your colon with either tap water or an over-the-counter preparation to soften and flush out the contents.

• Suppositories. Some over-the-counter constipation medications are meant to be inserted directly into the rectum. They typically work faster than laxatives you take by mouth.

• Prebiotics and probiotics. You may have digestive issues, including constipation, because of an imbalance in the bacteria that live naturally in your intestines. Supplements or foods containing prebiotics, like bananas and oatmeal, and probiotics, like yogurt and fermented foods, may help.            

Continued

Laxatives for constipation treatment 

A box of laxatives shouldn’t be the first place you turn to relieve constipation. Reserve laxatives for constipation that doesn’t improve after you’ve added fiber and water to your diet.

If your doctor recommends laxatives, ask what type is best for you, and for how long you should take them. Laxatives are best taken short-term only, because you don’t want to start relying on them to go to the bathroom. Also ask how to ease off laxatives when you no longer need them. Stopping them too abruptly can affect your colon’s ability to contract.

Laxatives come in several forms:

• Bulk-forming fiber supplements include calcium polycarbophil (Equilactin, Fibercon), methylcellulose fiber (Citrucel), and psyllium (Fiber-Lax, Konsyl, Metamucil), and wheat dextrin (Benefiber). Unlike other laxatives, you can take these every day. They make the stool bigger and softer. Although they are safe to use regularly, fiber supplements can interfere with your body’s ability to absorb certain medicines, and they may cause bloating, cramps, and gas. Drink a lot of water with them.

• Lubricant laxatives, including Zymenol, help the stool pass more easily through the colon. In general, doctors do not recommend using mineral oil or castor oil. Mineral oil can cause problems such as vitamin deficiencies, and castor oil can lead to long-term constipation.

• Osmotic laxativessuch as lactitol (Pizensy), lactulose (Kristalose), magnesium hydroxide (Milk of Magnesia), polyethylene glycol (Miralax), and Sorbitol help fluids move through your intestines. If you have diabetes, ask your doctor before taking osmotics because they can cause electrolyte imbalances.

• Stimulant laxativessuch as bisacodyl (Correctol, Dulcolax, Feen-a-Mint) and sennosides (Ex-Lax, Senokot) make the muscles in your intestines contract to help push stool out. These laxatives work quickly, but they can cause side effects, including cramping and diarrhea, so use them for as short a period of time as possible.

• Stool softeners such as docusate calcium (Surfak) and docusate sodium (Colace) make stools easier to pass by adding fluid to them. Having softer stool can prevent you from having to strain during bowel movements. Your doctor may recommend one of these products if your constipation is due to childbirth or surgery.

Medical Treatment for Constipation

Medicine

If over-the-counter treatments don’t do the job, your doctor may prescribe a different kind of medication.

• Prescription laxatives such as linaclotide, (Linzess) lubiprostone, (Amitiza) and plecanatide (Trulance) work by increasing the amount of water in your intestines and speeding up the movement of stool. Note that Amitiza is approved for use only in women.

• Serotonin 5-hydroxytryptamine 4 receptors. Prucalopride (Motegrity) is a powerful stimulant that’s used for chronic constipation without a known cause.

• PAMORAs. This is a shorter way of saying “peripherally acting mu-opioid receptor antagonists. ” These work on constipation that’s caused by opioid pain medicines. These drugs  include methylnaltrexone (Relistor) and naloxegol (Movantik.) 

Surgery for constipation treatment

Sometimes constipation is caused by a structural problem in your colon or rectum. Your colon may be blocked or unusually narrow, or you may have a partial collapse or a bulge in the wall of your rectum. In that case, surgery can correct the problem.

Surgery may also be a last resort if your colon just works too slowly and treatments haven’t helped. You may need to have a section of your colon removed.

When Constipation Is a Regular Problem

Regardless of what constipation treatment you use, give yourself enough time to sit on the toilet when you need to go. Holding in the urge can make your constipation worse. Set aside a regular time of the day when you know you’ll be left undisturbed for several minutes.

Also, don’t ignore the problem. Untreated constipation can lead to real problems, such as hemorrhoids and tears in the skin around the anus (called fissures) that make you bleed. If you strain too hard, you might even cause part of your intestines to push out through the anus — a condition called rectal prolapse that can sometimes require surgery.

Call your doctor right away if you have any of these symptoms with constipation:

Also, call if you’ve been having trouble going for more than three weeks and constipation treatments aren’t working. You may have a condition called Chronic Idiopathic Constipation (CIC) which means your constipation may be caused by something other than physical or physiological.

How To Get Rid of Constipation

Lately you’ve been feeling a little — to put it delicately — backed up. You’re not “going” as often as you should, and you feel bloated and uncomfortable.

A lot of Americans — more than 4 million by some estimates — deal with constipation on a regular basis. Women have constipation more often than men. This may have to do with the slower movement of food through a woman’s intestines, as well as with the effects of female hormones on the GI tract.

There are a few effective constipation treatments.

What is Constipation?

If you can’t go, it’s often because there isn’t enough water in your stool, a problem that occurs when you don’t drink enough fluids.

According to the National Digestive Diseases Information Clearinghouse, part of the National Institutes of Health, constipation is a condition in which you have fewer than three bowel movements in a week, and your stools are hard, dry, and small, making them painful and difficult to pass. Some people naturally have a bowel movement a few times a day, while others go just a few times a week. You don’t need constipation treatments unless you’re going to the bathroom a lot less often than usual.

Constipation Treatments

You have a lot of options for treating constipation. What you choose will depend on why you’re blocked, and whether it’s a new or a long-term problem for you.

Constipation Home Remedies

You may be able to solve your constipation problem yourself, without your doctor’s help. It may seem obvious, but your diet has a big impact on how you poop.

• Eat more fiber. Fiber makes stool bulkier and softer so it’s easier to pass. Gradually increase the amount of fiber in your diet until you’re getting at least 20 to 35 grams of fiber daily. Good sources include whole grains found in cereals, breads, and brown rice, beans, vegetables and fresh or dried fruits. Prunes and bran cereal are tried and true constipation remedies.

• Stay hydrated. Water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day.

• Try coffee. While caffeinated drinks and alcohol can make you dehydrated, there’s evidence a cup of coffee of tea in the morning may help you poop.

• Limit high fat/low fiber food.Cheese and other dairy products, processed foods, and meat can make constipation worse.

• Watch your FODMAPs.Certain carbohydrates cause digestive problems, including constipation, in some people. The names of the carbohydrates are abbreviated “FODMAPs.” Foods that contain them include dairy, apples, broccoli, wheat, and lentils. You might try cutting individual foods from your diet, but do it carefully. A lot of them are good sources of fiber and other nutrients you need.

Continued

Other things you can do to relieve constipation include:

• Exercise regularly. Moving your body will keep your bowels moving, too.

• Adjust your toilet posture. It may be easier to poop if you squat, raise your legs, or lean back.

• Check your meds. Many prescription drugs can cause constipation. Ask your doctor if this might be the problem and if there’s an alternative.   

• Biofeedback. Some people get constipated because they unconsciously clench their muscles when they try to poop. A therapist can help you train your pelvic floor muscles to relax.

• Massage. Massaging your own abdomen in a certain pattern can help encourage bowel movements.

• Enemas. You can irrigate your colon with either tap water or an over-the-counter preparation to soften and flush out the contents.

• Suppositories. Some over-the-counter constipation medications are meant to be inserted directly into the rectum. They typically work faster than laxatives you take by mouth.

• Prebiotics and probiotics. You may have digestive issues, including constipation, because of an imbalance in the bacteria that live naturally in your intestines. Supplements or foods containing prebiotics, like bananas and oatmeal, and probiotics, like yogurt and fermented foods, may help.            

Continued

Laxatives for constipation treatment 

A box of laxatives shouldn’t be the first place you turn to relieve constipation. Reserve laxatives for constipation that doesn’t improve after you’ve added fiber and water to your diet.

If your doctor recommends laxatives, ask what type is best for you, and for how long you should take them. Laxatives are best taken short-term only, because you don’t want to start relying on them to go to the bathroom. Also ask how to ease off laxatives when you no longer need them. Stopping them too abruptly can affect your colon’s ability to contract.

Laxatives come in several forms:

• Bulk-forming fiber supplements include calcium polycarbophil (Equilactin, Fibercon), methylcellulose fiber (Citrucel), and psyllium (Fiber-Lax, Konsyl, Metamucil), and wheat dextrin (Benefiber). Unlike other laxatives, you can take these every day. They make the stool bigger and softer. Although they are safe to use regularly, fiber supplements can interfere with your body’s ability to absorb certain medicines, and they may cause bloating, cramps, and gas. Drink a lot of water with them.

• Lubricant laxatives, including Zymenol, help the stool pass more easily through the colon. In general, doctors do not recommend using mineral oil or castor oil. Mineral oil can cause problems such as vitamin deficiencies, and castor oil can lead to long-term constipation.

• Osmotic laxativessuch as lactitol (Pizensy), lactulose (Kristalose), magnesium hydroxide (Milk of Magnesia), polyethylene glycol (Miralax), and Sorbitol help fluids move through your intestines. If you have diabetes, ask your doctor before taking osmotics because they can cause electrolyte imbalances.

• Stimulant laxativessuch as bisacodyl (Correctol, Dulcolax, Feen-a-Mint) and sennosides (Ex-Lax, Senokot) make the muscles in your intestines contract to help push stool out. These laxatives work quickly, but they can cause side effects, including cramping and diarrhea, so use them for as short a period of time as possible.

• Stool softeners such as docusate calcium (Surfak) and docusate sodium (Colace) make stools easier to pass by adding fluid to them. Having softer stool can prevent you from having to strain during bowel movements. Your doctor may recommend one of these products if your constipation is due to childbirth or surgery.

Medical Treatment for Constipation

Medicine

If over-the-counter treatments don’t do the job, your doctor may prescribe a different kind of medication.

• Prescription laxatives such as linaclotide, (Linzess) lubiprostone, (Amitiza) and plecanatide (Trulance) work by increasing the amount of water in your intestines and speeding up the movement of stool. Note that Amitiza is approved for use only in women.

• Serotonin 5-hydroxytryptamine 4 receptors. Prucalopride (Motegrity) is a powerful stimulant that’s used for chronic constipation without a known cause.

• PAMORAs. This is a shorter way of saying “peripherally acting mu-opioid receptor antagonists.” These work on constipation that’s caused by opioid pain medicines. These drugs  include methylnaltrexone (Relistor) and naloxegol (Movantik.) 

Surgery for constipation treatment

Sometimes constipation is caused by a structural problem in your colon or rectum. Your colon may be blocked or unusually narrow, or you may have a partial collapse or a bulge in the wall of your rectum. In that case, surgery can correct the problem.

Surgery may also be a last resort if your colon just works too slowly and treatments haven’t helped. You may need to have a section of your colon removed.

When Constipation Is a Regular Problem

Regardless of what constipation treatment you use, give yourself enough time to sit on the toilet when you need to go. Holding in the urge can make your constipation worse. Set aside a regular time of the day when you know you’ll be left undisturbed for several minutes.

Also, don’t ignore the problem. Untreated constipation can lead to real problems, such as hemorrhoids and tears in the skin around the anus (called fissures) that make you bleed. If you strain too hard, you might even cause part of your intestines to push out through the anus — a condition called rectal prolapse that can sometimes require surgery.

