Treatment for Constipation

How do doctors treat constipation?

Treatment for constipation depends on

  • what’s causing your constipation
  • how bad your constipation is
  • how long you’ve been constipated

Treatment for constipation may include the following:

Changes in eating, diet, and nutrition

Changes in your eating, diet, and nutrition can treat constipation. These changes include

  • drinking liquids throughout the day. A health care professional can recommend how much and what kind of liquids you should drink.
  • eating more fruits and vegetables.
  • eating more fiber.

Read about what you should eat to help prevent and relieve constipation and foods to avoid if you are constipated.

Exercise and lifestyle changes

Exercising every day may help prevent and relieve constipation.

You can also try to have a bowel movement at the same time each day. Picking a specific time of day may help you have a bowel movement regularly. For example, some people find that trying to have a bowel movement 15 to 45 minutes after breakfast helps them have a bowel movement. Eating helps your colon move stool. Make sure you give yourself enough time to have a bowel movement. You should also use the bathroom as soon as you feel the urge to have a bowel movement.

Two people walking for exercise.

Over-the-counter medicines

Your doctor may suggest using a laxative for a short time if you’re doing all the right things and are still constipated. Your doctor will tell you what type of laxative is best for you. Over-the-counter laxatives come in many forms, including liquid, tablet, capsule, powder, and granules.

If you’re taking an over-the-counter or prescription medicine or supplement that can cause constipation, your doctor may suggest you stop taking it or switch to a different one.

Bulk-forming agents. Bulk-forming agents absorb fluid in your intestines, making your stool bulkier. Bulkier stool helps trigger the bowel to contract and push stool out. Be sure to take bulk-forming agents with water or they can cause an obstruction or a blockage in your bowel. They can also cause bloating and pain in your abdomen. Brand names include

Osmotic agents. Osmotic agents help stool retain fluid. Stools with more fluid increase your number of bowel movements and soften stool. Older adults and people with heart or kidney failure should be careful when taking osmotic agents. They can cause dehydration or a mineral imbalance. Brand names include

Stool softeners. Stool softeners help mix fluid into stools to soften them. Doctors recommend stool softeners for people who should avoid straining while having a bowel movement. Doctors often recommend stool softeners after surgery or for women after childbirth. Brand names include

Lubricants. Lubricants work by coating the surface of stool, which helps the stool hold in fluid and pass more easily. Lubricants are simple, inexpensive laxatives. Doctors may recommend lubricants for people with anorectal blockage. Brand names include

  • Fleet
  • Zymenol

If these laxatives don’t work for you, your doctor may recommend other types of laxatives, including

Stimulants. Stimulant laxatives cause the intestines to contract, which moves stool. You should only use stimulants if your constipation is severe or other treatments have not worked. Brand names include

People should not use stimulant laxatives containing phenolphthalein. Phenolphthalein may increase your chances of cancer. Most laxatives sold in the United States do not contain phenolphthalein. Make sure to check the ingredients on the medicine’s package or bottle.

If you’ve been taking laxatives for a long time and can’t have a bowel movement without taking a laxative, talk with your doctor about how you can slowly stop using them. If you stop taking laxatives, over time, your colon should start moving stool normally.

Prescription medicines

If over-the-counter medicines do not relieve your symptoms, your doctor may prescribe one of the following medicines:

Chloride channel activator. If you have irritable bowel syndrome (IBS) with long-lasting or idiopathic—meaning the cause is not known—constipation, your doctor may prescribe lubiprostone (Amitiza). Lubiprostone is a chloride channel activator available with a prescription. Research has shown lubiprostone to be safe when used for 6 to 12 months. This type of medicine increases fluid in your GI tract, which helps to

  • reduce pain or discomfort in your abdomen
  • make your stool softer
  • reduce your need to strain when having a bowel movement
  • increase how often you have bowel movements

Guanylate cyclase-C agonist. If you have IBS with long-lasting or idiopathic constipation, your doctor may prescribe linaclotide (Linzess) to help make your bowel movements regular. Linaclotide is a guanylate cyclase-C agonist that eases pain in your abdomen and speeds up how often you have bowel movements.

Biofeedback

If you have problems with the muscles that control bowel movements, your doctor may recommend biofeedback to retrain your muscles. Biofeedback uses special sensors to measure bodily functions. A video monitor shows the measurements as line graphs, and sounds from the equipment tell you when you’re using the correct muscles. By watching the monitor and listening to the sounds, you learn how to change the muscle function. Practicing at home can improve muscle function. You may have to practice for 3 months before you get all the benefit from the training.

Surgery

You may need surgery to treat an anorectal blockage caused by rectal prolapse if other treatments don’t work. You may need surgery to remove your colon if your colon muscles don’t work correctly. Your doctor can tell you about the benefits and risks of surgery.

How do doctors treat complications of constipation?

Doctors can treat or tell you how to treat complications of constipation. Hemorrhoids, anal fissures, rectal prolapse, and fecal impaction all have different treatments.

Hemorrhoids

You can treat hemorrhoids at home by

  • making dietary changes to prevent constipation
  • taking warm tub baths
  • applying over-the-counter hemorrhoid cream to the area or using suppositories—a medicine you insert into your rectum—before bedtime

Talk with your doctor about hemorrhoids that do not respond to at-home treatments.

Anal fissures

You can treat anal fissures at home by

  • making changes in your diet to prevent constipation
  • applying over-the-counter hemorrhoid cream to numb the area or relax your muscles
  • using stool softeners
  • taking warm tub baths

Your doctor may recommend surgery to treat anal fissures that don’t heal with at-home treatments.

Rectal prolapse

Your doctor may be able to treat your rectal prolapse in his or her office by manually pushing the rectum back through your anus. If you have a severe or chronic—long-lasting—rectal prolapse, you may need surgery. The surgery will strengthen and tighten your anal sphincter muscle and repair the prolapsed lining. You can help prevent rectal prolapse caused by constipation by not straining during a bowel movement.

Fecal impaction

You can soften a fecal impaction with mineral oil that you take by mouth or through an enema. After softening the impaction, a health care professional may break up and remove part of the hardened stool by inserting one or two gloved, lubricated fingers into your anus.

November 2014
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