Call your doctor right away if you have any of these symptoms with constipation:

Also, call if you’ve been having trouble going for more than three weeks and constipation treatments aren’t working. You may have a condition called Chronic Idiopathic Constipation (CIC) which means your constipation may be caused by something other than physical or physiological.

How To Get Rid of Constipation

Lately you’ve been feeling a little — to put it delicately — backed up. You’re not “going” as often as you should, and you feel bloated and uncomfortable.

A lot of Americans — more than 4 million by some estimates — deal with constipation on a regular basis. Women have constipation more often than men. This may have to do with the slower movement of food through a woman’s intestines, as well as with the effects of female hormones on the GI tract.

There are a few effective constipation treatments.

What is Constipation?

If you can’t go, it’s often because there isn’t enough water in your stool, a problem that occurs when you don’t drink enough fluids.

According to the National Digestive Diseases Information Clearinghouse, part of the National Institutes of Health, constipation is a condition in which you have fewer than three bowel movements in a week, and your stools are hard, dry, and small, making them painful and difficult to pass. Some people naturally have a bowel movement a few times a day, while others go just a few times a week. You don’t need constipation treatments unless you’re going to the bathroom a lot less often than usual.

Constipation Treatments

You have a lot of options for treating constipation. What you choose will depend on why you’re blocked, and whether it’s a new or a long-term problem for you.

Constipation Home Remedies

You may be able to solve your constipation problem yourself, without your doctor’s help. It may seem obvious, but your diet has a big impact on how you poop.

• Eat more fiber. Fiber makes stool bulkier and softer so it’s easier to pass. Gradually increase the amount of fiber in your diet until you’re getting at least 20 to 35 grams of fiber daily. Good sources include whole grains found in cereals, breads, and brown rice, beans, vegetables and fresh or dried fruits. Prunes and bran cereal are tried and true constipation remedies.

• Stay hydrated. Water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day.

• Try coffee. While caffeinated drinks and alcohol can make you dehydrated, there’s evidence a cup of coffee of tea in the morning may help you poop.

• Limit high fat/low fiber food.Cheese and other dairy products, processed foods, and meat can make constipation worse.

• Watch your FODMAPs.Certain carbohydrates cause digestive problems, including constipation, in some people. The names of the carbohydrates are abbreviated “FODMAPs.” Foods that contain them include dairy, apples, broccoli, wheat, and lentils. You might try cutting individual foods from your diet, but do it carefully. A lot of them are good sources of fiber and other nutrients you need.

Continued

Other things you can do to relieve constipation include:

• Exercise regularly. Moving your body will keep your bowels moving, too.

• Adjust your toilet posture. It may be easier to poop if you squat, raise your legs, or lean back.

• Check your meds. Many prescription drugs can cause constipation. Ask your doctor if this might be the problem and if there’s an alternative.   

• Biofeedback. Some people get constipated because they unconsciously clench their muscles when they try to poop. A therapist can help you train your pelvic floor muscles to relax.

• Massage.  Massaging your own abdomen in a certain pattern can help encourage bowel movements.

• Enemas. You can irrigate your colon with either tap water or an over-the-counter preparation to soften and flush out the contents.

• Suppositories. Some over-the-counter constipation medications are meant to be inserted directly into the rectum. They typically work faster than laxatives you take by mouth.

• Prebiotics and probiotics. You may have digestive issues, including constipation, because of an imbalance in the bacteria that live naturally in your intestines. Supplements or foods containing prebiotics, like bananas and oatmeal, and probiotics, like yogurt and fermented foods, may help.            

Continued

Laxatives for constipation treatment 

A box of laxatives shouldn’t be the first place you turn to relieve constipation. Reserve laxatives for constipation that doesn’t improve after you’ve added fiber and water to your diet.

If your doctor recommends laxatives, ask what type is best for you, and for how long you should take them. Laxatives are best taken short-term only, because you don’t want to start relying on them to go to the bathroom. Also ask how to ease off laxatives when you no longer need them. Stopping them too abruptly can affect your colon’s ability to contract.

Laxatives come in several forms:

• Bulk-forming fiber supplements include calcium polycarbophil (Equilactin, Fibercon), methylcellulose fiber (Citrucel), and psyllium (Fiber-Lax, Konsyl, Metamucil), and wheat dextrin (Benefiber). Unlike other laxatives, you can take these every day. They make the stool bigger and softer. Although they are safe to use regularly, fiber supplements can interfere with your body’s ability to absorb certain medicines, and they may cause bloating, cramps, and gas. Drink a lot of water with them.

• Lubricant laxatives, including Zymenol, help the stool pass more easily through the colon. In general, doctors do not recommend using mineral oil or castor oil. Mineral oil can cause problems such as vitamin deficiencies, and castor oil can lead to long-term constipation.

• Osmotic laxativessuch as lactitol (Pizensy), lactulose (Kristalose), magnesium hydroxide (Milk of Magnesia), polyethylene glycol (Miralax), and Sorbitol help fluids move through your intestines. If you have diabetes, ask your doctor before taking osmotics because they can cause electrolyte imbalances.

• Stimulant laxativessuch as bisacodyl (Correctol, Dulcolax, Feen-a-Mint) and sennosides (Ex-Lax, Senokot) make the muscles in your intestines contract to help push stool out. These laxatives work quickly, but they can cause side effects, including cramping and diarrhea, so use them for as short a period of time as possible.

• Stool softeners such as docusate calcium (Surfak) and docusate sodium (Colace) make stools easier to pass by adding fluid to them. Having softer stool can prevent you from having to strain during bowel movements. Your doctor may recommend one of these products if your constipation is due to childbirth or surgery.

Medical Treatment for Constipation

Medicine

If over-the-counter treatments don’t do the job, your doctor may prescribe a different kind of medication.

• Prescription laxatives such as linaclotide, (Linzess) lubiprostone, (Amitiza) and plecanatide (Trulance) work by increasing the amount of water in your intestines and speeding up the movement of stool. Note that Amitiza is approved for use only in women.

• Serotonin 5-hydroxytryptamine 4 receptors. Prucalopride (Motegrity) is a powerful stimulant that’s used for chronic constipation without a known cause.

• PAMORAs. This is a shorter way of saying “peripherally acting mu-opioid receptor antagonists.” These work on constipation that’s caused by opioid pain medicines. These drugs  include methylnaltrexone (Relistor) and naloxegol (Movantik.) 

Surgery for constipation treatment

Sometimes constipation is caused by a structural problem in your colon or rectum. Your colon may be blocked or unusually narrow, or you may have a partial collapse or a bulge in the wall of your rectum. In that case, surgery can correct the problem.

Surgery may also be a last resort if your colon just works too slowly and treatments haven’t helped. You may need to have a section of your colon removed.

When Constipation Is a Regular Problem

Regardless of what constipation treatment you use, give yourself enough time to sit on the toilet when you need to go. Holding in the urge can make your constipation worse. Set aside a regular time of the day when you know you’ll be left undisturbed for several minutes.

Also, don’t ignore the problem. Untreated constipation can lead to real problems, such as hemorrhoids and tears in the skin around the anus (called fissures) that make you bleed. If you strain too hard, you might even cause part of your intestines to push out through the anus — a condition called rectal prolapse that can sometimes require surgery.

Call your doctor right away if you have any of these symptoms with constipation:

Also, call if you’ve been having trouble going for more than three weeks and constipation treatments aren’t working. You may have a condition called Chronic Idiopathic Constipation (CIC) which means your constipation may be caused by something other than physical or physiological.

13 home remedies to relieve constipation naturally

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Constipation is an incredibly common problem.

Constipation affects around 20% of people in the United States, resulting in 8 million doctor visits per year (1, 2).

People may experience constipation due to the foods they eat or avoid, their lifestyle choices, the medications they take, or the medical conditions they have. For many, the cause of their chronic constipation is unknown. This is known as chronic idiopathic constipation.

Constipation is characterized by the following symptoms (3):

• fewer than three bowel movements per week
• hard, dry, or lumpy stools
• difficulty or pain when passing stools
• a feeling that not all stool has passed

Constipation can have a serious negative effect on quality of life, as well as on physical and mental health (1, 4, 5).

There are many natural ways to help relieve constipation. People can do these in the comfort of their own homes, and most of them are supported by science.

Here are 13 natural home remedies to relieve constipation.

Being dehydrated regularly can make a person constipated. To prevent this, it is important to drink enough water and stay hydrated (6, 7, 8).

When a person is constipated, they might find relief from drinking some carbonated (sparkling) water. This can help them rehydrate and get things moving again.

Some studies have found sparkling water to be more effective than tap water at relieving constipation. This includes in people with indigestion, or dyspepsia, and people with chronic idiopathic constipation (9, 10, 11).

However, drinking carbonated drinks such as sugary soda is not a good idea, as these beverages can have harmful health effects and may make constipation worse (12, 13).

Some people with irritable bowel syndrome (IBS) find that carbonated drinks worsen their symptoms, so these individuals may wish to avoid sparkling water and other carbonated drinks.

Bottom line: Dehydration can cause constipation, so be sure to drink enough water. Sparkling water may be even more effective at relieving constipation.

To treat constipation, doctors often tell people to increase their dietary fiber intake.

This is because increasing fiber intake increases the bulk and consistency of bowel movements, making them easier to pass. It also helps them pass through the digestive system more quickly (14).

In fact, one 2016 review found that 77% of people with chronic constipation benefited from supplementing with fiber (15).

However, some studies have found that increasing fiber intake can actually make the problem worse. Others report that dietary fiber improves stool frequency but may not help with other symptoms of constipation, such as stool consistency, pain, bloating, and gas (16, 17).

This is because different types of dietary fiber have different effects on digestion.

There are many different dietary fibers, but in general, they fall into two categories: insoluble fibers and soluble fibers.

Insoluble fibers — present in wheat bran, vegetables, and whole grains — add bulk to stools and may help them pass more quickly and easily through the digestive system.

Soluble fibers — present in oat bran, barley, nuts, seeds, beans, lentils, and peas, as well as some fruits and vegetables — absorb water and form a gel-like paste, which softens the stools and improves its consistency.

Non-fermentable soluble fibers, such as psyllium, are the best choice for treating constipation (18, 19, 20).

One 2020 review found psyllium to be 3.4 times more effective than insoluble wheat bran for constipation (18).

Various brands of psyllium fiber are available online.

Studies examining the effects of insoluble fiber as a treatment for constipation have yielded mixed results.

This is partly because insoluble fiber can make the problem worse in some people with a functional bowel problem, such as IBS or chronic idiopathic constipation (19, 20, 21)

Some fermentable soluble fibers may also be ineffective at treating constipation, as they are fermented by bacteria in the gut and lose their water-holding capacity (22).

To prevent constipation, people should aim to consume a mix of soluble and insoluble fibers. The total recommended fiber intake per day is 25 grams (g) for females and 38 g for males (14).

Bottom line: Try eating more high fiber foods. Supplementing the diet with soluble non-fermentable fiber, such as psyllium, can also help.

Various research studies have reported that exercise could help improve the symptoms of constipation (23, 24, 25, 26).

Studies have linked sedentary lifestyles with an increased risk of constipation. Because of this, some healthcare experts recommend increasing exercise to get the stool moving (23).

That said, not all studies agree that exercise treats constipation. Therefore, more research is needed (27).

Other studies have reported that although exercise did not always improve the number of times people went to the bathroom, it did reduce some symptoms and improved people’s quality of life scores (28).

In people with IBS, moderate exercise (brisk walking) can improve digestive symptoms and quality of life scores. However, vigorous exercise (jogging) could make symptoms worse for some (29).

Try doing some gentle exercise — such as going for regular walks, swimming, cycling, or jogging — to see if it helps.

Bottom line: Exercise may reduce the symptoms of constipation in some people.

For some people, consuming coffee can increase the urge to go to the bathroom. This is because coffee stimulates the muscles in the digestive system (29, 30).

In fact, one 1998 study found that caffeinated coffee can stimulate the gut in the same way that a meal can. This effect was 60% stronger than drinking water and 23% stronger than drinking decaffeinated coffee (31).

Coffee may also contain small amounts of soluble fibers that help prevent constipation by improving the balance of gut bacteria (32, 33).

That said, the bowel-stimulating qualities of caffeine may be stronger in people with IBS. It could also make digestive symptoms worse (30).

People with IBS can try removing caffeine from their diet to see if it helps.

Learn more about foods and beverages that can relieve constipation here.

Bottom line: Coffee can help relieve constipation by stimulating the muscles in the gut. It may also contain small amounts of soluble fiber.

Senna is a popular safe and effective herbal laxative that helps treat constipation (34, 35). It is available over the counter and online, in both oral and rectal forms.

Senna contains plant compounds called glycosides, which stimulate the nerves in the gut and help speed up bowel movements (36).

Doctors consider Senna safe for adults for short periods of time, but people should consult a doctor if their symptoms do not go away after a few days.

Doctors usually do not recommend Senna for pregnant women, those who are breastfeeding, or people with certain health conditions, such as inflammatory bowel disease.

Bottom line: The herbal laxative Senna is a popular remedy for constipation. It stimulates the nerves in the gut to speed up bowel movements.

Probiotics may help prevent chronic constipation. Probiotics are live, beneficial bacteria that naturally occur in the gut. They include Bifidobacteria and Lactobacillus.

People can increase their levels by eating probiotic foods.

Some people who have chronic constipation have an imbalance of bacteria in their gut. Consuming more probiotic foods could help improve this balance and prevent constipation.

A 2019 review found that taking probiotics for 2 weeks can help treat constipation, increasing stool frequency and stool consistency (37).

They could also help treat constipation by producing short-chain fatty acids. These may improve gut movements, making it easier to pass stools (38).

Alternatively, try a probiotic supplement. Some studies have found that people started to feel the benefits of these supplements after 4 weeks (39).

Try taking probiotic supplements, which are available online, or eating more probiotic-rich foods to see if this helps with constipation. Prebiotic foods include:

Bottom line: Probiotics may help treat chronic constipation. Try eating probiotic foods or taking a supplement.

A person can speak to a doctor or pharmacist about choosing an appropriate laxative. Different types have varying methods of action, but all are effective for constipation (40, 41).

A doctor may recommend one of the following types:

• Bulking agents: These are fiber-based laxatives that increase the water content of stool.
• Stool softeners: These contain oils to soften stools and ease their passage through the gut.
• Stimulant laxatives: These stimulate the nerves in the gut to increase bowel movements.
• Osmotic laxatives: These soften stool by pulling water from the surrounding tissues into the digestive system.

However, people should not take most of these laxatives on a regular basis without speaking to a doctor.

Bottom line: Laxatives are effective for relieving constipation. Speak to a doctor or pharmacist about the best ones to use.

Constipation can be a symptom of IBS. The low FODMAP diet is an elimination diet that helps treat IBS and may relieve IBS-related constipation (42, 43, 44).

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

The diet involves limiting high FODMAP foods for a period of time before reintroducing them to determine which ones the body can tolerate (45).

In people with constipation-predominant IBS, the low FODMAP diet alone is often not enough.

Such people will probably need to pay attention to other aspects of their diet, such as getting enough water and fiber, to experience relief from their symptoms (46, 47).

Bottom line: A low FODMAP diet may help relieve IBS-related constipation. However, that alone may not provide sufficient relief.

Glucomannan is a type of soluble fiber from the roots of the konjac plant. Some research suggests that it is effective against constipation (48, 49).

As well as improving bowel movements, glucomannan may act as a prebiotic to improve the balance of good bacteria in the gut.

One study in children found that 45% of those taking glucomannan experienced relief from severe constipation, compared with only 13% in the control group (50).

However, another controlled study found no significant effects (51).

People can get glucomannan from supplements or by eating shirataki, or konjac, noodles.

Glucomannan supplements are also available. They vary in their benefits by brand, so it is best to compare brands before making a purchase. Glucomannan supplements are available online.

Bottom line: Glucomannan may help treat constipation in some people. Sources include supplements and shirataki noodles.

Prebiotics are an indigestible carbohydrate fiber. Prebiotics include oligosaccharide and inulin.

Although dietary fibers reduce constipation by improving the consistency and bulk of stool, prebiotics have their effects by improving digestive health.

Prebiotic fibers improve digestive health by feeding the beneficial bacteria in the gut, which boosts probiotics and improves the balance of the gut bacteria (37, 52).

In fact, some prebiotics may help increase the frequency of bowel movements, as well as make stools softer (53).

Prebiotic foods include:

Bottom line: Foods that contain prebiotic fibers can improve digestive health and the balance of beneficial gut bacteria. Prebiotics may help relieve constipation.

Magnesium citrate is a popular home remedy against constipation. It is a type of osmotic laxative that people can buy over the counter or online.

Taking moderate amounts of magnesium supplements can help relieve constipation. Doctors use higher dosages to prepare and clean out the bowel before surgery or other medical procedures (54, 55).

Bottom line: Taking magnesium citrate, an over-the-counter supplement, can help relieve constipation.

People often tout prunes and prune juice as nature’s remedy for constipation — and for good reason. Prunes may be the most accessible natural solution available.

In addition to fiber, prunes contain sorbitol. This is a sugar alcohol that has a laxative effect (56, 57).

Some studies have shown that prunes may be more effective than fibers such as psyllium (58, 59).

The effective dosage may be around 50 g, or seven medium prunes, twice per day (59).

However, people with IBS may want to avoid prunes, because sugar alcohols are high FODMAP foods.

Learn more about prune juice for constipation and other juices for constipation here.

Bottom line: Prunes contain the sugar alcohol sorbitol, which has a laxative effect. Prunes can be a very effective remedy for constipation.

In people with an intolerance to it, eating dairy can cause constipation due to its effect on the gut’s movements (60).

This includes children who are intolerant to cow’s milk protein and adults with lactose intolerance.

If someone suspects a dairy intolerance, they can see their doctor for diagnosis. The doctor may recommend temporarily removing dairy from the diet, while increasing other calcium-rich foods, to see if it improves the symptoms.

Bottom line: Dairy or lactose intolerance may cause constipation in some people. In these people, removing dairy from the diet can help relieve symptoms.

Constipation is uncomfortable and has a number of potential underlying causes. However, many home remedies and natural methods can help.

If constipation persists, a person can talk to their doctor to identify the cause and find an effective treatment.

That said, many of the natural home remedies in this article can provide significant relief.

Read the article in Spanish.

Psyllium: Benefits, safety, and dosage

Psyllium is a type of fiber that acts as a gentle, bulk forming laxative.

Psyllium, similarly to other soluble fibers, passes through the small intestine without being completely broken down or absorbed.

Instead, it absorbs water and becomes a viscous compound that benefits constipation, diarrhea, blood sugar, blood pressure, cholesterol, and weight loss.

This article explains all there is to know about psyllium, including seven ways it can benefit your health.

Psyllium is a soluble fiber derived from the seeds of Plantago ovata, an herb grown mainly in India (1).

People use psyllium as a dietary supplement. It is available in the form of husk, granules, capsules, or powder. Manufacturers may also fortify breakfast cereals and baked goods with psyllium.

Psyllium husk is the main active ingredient in Metamucil, a fiber supplement that reduces constipation.

Because of its excellent water solubility, psyllium can absorb water and become a thick, viscous compound that resists digestion in the small intestine.

Its resistance to digestion allows it to help regulate high cholesterol, triglycerides, and blood sugar levels. It can also aid weight management and relieve mild diarrhea as well as constipation (2, 3, 4, 5).

Moreover, unlike some other potent sources of fiber, the body typically tolerates psyllium well.

Psyllium is available in various forms and has many health benefits.

1. Psyllium relieves constipation

Psyllium is a bulk forming laxative. It works by increasing stool size and helping relieve constipation (1, 2).

Initially, it works by binding to partially digested food that is passing from the stomach into the small intestine.

It then helps with the absorption of water, which increases the size and moisture of stools. The end product is bigger and easier-to-pass stools.

One study found that psyllium, which is a soluble fiber, had a greater effect than wheat bran, which is insoluble fiber, on the moisture, total weight, and texture of stools (6).

Another study showed that taking 5.1 grams (g) of psyllium twice a day for 2 weeks significantly increased the water content and weight of stools, as well as the total number of bowel movements, in 170 individuals with chronic constipation (7).

For these reasons, taking psyllium supplements promotes regularity.

2. It may help treat diarrhea

Research shows that psyllium can relieve diarrhea (1, 2). It does this by acting as a water absorbing agent. It can increase stool thickness and slow down its passage through the colon.

One older study showed psyllium husk significantly decreased diarrhea in 30 people who were undergoing radiation therapy for cancer (8).

In another older study, researchers treated eight people who had lactulose-induced diarrhea with 3.5 g of psyllium three times daily. Doing so increased their stomach emptying time from 69 to 87 minutes, with accompanied slowing in the colon, which meant fewer bowel movements (9).

Psyllium can, therefore, both prevent constipation and reduce diarrhea, effectively helping to normalize bowel movements.

3. It can lower blood sugar levels

Taking fiber supplements can help control the body’s glycemic response to a meal, such as reducing insulin and blood sugar levels. This is particularly the case with water soluble fibers such as psyllium (4, 10, 11).

In fact, psyllium works better for this mechanism than other fibers, such as bran. This is because the gel forming fibers in psyllium can slow down the digestion of food, which helps regulate blood sugar levels.

In one study, researchers gave 51 people with type 2 diabetes and constipation 10 g of psyllium twice per day. This resulted in reduced constipation, body weight, blood sugar levels, and cholesterol (12).

Because psyllium slows down the digestion of food, people should take it with food, rather than on its own, so it has a greater effect on blood sugar levels (13).

It seems that a daily dose of at least 10.2 g can promote lower blood sugar levels (14, 15).

4. It may boost satiety and aid weight loss

Fibers that form viscous compounds, including psyllium, can help control appetite and aid weight loss (12, 16).

Psyllium may aid appetite control by slowing down stomach emptying and reducing appetite. Decreased appetite and calorie intake may support weight loss.

One study found that taking up to 10.2 g of psyllium before breakfast and lunch led to significant reductions in hunger, desire to eat, and increased fullness between meals compared to a placebo (17).

Another older study from 2011 showed that psyllium supplementation on its own, as well as paired with a fiber-rich diet, resulted in a significant reduction of weight, body mass index, and percentage of body fat (18).

That said, a 2020 review of 22 trials reported no overall effect of psyllium on body weight, BMI, or waist circumference (19).

Researchers need to do more studies before knowing the true effects of psyllium on weight loss.

5. It can lower cholesterol levels

Psyllium binds to fat and bile acids, helping the body to excrete them.

In the process of replacing these lost bile acids, the liver uses cholesterol to produce more. As a result, blood cholesterol levels decrease (2).

In one study, 47 healthy participants experienced a 6% reduction in LDL (“bad”) cholesterol after taking 6 g of psyllium each day for 6 weeks (20).

Furthermore, psyllium can help increase HDL (“good”) cholesterol levels (21).

In one study, taking 5.1 g twice a day for 8 weeks resulted in a decrease in total and LDL cholesterol, as well as an increase in HDL levels in 49 people with type 2 diabetes (22).

Interestingly, a review of 21 studies reported that reductions in total and LDL cholesterol are dose dependent. This means greater results were observed with treatments of 20.4 g of psyllium per day than 3.0 g per day (21).

6. It seems to be good for the heart

All types of fiber can be good for the heart. The American Heart Association (AHA) say that dietary fiber can improve cholesterol, and lower the risk of heart disease, stroke, type 2 diabetes, and obesity (23).

Water soluble fibers, including psyllium, could help reduce blood triglycerides, blood pressure, and the risk of heart disease (1, 3).

A review of 28 trials found that taking a median of 10.2 g psyllium per day could effectively improve markers of heart health, including lowering LDL cholesterol. This can helps reduce the risk of heart disease (3).

A 2020 review of 11 trials reported that psyllium could reduce systolic blood pressure by 2.04 millimeters of mercury (mmHg). The authors recommend using psyllium to help treat hypertension (24).

7. It has prebiotic effects

Prebiotics are nondigestible compounds that nourish intestinal bacteria and help them grow. Researchers believe that psyllium has prebiotic effects (25).

Although psyllium is somewhat resistant to fermentation, intestinal bacteria can ferment a small portion of psyllium fibers. This fermentation can produce short-chain fatty acids (SCFA), including butyrate. Research has linked SCFAs with health benefits (26, 27).

Also, because it ferments more slowly than other fibers, psyllium does not increase gas and digestive discomfort.

In fact, treatment with psyllium for 4 months helped reduce digestive symptoms by a difference of 45% in people with ulcerative colitis (UC) compared to the placebo (28).

Constipation; Symptoms, Causes, Treatment & Prevention

Overview

What is constipation?

Having fewer than three bowel movements a week is, technically, the definition of constipation. However, how often you “go” varies widely from person to person. Some people have bowel movements several times a day while others have them only one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you – as long as you don’t stray too far from your pattern.

Regardless of your bowel pattern, one fact is certain: the longer you go before you “go,” the more difficult it becomes for stool/poop to pass. Other key features that usually define constipation include:

• Your stools are dry and hard.
• Your bowel movement is painful and stools are difficult to pass.
• You have a feeling that you have not fully emptied your bowels.

How common is constipation?

You are not alone if you have constipation. Constipation is one of the most frequent gastrointestinal complaints in the United States. At least 2.5 million people see their doctor each year due to constipation.

People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated (“chronic constipation”). These include:

• Older age. Older people tend to be less active, have a slower metabolism and less muscle contraction strength along their digestive tract than when they were younger.
• Being a woman, especially while you are pregnant and after childbirth. Changes in a woman’s hormones make them more prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool.
• Not eating enough high-fiber foods. High-fiber foods keep food moving through the digestive system.
• Taking certain medications (see causes).
• Having certain neurological (diseases of the brain and spinal cord) and digestive disorders (see causes).

How does constipation happen?

Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the stool making it hard in consistency and difficult to push out of the body.

To back up a bit, as food normally moves through the digestive tract, nutrients are absorbed. The partially digested food (waste) that remains moves from the small intestine to the large intestine, also called the colon. The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. This gives the colon more time – too much time – to absorb water from the waste. The stool becomes dry, hard, and difficult to push out.

Pathway of food waste through colon, rectum and anus.

Can constipation cause internal damage or lead to other health problems?

There are a few complications that could happen if you don’t have soft, regular bowel movements. Some complications include:

• Swollen, inflamed veins in your rectum (a condition called hemorrhoids).
• Tears in the lining of your anus from hardened stool trying to pass through (called anal fissures).
• An infection in pouches that sometimes form off the colon wall from stool that has become trapped and infected (a condition called diverticulitis)
• A pile-up of too much stool/poop in the rectum and anus (a condition called fecal impaction).
• Damage to your pelvic floor muscles from straining to move your bowels. These muscles help control your bladder. Too much straining for too long a period of time may cause urine to leak from the bladder (a condition called stress urinary incontinence).

Does not having regular bowel movements cause toxins to build up in my body and make me sick?

Don’t worry, this usually isn’t the case. Although your colon holds on to stool longer when you are constipated and you may feel uncomfortable, the colon is an expandable container for your waste. There is possibly a slight risk of a bacterial infection if waste gets into an existing wound in the colon or rectum.

Symptoms and Causes

What causes constipation?

There are many causes of constipation – lifestyle choices, medications, medical conditions, and pregnancy.

Common lifestyle causes of constipation include:

• Eating foods low in fiber.
• Not drinking enough water (dehydration).
• Not getting enough exercise.
• Changes in your regular routine, such as traveling or eating or going to bed at different times.
• Eating large amounts of milk or cheese.
• Stress.
• Resisting the urge to have a bowel movement.

Medications that can cause constipation include:

• Strong pain medicines, like the narcotics containing codeine, oxycodone (Oxycontin®) and hydromorphone (Dilaudid®).
• Nonsteroidal anti-inflammatory drugs, like ibuprofen (Advil®, Motrin®) and naproxen (Aleve®).
• Antidepressants, including the selective serotonin reuptake inhibitors (like fluoxetine [Prozac®]) or tricyclic antidepressants (like amitriptyline [Elavil®]).
• Antacids containing calcium or aluminum, such as Tums®.
• Iron pills.
• Allergy medications, such as antihistamines (like diphenhydramine [Benadryl®]).
• Certain blood pressure medicines, including calcium channel blockers (like verapamil [Calan SR], diltiazem [Cardizem®] and nifedipine [Procardia®]) and beta-blockers (like atenolol [Tenormin®]).
• Psychiatric medications, like clozapine (Clozaril®) and olanzapine (Zyprexa®).
• Anticonvulsant/seizure medications, such as phenytoin and gabapentin.
• Antinausea medications, like ondansetron (Zofran®).

Many drugs can cause constipation. Ask your doctor or pharmacist if you have any questions or concerns.

Medical and health conditions that can cause constipation include:

• Endocrine problems, like underactive thyroid gland (hypothyroidism), diabetes, uremia, hypercalcemia.
• Colorectal cancer.
• Irritable bowel syndrome (IBS).
• Diverticular disease.
• Outlet dysfunction constipation. (A defect in the coordination of pelvic floor muscles. These muscles support the organs within the pelvis and lower abdomen. They are needed to help release stool.)
• Neurologic disorders including spinal cord injury, multiple sclerosis, Parkinson’s disease, and stroke.
• Lazy bowel syndrome. The colon contracts poorly and retains stool.
• Intestinal obstruction.
• Structural defects in the digestive tract (like fistula, colonic atresia, volvulus, intussusception, imperforate anus, or malrotation.)
• Multiple organ diseases, such as amyloidosis, lupus, and scleroderma.
• Pregnancy.

What are the symptoms of constipation?

Symptoms of constipation include:

• You have fewer than three bowel movements a week.
• Your stools are dry, hard and/or lumpy.
• Your stools are difficult or painful to pass.
• You have a stomach ache or cramps.
• You feel bloated and nauseous.
• You feel that you haven’t completely emptied your bowels after a movement.

Diagnosis and Tests

What should I expect when I talk to my doctor about my constipation?

Talking to your doctor – or anyone – about your bowel movements (or lack of them) is not the most pleasant of topics. Know that your doctor is there for you. Doctors are trained health professionals who have discussed just about every health topic you can think of with their patients.

Your doctor will first ask you questions about your medical history, bowel movements, and your lifestyle and routines.

Medical history

These questions may include:

• What are your current and past diseases/health conditions?
• Have you lost or gained any weight recently?
• Have you had any previous digestive tract surgeries?
• What medications and supplements do you take for other disorders and for the relief of constipation?
• Does anyone in your family have constipation or diseases of the digestive tract or a history of colon cancer?
• Have you had a colonoscopy?

Bowel movement history

These questions may include:

• How often do you have a bowel movement?
• What do your stools look like?
• Have you noticed any blood or red streaks in your stool?
• Have you ever seen blood in the toilet bowl or on the toilet paper after you wipe?

Lifestyle habits and routines

• What food and beverages do you eat and drink?
• What is your exercise routine?

Your doctor will also perform a physical exam, which includes a check of your vital signs (temperature, pulse, blood pressure). He or she will use a stethoscope to listen to the sounds in your abdomen. Your abdomen will also be touched to check for pain, tenderness, swelling, and lumps.

Be aware that your doctor will also perform a rectal exam. This is a finger exam of the inside of your rectum. It’s a quick check for any masses or problems that can be felt by finger.

What lab tests and other medical tests may be done to find the cause of my constipation?

Your doctor can order no tests or many types of tests and procedures. The decision of which ones your doctor might order for you depends on your symptoms, medical history, and overall health.

Lab tests: Blood and urine tests reveal signs of hypothyroidism, anemia, and diabetes. A stool sample checks for signs of infection, inflammation, and cancer.

Imaging tests: Computed tomography (CT), magnetic resonance imaging (MRI) or lower gastrointestinal tract series may be ordered to identify other problems that could be causing your constipation.

Colonoscopy: A colonoscopy or sigmoidoscopy– an internal view of your colon with a scope – may be performed. During this procedure, a small sample of tissue (biopsy) may be taken to test for cancer or other problems and any found polyps will be removed.

Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines.

Other bowel function tests: Your doctor may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of x-ray (defecography), done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into the rectum (balloon expulsion test and anorectal manometry).

Management and Treatment

How is constipation treated?

Self-care

Most cases of mild to moderate constipation can be managed by you at home. Self-care starts by taking an inventory of what you eat and drink and then making changes.

Some recommendations to help relieve your constipation include:

• Drink two to four extra glasses of water a day. Avoid caffeine-containing drinks and alcohol, which can cause dehydration.
• Add fruits, vegetables whole grains and other high-fiber foods to your diet. Eat fewer high-fat foods, like meat, eggs and cheese.
• Eat prunes and/or bran cereal.
• Keep a food diary and single out foods that constipate you.
• Get moving, exercise.
• Check how you sit on the toilet. Raising your feet, leaning back or squatting may make having a bowel movement easier.
• Add an over-the-counter supplemental fiber to your diet (like Metamucil®, Citrucel®, and Benefiber®).
• If needed, take a very mild over-the-counter stool softener or laxative (such as docusate [Colace®] or Milk of Magnesia®). Mineral oil enemas, like Fleet®, and stimulant laxatives, like bisacodyl (Dulcolax®) or senna (Senokot®), are other options. There are many laxative choices. Ask your pharmacist or doctor for help in making a choice. Do not use laxatives for more than two weeks without calling your doctor. Overuse of laxatives can worsen your symptoms.
• Do not read, use your phone or other devices while trying to move your bowels.

Medication/supplement review

In addition to self-care methods, your doctor will review your medications and supplements (if you take any). Some of these products can cause constipation. If they do, your doctor may change the dose, switch to another drug and/or ask that you stop taking the supplement. Never stop taking your medications or supplements before talking with your doctor first.

Prescription medications

A few prescription drugs are available to treat constipation. These include lubiprostone (Amitiza®), prucalopride (Prudac®, Motegrity®), plecanatide (Trulance®), lactulose (Cephulac®, Kristalose®) and linaclotide (Linzess®). Your doctor will pick the drug that might work best for you based on the results of your tests.

Surgery

Surgery is rarely needed to treat constipation. Your doctor may, however, recommend surgery if constipation is caused by a structural problem in the colon. Examples of these problems include a blockage in the colon (intestinal obstruction), a narrowing in a portion of the intestine (intestinal stricture), tear in the anus (anal fissure) or the collapse of part of the rectum into the vagina (rectal prolapse). Some causes of outlet dysfunction constipation may be treated with surgery. This is best discussed after testing. You may also need surgery if cancer was found in your colon, rectum or anus.

Prevention

How can I prevent constipation?

Use the same home-based methods you used to treat constipation to prevent it from becoming a chronic problem:

• Eat a well-balanced diet with plenty of fiber. Good sources of fiber are fruits, vegetables, legumes, and whole-grain breads and cereals. Fiber and water help the colon pass stool. Most of the fiber in fruits is found in the skins, such as in apples. Fruits with seeds you can eat, like strawberries, have the most fiber. Bran is a great source of fiber. Eat bran cereal or add bran cereal to other foods, like soup and yogurt. People with constipation should eat between 18 and 30 grams of fiber every day.
• Drink eight 8-ounce glasses of water a day. (Note: Milk can cause constipation in some people.) Liquids that contain caffeine, such as coffee and soft drinks, can dehydrate you. You may need to stop drinking these products until your bowel habits return to normal.
• Exercise regularly.
• Treat mild constipation with a dietary supplement like magnesium. (Not everyone should take magnesium. Check with your doctor before taking.)
• Move your bowels when you feel the urge. Do not wait.

Living With

When should I call my doctor?

Call your healthcare provider if:

• Constipation is a new problem for you.
• You see blood in your stool.
• You are losing weight unintentionally.
• You have severe pain with bowel movements.
• Your constipation has lasted more than three weeks.
• You have symptoms of outlet dysfunction constipation.

Remember, talk openly and honestly with your doctor about your bowel movements and any questions or concerns you may have. Pooping is something we all should be doing. Constipation may be a temporary situation, a long-term problem or a sign of a more serious condition. Be safe. See your doctor, especially if you’ve noticed a change in your bowel pattern or if your life is being ruled by your bowels.

how to make stool regular and live longer / Clinic EXPERT

Zinovieva Evgeniya Nikolaevna

Chief physician, therapist, gastroenterologist, hepatologist of the highest category, Ph.D., associate professor

06 March 2018

353.7 thousand views

Everyone has constipation at least once in their life, and from 30 to 50% of the population suffers from constant constipation. We will talk about the regularity of the stool, what is it normal, how to improve the situation, who to contact and what examinations to undergo if the constipation persists.

How does it work and what kind of normal stool is it?

In short, in the large intestine, food residues are mixed, water is absorbed, fecal masses are formed and move to the “exit” – the rectum, where the wall is stretched, the urge to defecate appears and the feces are excreted.

Why know this? To distinguish norm from non-norm. Regular bowel movements are a sign of good digestion and promote health and longevity.

It takes a minimum of 20 hours and a maximum of 3 days for the feces to pass completely through the intestines.When the stool stays in the colon longer, it becomes hard, like “sheep”. Therefore, if you visit the toilet less than once every 3 days, and the feces are similar to the first 2 pictures, this is constipation. See which feces are considered normal (types 3 and 4):

If you want to go to the toilet at night, these are signs of illness. Because the contractions of the large intestine – peristalsis, appear in the morning, the intestines “rest” at night. See a doctor, do not treat yourself if during a bowel movement you have a feeling that:

• you have “something else left” in your intestines, there is no feeling of relief
• you need to push
• you want but cannot go to the toilet
• everything is “blocked” in the stomach
• you are swollen
• you need help to empty the intestines
• this condition lasts more than six months and the situation is getting worse.

What is the danger of “regular” constipation?

Stool retention is not so harmless. Constipation is the cause of many health problems:

1. Hemorrhoids worsen, anal fissures appear, the risk of rectal prolapse is increased – in 7 out of every 10 patients.
2. A disorder of function appears – irritable bowel syndrome.
3. There are predisposing factors for the development of colitis, allergies.
4. The body does not receive the necessary vitamins and minerals.
5. The patient becomes irritable and suffers from depression and neurosis.
6. Often worried about chronic fatigue syndrome.

Those who suffer from constipation have an increased risk of:

• colon diverticulosis (bulging and thinning of the intestinal wall) and its complications, up to intestinal perforation and peritonitis – in every fifth
• intestinal polyps are found in every tenth

90,029 colon and rectal cancer – one in twentieth.

Don’t take it to the extreme – treat constipation on time.

5 tips from a gastroenterologist for those who want to get rid of constipation

Advice number 1 – change your lifestyle

If you want to get rid of constipation, you should not overeat, eat fast food and drink it with soda, sit for days in the office, be nervous and do not sleep all night long. The intestines “love” the right food, regularity in its intake – 3-4 times a day, and a calm atmosphere, without extreme.

Advice number 2 – choose a diet

At the “exit” you get the consequences of what you received “at the entrance”. There are foods that make your stools softer and your intestines work harder. Include in the diet: vegetable oils, freshly squeezed vegetable juices, dairy products – fresh kefir, crumbly cereals with dried fruits, soups, fruits, raw and processed vegetables, healthy fiber. Fried, fatty, smoked products, preservatives and other “chemicals” in products are prohibited.

Advice # 3 – Drink plenty of fluids

You, of course, have heard that “you need to drink a lot.”But how much is enough? Scientists have established the norm – 30 ml per 1 kg of ideal body weight (you can find a body weight calculator on the network, and, substituting your data, calculate it). The liquid should be warm to quickly enter the intestines, and honey can be added to the water.

Advice number 4 – do not lie on the couch

If you spend your days in the office, and evenings – watching TV or “hanging out” on the Internet – the intestines may well arrange a “strike”. For the stool to be regular, physical activity for at least an hour 3 times a week is the best way out.Can’t devote so much time, there is no way to visit the gym? Walk, climb stairs, use every minute to keep fit.

Advice number 5 – do not treat yourself, see a doctor

When kefir, prunes on an empty stomach and warm water with honey do not help, but it’s time to see a doctor:

• in the feces you noticed blood
• the appearance of feces has changed – thin or like a tape
• a malfunction in the intestines appeared suddenly, especially after 50 years
• you suffer from constipation, have lost a lot of weight, but the diet has remained the same
• you have abdominal pain or discomfort before or after a bowel movement
• constipation replaces diarrhea
• pains in the rectum appeared
• appetite worsened, aversion to certain foods appeared
• you began to get tired faster
• you do not understand why the temperature rises
• you suffer from constipation, and there were cases of colon and rectal cancer in the family, ulcerative colitis, Crohn’s disease.

In conclusion, some interesting clinical cases from our practice:

Constipation and … thyroid gland: where is the connection?

A young girl, 23 years old, contacted us. It turned out that she was worried about constipation for 1.5 years! Our doctor carefully interviewed the patient and found out that during pregnancy, 3 years ago, she was diagnosed with a dysfunction of the thyroid gland, but nothing bothered and no treatment was carried out.

We examined her more thoroughly and found out that the cause of constipation was autoimmune thyroiditis – a common situation in women, when the body “attacks” its own thyroid gland, it gradually collapses and the level of hormones drops.One of the symptoms of autoimmune thyroiditis is constipation. Our endocrinologist prescribed treatment, the function of the thyroid gland returned to normal, and the joint work with the gastroenterologist gave the result – the constipation was gone.

Constipation and something else

A 67-year-old patient came to us with complaints of constipation. Laxatives didn’t help. The doctor examined him, but found no significant abnormalities. Nevertheless, the age and nature of the complaints were alarming, and the patient was sent for a detailed examination.

A blood test revealed a decrease in hemoglobin, an increase in ESR, occult blood in the feces using the Colon View ultrasensitive fecal occult blood test.We performed a colonoscopy – examining the intestines with a flexible endoscope and revealed a bowel tumor. Fortunately, we made it on time.

The patient has been successfully operated on and is under the supervision of a gastroenterologist and oncologist.

How and how can we help you?

1. Consult a competent specialist – our gastroenterologist will examine you in detail, if necessary, appoint additional consultations from related specialists and monitor the treatment process, from the first visit to the result.
2. Identify the cause of constipation – we have all the necessary expert-class equipment and highly qualified diagnostic specialists to conduct a detailed examination – analyzes, ultrasound, endoscopic examinations.
3. Save you time and money – to find out why your intestines refuse to work on a regular basis, we created a free consultation with a gastroenterologist to schedule an examination. If you are worried about the symptoms, but you do not know where to start, during the conversation you will be assigned the necessary range of tests.

Constipation is the cause and effect of many diseases. A competent doctor will help you to understand them. You should not prescribe laxatives to yourself, get carried away with enemas and “pull” a visit to the gastroenterologist. You can miss something important and waste valuable time. Don’t risk it – see a specialist.

90,000 Methods for the treatment of constipation during pregnancy

What is the problem?

The term “constipation” is defined as difficulty in passing stools and a decrease in stool frequency (bowel movements – bowel movements to empty it).Constipation is characterized by discomfort, excessive exertion, hard or lumpy stools, a feeling of incomplete emptying, and infrequent bowel movements. Constipation is a common symptom during pregnancy. This may be the result of a combination of factors, including hormonal changes (shifts) during pregnancy, affecting the digestive system, low physical activity, and changes in dietary habits during pregnancy. In addition, as the fetus (baby) grows, it can squeeze the mother’s intestines and thereby cause delayed bowel movements / obstructions.

Why is this important?

Constipation during pregnancy is associated with impaired quality of life and distress for pregnant women, as well as physical problems, including the development of hemorrhoids. A number of treatment options have been proposed, including the use of drugs, nutritional supplements, or dietary changes.

As a rule, it is initially recommended to use non-drug interventions (changes in diet, water intake and exercise), and if they are ineffective or insufficient, drug (pharmacological) interventions.Medication interventions include a wide range of medications: lubricants (lubricants), stool-promoting agents, osmotic and stimulant laxatives, stool softeners (emollient laxatives), enemas and suppositories (suppository and enemas laxatives).

This review examined the benefits of drug and non-drug interventions in the management of constipation during pregnancy, and whether they are safe for women and children.

What evidence have we found?

We identified four studies, but only two studies (a total of 180 women) provided data for analysis. These studies compared stimulant laxatives with bulk laxatives and dietary supplements (dietary fiber) with no intervention. The included studies were considered to be of moderate (moderate) quality.

We have covered two main comparisons.In a first comparison, we found that stimulant laxatives may be more effective in treating constipation than bulk laxatives ( average quality of evidence ). However, it can also lead to more abdominal discomfort ( low-quality evidence ) and diarrhea ( moderate-quality evidence ). We found no difference in women’s satisfaction ( mean quality evidence ). A second comparison, between fiber supplementation and no intervention, found that fiber supplementation may be effective in increasing stool frequency ( mean quality evidence ).The use of dietary supplements (fiber) was associated with improved stool consistency as determined by the testers (hard stool frequency decreased by 11% to 14%, normal stool increased by 5% to 10%, and loose stool frequency increased by 0% to 6 %).

There were no studies that looked at other types of interventions such as osmotic laxatives, stool softeners (laxatives that soften stool), lubricants (lubricating laxatives – lubricants), enemas and suppositories (suppositories).

What does this mean?

Little evidence exists to suggest that dietary supplements rich in fiber (or fiber — bulking laxatives or fillers) may increase stool frequency. When choosing between stimulant or bulk laxatives: Stimulant laxatives may better relieve constipation but are more likely to cause abdominal discomfort and diarrhea.

More research is needed in this area.

Is there a relationship between constipation and hemorrhoids?

Constipation and hemorrhoids are a very common problem, therefore, one condition is often associated with another. At the same time, both constipation and hemorrhoids can occur independently of each other. We will talk about all the features of the development and course of these pathological conditions in this article.

What is constipation

In case of constipation, a violation of the bowel movement is noted. Usually, patients complain of a decrease in the frequency of passing feces, slowing down or difficulty.The disease can be acute or chronic, although not all experts consider constipation to be a disease. Domestic doctors consider it only as a symptom of other pathological processes. If we turn to the International Classification of Diseases (ICD-10), then constipation is included in a separate disease (code K59.0).

The causes of constipation can be very varied. Among the most common predisposing factors are:

• Incorrect power supply.
• Sedentary lifestyle.
• Uncontrolled use of laxatives.
• Pregnancy.
• Diseases in which there is a decrease in intestinal motility.
• Spinal cord injury.
• Taking certain medications, etc.

In addition, hemorrhoids are included in the list of causes of constipation. Discomfort and pain during bowel movements with hemorrhoids force the patient to postpone going to the toilet for as long as possible. The psychological influence is sometimes very strong and leads to the development of constipation, even with a normally functioning intestine.The disease can be chronic and manifest even after hemorrhoid treatment.

What is hemorrhoids

Hemorrhoids are called pathological expansion of hemorrhoidal veins, which is accompanied by inflammation, thrombosis, and the formation of nodes. Among the most common causes of the development of the disease are noted:

• Hypodynamics.
• Obesity (more details).
• Incorrect power supply (more details).
• Hereditary predisposition.
• Violation of blood circulation in the pelvic organs, etc.

As you can see, some of the predisposing factors are common to both diseases. With constipation, the patient is forced to push for a long time and hard to empty the intestines, which leads to an increase in intra-abdominal pressure. At the same time, hard and dense feces injure the rectal mucosa, which also contributes to the development of hemorrhoids. Often in the practice of a proctologist, there are cases when both diseases are simultaneously detected.In this case, before proceeding with the treatment of hemorrhoids, it is necessary to eliminate constipation, and for this it is necessary to normalize the diet and adjust the lifestyle. Additionally, the doctor may prescribe medication.

How to avoid constipation and hemorrhoids

Prevention of these diseases also has common features. First of all, you need to adjust your diet: it is necessary to exclude fatty, fried and smoked foods from it, as well as foods that have a fixing effect.The optimal amount of liquid that you need to drink every day is at least 1.5 liters of ordinary clean water. Do not forget about components such as fiber and foods that maintain intestinal motility at the proper level (dried fruits, kefir, fermented baked milk, fresh vegetables, cereals, etc.) Read more about the diet for hemorrhoids here.

The second important rule concerns physical activity. It is especially true for people who are busy with sedentary work. Every hour you need to take short breaks of 5-10 minutes, during which you need to do simple physical exercises or just walk on foot.Experts recommend keeping the whole body in good physical shape, which will reduce the risk of developing not only hemorrhoids and constipation, but also many other diseases.

It is equally important to choose the right laxatives and not to abuse drugs that can cause constipation. Any treatment, even the most harmless and simple, should be prescribed by a doctor and periodically controlled by the patient’s condition. It is imperative to consult a doctor in cases where symptoms such as discomfort, itching and burning in the rectum, the appearance of blood impurities in the feces, pain during bowel movements, etc. develop along with indigestion.In order to identify the cause of these manifestations, it is necessary to undergo an examination and only then start treatment. Uncontrolled intake of drugs can lead to the development of complications and deterioration in health.

90,000 Chronic constipation: from symptom to diagnosis and effective therapy. The algorithm of our actions | Livzan M.A., Osipenko M.F.

The article provides an algorithm for the diagnosis and treatment of chronic constipation

When visiting a therapist and gastroenterologist, patients often complain of constipation, a problem that many consider to be a very delicate one that significantly reduces the quality of life.
In 2011, experts from the International Association of Gastroenterologists approved recommendations (algorithm and cascades) for the management of patients with constipation syndrome [1]. According to the document, constipation is a violation of bowel function, manifested by an increase in the intervals between bowel movements compared to the individual norm or systematic insufficient bowel movement.
Let’s demonstrate how this algorithm works in practice.
Patient V., 35 years old, complaining of constipation.
STEP 1. It is important to clarify whether the patient’s subjective perception of constipation really meets the existing criteria for this suffering.
Subjective and objective definitions of functional constipation (Rome III) include the presence of at least 3 of the following criteria [2]:
A. Straining for at least 25% of bowel movements.
B. Rough or hard stools in at least 25% of bowel movements.
C. Feeling of incomplete evacuation in at least 25% of bowel movements.
D. Feeling of anorectal obstruction / blockage for at least 25% of bowel movements.
E. The need for manual techniques to relieve at least 25% of bowel movements (eg, finger evacuation, pelvic floor support).
F. Less than 3 bowel movements per week. Self-reliant stools rarely occur without the use of laxatives.
After clarifying questions, our patient specified complaints about a rare stool frequency – no more than 2 times a week, a change in its consistency (hard, “lumps”) and a feeling of anorectal obstruction.All this allows us to confirm the presence of constipation syndrome in our patient.
From the anamnesis: considers himself a patient for 10 years, when after pregnancy she began to notice first episodes of stool retention for 1-2 days, and then a change in its consistency. 3 years ago, in connection with this, she was examined on an outpatient basis, a colonoscopy was performed, no organic pathology was revealed. The therapist prescribed lactulose in a dose of 15 ml daily. However, due to the appearance of bloating and the absence of a rapid laxative effect, the patient began to independently cleanse the intestines with enemas, and later underwent 5 courses of colon hydrotherapy without a stable clinical effect.No cases of gastrointestinal tract pathology, including inflammatory bowel disease, colorectal cancer, polyposis, have been identified.
Works as a manager, work is associated with frequent business trips, psycho-emotional stress, low level of physical activity. Divorced. Regularly undergoes examinations in connection with medical examination. The last time was examined 1 month. back.
STEP 2. After a thorough examination of the history, it becomes clear that constipation is chronic. The incidence of constipation both in Russia and in the world is quite high.Thus, according to the latest population study MUZA [3], conducted in 2011 in Moscow, the prevalence of constipation classified in accordance with Rome III criteria is 16.5% among the adult population. The incidence of constipation consistently increases with age and among 18-24-year-olds it is 3.6%, 45-54-year-olds – 17.8%, and in patients over 65 years old it rises to 32.8%. Gender differences (women / men) in the incidence of constipation total 2.1 (in the group of persons 18-24 years old – 1.2, 25-34 years old – 2.4, 35-44 years old – 2.1, 45-54 years old – 3.2, 55-64 – 1.9, from 65 years and older – 2.7).
Chronic constipation can be associated with lifestyle, endocrine and metabolic disorders, neurological and psychogenic factors, gastroenterological diseases, pathology of the anorectal zone.
STEP 3. After identifying the symptom complex of chronic constipation, the most important goal of further examination is to identify the “symptoms of anxiety.” It is their presence / absence that determines the scope of the patient’s examination.
The “red flags” or “symptoms of anxiety” include: weight loss, fever, sudden onset of the disease after 50 years, the presence of malignant tumors of the gastrointestinal tract in relatives, intestinal bleeding, a positive test for occult blood in the stool, changes in the blood: anemia, leukocytosis, accelerated ESR.The presence of “anxiety symptoms” is an indication for detailed imaging examinations of the gastrointestinal tract, including colonoscopy. Colorectal cancer screening is also required for patients aged 50 and older due to the increased risk of colorectal cancer in this age group.
The patient’s objective status is as follows. The condition is satisfactory. The food is sufficient. Weight – 88 kg, height – 175 cm. The skin is pale pink, there are single ruby ​​spots.Thyroid gland 0 degree according to WHO. Vesicular breathing, no wheezing. Heart sounds are somewhat muffled at the apex, 66 / min. The abdomen is soft and painless on palpation. The liver is not enlarged. The spleen is not palpable.
In addition to the general clinical study, an examination of the perianal region with palpation of the rectum was carried out to identify perianal changes, prolapse of the rectum, prolapse of the perineum, as well as to exclude volumetric processes in the rectum and rectocele.
Careful collection of anamnesis, familiarity with previous studies, as well as an objective examination of the patient made it possible to establish the absence of “symptoms of anxiety” and pathology of the perianal region.
STEP 4. The next stage of the examination is to identify drugs that can cause constipation. Table 1 provides a list of drug groups that may have constipation as a side effect.
A survey of the patient made it possible to exclude the drug genesis of constipation.

STEP 5. Thus, the clinical analysis allows to establish the diagnosis: functional constipation (K 59.0).
STEP 6. Determination of the need for additional examination.
In case of detection of an organic disease that caused the “symptoms of anxiety”, further necessary examinations and treatment are carried out.
We found no organic causes of constipation or drug side effects in our patient. Her complaints meet the diagnostic criteria for functional pathology, so therapy can be prescribed without additional research.
STEP 7. The next critical step is the selection of treatment, taking into account the characteristics of the lifestyle, identification of factors associated with an increased risk of constipation, as well as previous treatment experience.
In the treatment of patients with constipation syndrome, the basis of therapy is the correction of lifestyle and nutrition (non-drug methods of therapy). When choosing medications, drugs with a low risk of drug interactions and a reliable predictable effect should be used.
Non-drug therapy. The patient’s dietary habits were analyzed. We tried to convince the patient to form a habit of regular bowel movements and to activate physical activity. In the diet of a patient suffering from constipation, foods with a high content of vegetable fiber should prevail: vegetables, fruits, cereals, muesli, wholemeal bread, prunes, dried apricots, figs. The use of rice, semolina, chocolate, baked goods, confectionery and pasta should be limited. It is recommended to increase the drinking regime up to 1.5-2 l / day, and in the choice of drinks give preference to mineral water, juices (carrot, peach, apricot, plum, pumpkin) and fermented milk products.It is advisable to refuse from cocoa, black strong tea and sugary carbonated drinks or significantly limit their use.
In addition, the patient was discussed with her daily routine and habits of defecation. The patient is focused on recognizing the urge to defecate and providing the conditions for its implementation; she is advised to resort to straining only when the urge to defecate. It is necessary to increase physical activity, perform physical exercises to strengthen the muscles of the anterior abdominal wall and pelvic floor.
Non-pharmacological methods of therapy include biofeedback, aimed at developing and maintaining effective straining when urging to defecate, which we had in mind, but have not yet recommended for this patient.
Next, we tried to find the optimal laxatives. What do we have in our arsenal (in terms of evidence-based medicine) [5]?
1. Laxatives containing dietary fiber – organic polymers that retain water in the intestinal contents.Drugs in this group have been shown to promote less hard stools (grade B).
2. Osmotic laxatives. Contains poorly absorbed ions or molecules that increase the osmotic gradient: lactulose, polyethylene glycol, magnesia hydroxide. Lactulose and polyethylene glycol increase stool frequency and improve stool consistency in patients with chronic constipation (recommendation grade A).
3. Enterokinetics. To date, the only drug of this class is available in Russia – prucaloprid.The drug is a full agonist of type 4 serotonergic receptors (5HT4) and does not interact with other types of receptors at usual therapeutic dosages.
4. Activators of chloride channels. Lubiprostone is a type 2 chloride channel activator, enhances intestinal secretion without changing the concentration of electrolytes in serum, accelerates the passage of intestinal contents.
5. Stimulant laxatives. Stimulant laxatives are among the most effective (recommendation level B) for normalizing stools in the shortest possible time.The safety of different representatives of this group is not the same. So, some laxatives of this group (primarily senna preparations) have, in addition, a pronounced dose-dependent effect and, with prolonged use in increasing doses, can lead to severe laxative disease, melanosis of the colon mucosa. Perhaps the most complete evidence base has been accumulated in relation to the drug Dulcolax® (bisacodyl). Since 1959, more than 100 clinical studies have been conducted that have proven the efficacy and safety of the drug, and the list of evidence is growing.Thus, as a result of a multicenter 4-week, double-blind, randomized, placebo-controlled study of the treatment of patients with chronic constipation, the efficacy and safety of Dulcolax was demonstrated by restoring regular urge and emptying the bowel, while the average effect was maintained for at least 4 weeks. [6].
In a systematic review published in 2011 [7], the authors assessed the effectiveness of long-term (at least 1 week) use of laxatives for the treatment of chronic constipation.Of the 11,077 studies, only those that met all the requirements of evidence-based medicine were selected. As a result of the dropout, 21 studies were included in the systematic review and meta-analysis evaluating the efficacy and safety of both well-known laxatives (polyethylene glycol, lactulose, sodium picosulfate, bisacodyl) and new ones introduced to the pharmaceutical market in the last decade: the serotonin receptor agonist 4- type II (5-HT4) prucalopride, the chloride channel activator lubiprostone and the intestinal guanylate cyclase agonist linaclotide.The lack of an assessment of the efficacy of senna preparations for chronic constipation deserves attention, since there are no controlled randomized trials with a sufficient sample size to assess the effectiveness of these drugs, and there is also no sufficient evidence to recognize the safety of long-term use of senna preparations (the safety profile is classified by the FDA [8] category III ). Traditional laxatives (polyethylene glycol, lactulose, sodium picosulfate, bisacodyl – 7 studies, 1411 patients, RR = 0.52; 95% CI from 0.46 to 0.60), prucaloprid (7 studies, 2639 patients, RR = 0, 82; 95% CI 0.76 to 0.88), lubiprostone (3 studies, 610 patients, RR = 0.67; 95% CI 0.56 to 0.80), and linaclotide (3 studies, 1582 patients, RR = 0.84; 95% CI 0.80 to 0.87) were superior to placebo in efficacy, while evidence for the efficacy of lactulose versus placebo was limited.149 (37.6%) of 396 patients who were prescribed osmotic laxatives did not respond to therapy, compared with 193 (68.9%) of 280 patients who were assigned to placebo (RR = 0.50 ; 95% CI 0.39 to 0.63). Both trials of stimulant laxatives, involving 735 patients, confirmed the efficacy of picosulfate and bisacodyl. 202 (42.1%) of 480 patients randomized to stimulant laxatives did not respond to therapy, compared with 199 (78.0%) of 255 patients who received placebo (RR = 0.54; 95% CI 0.42 to 0.69).The study demonstrated not only the high clinical efficacy of picosulfate and bisacodyl in relieving constipation symptoms, but also a favorable safety and tolerability profile of therapy with stimulant laxatives, both according to doctors and the patients themselves. Only 3 randomized clinical trials provided data evaluating individual symptoms of chronic constipation. In 2 studies involving 118 patients, data on straining during bowel movements were available, and data on stool hardness during treatment were presented in 3 studies in which 269 patients participated.The relative risk of persistence of symptoms in both studies was significantly reduced with laxatives (0.37; 95% CI 0.19 to 0.71 and 0.26; 95% CI 0.16 to 0.44 respectively). The average number of bowel movements per week was significantly higher with laxatives than with placebo. It was found that such a beneficial effect is observed when taking both osmotic and stimulant laxatives.
Our patient was recommended a set of non-drug measures (lifestyle modification and dietary habits), and also prescribed a course of stimulating laxative Guttalax® at a dose of 15 drops in the evening for 14 days and macrogol – 1 sachet 2 r./ day with water and after meals for up to 1 month.
STEP 8. Evaluation of the effectiveness of therapy and making adjustments if necessary.
After 2 weeks. the patient noted a good effect of therapy. Taking into account the adjustments that she made to her lifestyle and diet, it was decided to abandon the constant intake of laxatives; if defecation is delayed (less than 3 times a week) or the appearance of other symptoms of constipation, especially associated with business trips, periodically use Guttalax®.
If the problem reoccurs, you need to seek advice again.
This clinical example makes it possible to demonstrate the application of international and Russian recommendations for the examination and treatment of patients with constipation syndrome, as well as to illustrate the effectiveness of complex drug therapy with the use of stimulant laxatives.

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Stool tests for constipation

Stool analyzes for constipation are mandatory laboratory tests.They should be taken by anyone who is faced with the problem of difficult bowel movement. This study allows you to identify inflammatory processes and determine the presence of pathogenic intestinal microflora.

Constipation is quite common. They are especially common among residents of megacities, often becoming chronic. Various factors can provoke constipation:

• unhealthy diet – in particular, a low-fiber diet,
• sedentary lifestyle,
• hormonal changes during menstruation, during pregnancy and lactation,
• spinal injury,
• pelvic floor dysfunction,
• taking certain medications – antihistamines, diuretics, antihypertensive drugs, calcium preparations,
• poisoning by toxic substances,
• prolonged depression,
• a number of diseases – hypothyroidism, scleroderma, Parkinson’s disease, hemorrhoids, multiple sclerosis and others.

Constipation characteristics:

• chair in the form of small dense lumps,
• bowel movements less than three times a week,
• the need for strong straining during bowel movements.

If constipation recurs regularly and becomes chronic, it is necessary to undergo a comprehensive examination to establish the cause of the stool retention. First of all, you need to pass feces tests:

• for helminth eggs – for the diagnosis of helminthiasis,
• for occult blood – allows you to identify inflammatory processes in the intestines,
• bacteriological – to assess the characteristics of the intestinal microflora.

Stool tests for constipation play an important role in identifying all types of disorders. Based on the results, the doctor will make the correct diagnosis and offer effective treatment.

Diagnosis in case of stool disorders in Litekh

The Litekh laboratory network specializes in the diagnosis of diseases and pathological conditions. We offer a large number of research profiles. To assess the functions of the intestines with constipation, the coprogram is not enough – it is additionally recommended to take a blood test:

• general clinical – shows if there is anemia and inflammation,
• for sugar – to exclude diabetes mellitus.

To find out if you have a predisposition to hereditary diseases of the gastrointestinal tract, order a genetic health passport – male or female. You will receive the document and the conclusion of the geneticist in 28 working days.

For a quick and easy appointment, use the online registry. This is also a great way to save money – patients who sign up through the form on the site receive a 5% discount on services. Check the details by calling the nearest Litekh offices.

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90,000 15 ways to help yourself with constipation without medication

Today I would like to talk to you on a rather intimate topic – constipation. It is not customary to discuss this problem in a wide circle, but almost everyone faces it, and many – on a regular basis (with chronic constipation). Not only does constipation itself cause discomfort in the abdomen, heaviness, bloating and sometimes increased gas formation and decreased appetite, but it also disrupts the usual way of life and makes a person worry about this.

How regularly we go to the toilet affects not only the health of the intestines and our emotional background, but also the health of the blood – if toxins are not removed from the body in a timely manner, they enter the bloodstream and are then carried throughout the body. Therefore, the quality of blood affects almost everything: the health of joints, skin, hair, immunity, and so on.

If constipation occurs frequently, and nothing is done about it, then they can go into a chronic stage. In modern Western medicine , chronic constipation is diagnosed if bowel movements occur less often than once every three days, while in a quarter of cases you have to make a lot of effort, and the sensation of complete emptying does not remain, and the stool itself is dry, hard, small solid fractions …Ideally, emptying should occur once or twice every day. To understand how we can help ourselves if we rarely have this, let’s first look at what are the main causes of constipation.

Causes of constipation

There are many reasons for constipation. Most often, this topic worries women due to a certain physiological structure and hormonal background (for example, constipation often occurs before menstruation, during pregnancy, after childbirth, and is often aggravated with age), as well as people with an unbalanced diet and everyone who travels a lot or nervous.

Often, on the day of travel or after it, constipation occurs. This can be attributed to the loss of fluid: airports and aircraft tend to have very dry conditioned air; in addition, we try to drink less so that we do not have to run unscheduled around the airport and look for a toilet, and on the plane we do not always have the opportunity to retire.

Another possible reason is that our usual schedule of gets confused: a very early rise or a night flight, a long road, sitting motionless for many hours in an airplane or car seat, tiring queuing, lack of breakfast and, in general, our usual food. Eating sandwiches and dry snacks instead of a full meal, coupled with dehydration, does not contribute to good digestion in any way.

Often we ourselves block the signals of our body about the need to visit the toilet, because, in our opinion, now is not the time. Our gut knows our schedule like no one else and at normal times works like a clock, adjusting to our lifestyle. But on trips, everything is different: unusual activity at an unusual time or, conversely, its absence, change of time zones – all this affects the work of the intestines, which is very sensitive to such changes.

Stress can also cause constipation (or vice versa, diarrhea – whoever is “lucky”, everyone has a different response).When we are nervous, our sympathetic nervous system is activated, which is responsible for the fight / flight reactions, and digestion and everything related to it fade into the background as less vital functions. Blood flows from the intestines to the periphery (head, arms and legs), so that we can think well in case of danger, give back or gurgle. Although in modern life our stress is often not associated with immediate danger, the reactions of our bodies have remained similar to those of ancient people. At such times, some of us also experience constipation, which can last up to several days.

Boiled beetroot is a good source of soft fiber // Thanks for the photo Natalia Fogarty from Unsplash.com

Another reason for gas and constipation can be a large amount of fermentable carbohydrates in food. These are the carbohydrates that are fermented by intestinal bacteria. If the body is healthy, then, as a rule, there is nothing wrong with it (and this is even good, since our bacteria get food in this way). However, this can become a problem if an unfriendly flora is involved in the process, which provokes colic, severe bloating, unpleasant gas and impairs the absorption of nutrients by the intestinal walls.

Quite often, such hyperfermentation is caused by fructose (fruit, honey), yeast (for example, butter white bread), products containing inulin (a type of soluble fiber consisting of fructose residues found in Jerusalem artichoke, onion, garlic, also used as an additive in finished products) or fermentation products (for example, wine), as well as cabbage and legumes. Many people have reactions to at least some of these foods.

In addition, many medications have side effects in the form of constipation.This is worth remembering if you have a tendency to constipation, and it is worth taking measures to prevent it if you have been prescribed medications with similar effects. Poorly functioning kidneys that drain water too quickly can also trigger constipation, as can some allergies. Also, the causes of constipation can be tumors in the intestines or the postoperative period, but in this case we cannot do without medical help and we do not consider such reasons in this article.

Thus, we see that the main causes of constipation are associated with malnutrition (we eat foods that are unsuitable or new for us or in an unsuitable combination for us, drink little liquid (less than 2.5 liters per day) or with disorders of the psycho-emotional background or lifestyle (we experience stress, limited mobility due to a trip or due to illness, we eat at the wrong time, etc.)etc.). Based on this, you can help yourself by eliminating these reasons or reducing their impact. To do this, you need to add foods or rituals with the opposite effect to your diet or daily routine.

How to Help: Nutrition

If you understand that in your case, the wrong diet is most likely to blame (and this is the most common cause of ), then you can take the following steps to improve the situation:

1. Avoid foods that cause bloating for a while. .This, as a rule, cabbage of all kinds, fructose (fresh fruits, honey, other sweet), legumes (beans, peas, lentils, chickpeas, etc.), foods with yeast, other foods to which you have noticed a reaction bloating. The same goes for insoluble fiber – especially in the evening when digestion becomes weaker. You can return it when the problem is resolved.
2. Avoid cold foods : drinks straight from the refrigerator or with ice, ice cream, etc. We need to improve blood flow around the intestines, and the cold narrows the blood vessels.
3. For the time being, skip raw salads , especially in the afternoon. They are harder to digest than cooked vegetables, and we need to make digestion easier.
4. Eliminate (at least temporarily) caffeine and alcohol : they irritate the gastrointestinal tract and damage its mucous membrane, and we don’t need it at all now. In addition, there are studies that prove that caffeine provokes increased peristalsis in the intestines, first making it easier for us to go to the toilet (which is why many people like to drink coffee in the morning ), and over time, causing addiction to the nerve cells of the intestine and provoking a reverse reaction – constipation …
5. Reduce your intake of salt and salty foods , as salt contributes to dehydration, and during constipation, the intestines are already very lacking in water. The same applies to dry foods such as nuts, seeds, crackers, crisps, croutons, chips (even healthy), and some dried fruits. They dehydrate the intestines even more. Exception: prunes are a well-known remedy for constipation, which, on the contrary, attracts water molecules. In any case, it is better to pre-soak all dried fruits and nuts and some seeds so that they do not dry us out from the inside.
6. Drink enough liquid (if you usually don’t drink enough), because if we don’t drink enough, the intestines try to draw in all the water from the food lump, making it even drier and making it more difficult to move to the exit. It is optimal to drink 2.5 liters a day: it is better if it is still unsweetened warm water, herbal tea, unsweetened vegetable juices, soups. Tea with ginger normalizes the work of the digestive tract very well (if there is no severe inflammation in the digestive tract).
7. Temporarily switch to gentle diet : no hard-to-digest foods (especially in the afternoon), with one type of protein per meal, plenty of warm soups, vegetable stews, broths, smoothies.
8. To help your digestion, you can drink a glass of warm water with lemon juice about half an hour before meals. This drink works great in the morning, starting up the digestive tract and helping further bowel movements. I especially recommend it to those who have started their morning with a cup of coffee before, so that they can go to the toilet normally afterwards.

Lemon and ginger will help improve the digestive tract // Thanks for the photo of Dominik Martin from Unsplash.com

At first, the effect will be weaker than that of coffee, but after one or two weeks the body will rebuild and the process will go much easier, and most importantly, there will be no unnecessary irritation of the intestinal walls, as is the case with caffeine.The amount of lemon juice (or lime – which one likes more) can be varied to your taste: start with a few drops, then look at your reaction – this will be enough for someone, but someone will want to add more, up to half a lemon per glass water. Lemon and lime can be substituted with quality apple cider vinegar (just a few drops per 200 ml). People with gastritis with high acidity or stomach ulcers should be more careful with this drink.

9. Probiotics may also be helpful if your gut is dominated by an unfriendly microflora.And do not forget about prebiotics – a useful food for our bacteria (more about prebiotics and probiotics – here ). Choose foods with soluble fiber that have been mildly cooked or thoroughly ground (like in a smoothie). We temporarily excluded cabbage, but you can try to eat one or two tablespoons of sauerkraut – it is already partially fermented and is easier to digest than other types, moreover, it contains the lactobacilli we need.

10.Some spices help fight bloating: fennel, coriander, cumin (cumin), ginger mentioned above. You can brew them as tea, pitch the seeds in a mortar or coffee grinder beforehand, and peel and grind the ginger (in a proportion of ½ teaspoon of different seeds + 1 cm of ginger root per glass of water), let it brew for 15-30 minutes and drink during breakfast or lunch.

How to help: habits, rituals, lifestyle

Sometimes dietary changes alone are not enough. This may be the case if the constipation is caused by stress, improper habits, intense physical exertion or forced restriction of movement.What can we do in this case:

1. If the reason is stress, then you need to try to relieve this stress. To do this, you need to use the parasympathetic nervous system . Any relaxation technique you usually find yourself saving will do. For example, self-massage of the abdominal area to improve motility with sesame or coconut oil, to which you can add a few drops of peppermint oil, sweet orange, cinnamon, rose and other oils that have a relaxing effect.

Many yoga asanas help with constipation. stomach. Walking outdoors before bed can also help relieve unpleasant thoughts and anxiety. A few minutes of meditation or deep abdominal breathing also work well on the parasympathetic.

2. Increasing physical activity will help if before that you had a period of limited movement (for example, you were sick and had to lie in bed for several days, or traveled by plane or car, having spent many hours sitting in a chair).You can go jogging, yoga or Pilates.

If you practice yoga, then it contains a lot of asanas to improve peristalsis and to combat constipation. Asanas with a turn of the body (for example, Parivrita Parshvakonasana – an inverted pose of a stretched side; Jathara Parivartanasana), bending and stretching (for example, Dog facing down – Adho Mukha Svanasana, Ardha Chandrasana – a crescent pose, Janu Shirshasana type I twisting) , Marichiasana), asanas with pressing the knees to the stomach (such as the child’s pose), the garland pose (Malasana), backbends, for example, the locust pose (Shalabhasana), Dhanurasana, Ushtrasana, etc.d.

3. It is very important to give the previous meal to digest – this means, eat when you are really hungry, and not “when it’s time” or for a company, do not bite, try to maintain a break in food for at least 3 hours. Also, you need to chew thoroughly food, because poorly chewed food, even the most useful one, will fall into the stomach in a heavy lump and then it will take a long time to digest it, and there is a high probability that it will go further into the small and large intestines with such an undivided lump.It is best to eat without distraction, without talking at the moment when you are chewing something, in a calm place, focusing on the taste, color, smell of food, and not on thoughts about work or business.

4. Some people have a problem called by Julia Enders in her book Charming Bowels the not my toilet syndrome. People suffering from this syndrome simply cannot relax in someone else’s toilet (whether at a party, in the office, in a cafe or on a trip) and endure as much as they can, resorting to someone else’s toilet only as a last resort, but even then they may fail.You will have to work with yourself in this regard, “allowing” yourself to go to the toilet when you need it. Otherwise, over time, this can lead to a decrease in the reflex of the rectum to stretch and the mismatch of muscles and nerves in our intestines and brain, and as a result, there is no trace of their well-coordinated work, and we may experience chronic constipation, which is much more difficult to deal with.

It is especially important to teach your children not to be shy and ask to use the toilet in kindergarten or school. If you nevertheless decide to visit someone else’s toilet, but “it doesn’t work,” you can try to create more physiological conditions for emptying your bowels by tucking your knees slightly to your chest (for example, squatting down for a while, or putting a small bench under your feet) or , as Julia Anders recommends: try sitting on the toilet, tilt your body to your feet, then straighten back and tilt again, and so on several times – this exercise often helps.

5. If digestive problems such as constipation bother you on a regular basis, it makes sense to at least keep a food diary (write down everything you eat, how it was prepared, your feelings before and after meals for several days ) and analyze it independently or with a specialist (nutritionist, nutritionist). Also, with a specialist, you can go through the 4R program or the elimination nutrition protocol , which excludes some products, in order to track the individual reactions of your body and comprehensively establish the work of the digestive tract.

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90,000 Constipation in pregnant women – what to do? Consults an obstetrician-gynecologist: articles of the medical center Oxford Medical Ivano-Frankivsk

Deba Victoria Tarasovna – obstetrician-gynecologist of the medical center Oxford Medical.

Pregnancy is a special condition during which a woman requires attention, care and safety. When you carry a separate life under your heart, you feel a special responsibility, you try to pay more attention to your health, you create optimal conditions for your environment. This condition is difficult to describe in words, therefore, I think that every pregnant woman will simply understand me.

Unfortunately, during pregnancy, our body also throws out not very pleasant things: toxicosis, edema, mood swings.Did you know that constipation is the most common problem during pregnancy?

Why does constipation occur in pregnant women?

Normally, bowel movements should be 1 time per day. According to statistics, eight out of ten women go to the doctor with complaints of constipation. So what is the connection between pregnancy and constipation tendency?

It so happened that anatomically, the uterus and intestines in women have a common innervation. Accordingly, during pregnancy, the woman’s body mobilizes all forces so that the uterus is relaxed.And next to the uterus, the intestines relax. This process is activated by the pregnancy hormone progesterone.

Therefore, a pregnant woman can, at best, go to a chair once every 1-2 weeks. Of course, this is accompanied by discomfort, flatulence, and abdominal pain. This process is also facilitated by a decrease in physical activity, a decrease in water consumption due to the fear of edema, and compression of the intestines by the uterus.

It is worth noting that taking certain medications, such as iron and calcium supplements, which are recommended for pregnant women, also cause constipation.

What can complicate constipation?

As stool stagnates in the intestine, it becomes hard due to the constant absorption of fluid in the large intestine. The exit of solid feces from the rectum is accompanied by constant attempts in a woman, and this very soon can lead to the appearance of hemorrhoids. Also, hard feces irritate the walls of the anus, which creates the risk of anal fissures.

Nutrition Tips for Pregnant Women

In order to eliminate the problem of constipation and prevent complications, it is worth reviewing your diet and making certain adjustments.Let’s start with drinking water: you should consume at least 1.5 liters of water. If such an amount causes swelling, it is worth consulting with a leading obstetrician-gynecologist to eliminate this problem.

In the future, completely eliminate during pregnancy such products as:

• chocolate; 90,030 90,029 mushrooms;
• legumes; 90,030 90,029 sweets;
• strong tea and strong coffee;
• hard cheeses;
• smoked sausages;
• spices;
• animal fats;
• white bread, etc.

It is easy to understand that everyone who sees this list will at least want to cry, because how can you refuse this yummy? And we will provide options for wonderful alternatives that will be both tasty and healthy for a pregnant woman:

• fiber-rich foods: greens, apples (raw and baked), green beans, whole grain bread;
• baked pumpkin, pumpkin cream soup;
• dried fruits;
• as sweet fruits: kiwi, bananas;
• fermented milk products (preferably in the first and second trimester, not recommended in the third)
• boiled rabbit, chicken;
• The mandatory ratio of meat to vegetables is 1: 2 (zucchini, broccoli, carrots, cucumbers, etc.