Managing Constipation

This information describes the signs and causes of constipation. It also describes ways to prevent and treat constipation.

About constipation

Constipation is a common problem that makes it hard to have bowel movements (poop).

Your bowel movements or stool (poop) might be:

• Too hard.
• Too small.
• Hard to get out.
• Happening fewer than 3 times a week.

If you’re having any of these signs, you might be constipated.

Causes of constipation

Constipation can be caused by many things, including:

• Medicines, such as:
  • Pain medicine.
  • Chemotherapy (chemo).
  • Antiemetics (medicine to control nausea).
  • Antidepressants (medicine to help manage depression).
  • Anticonvulsants (medicine to prevent seizures).
  • Blood pressure medicine.
  • Antihistamines (allergy medicine).
  • Antacids, such as Tums® or Rolaids®.
  • Dietary supplements (vitamins), such as iron and calcium.
• Medical conditions, such as:
  • Diabetes.
  • Depression.
  • Parkinson’s disease.
  • Hypothyroidism (a condition in which your thyroid gland doesn’t produce enough hormones).
  • Hypercalcemia (too much calcium in your blood).
  • Spinal cord compression (pressure on your spinal cord from a tumor or injury).
  • Intestinal obstruction (a blockage in your intestines).
• Other things, such as:
  • Ignoring the urge to have a bowel movement.
  • Not having enough time or privacy to have a bowel movement.
  • Inactivity, such as not moving around or walking enough.
  • Not drinking enough liquids.
  • Not eating enough fiber.
  • Old age.

Lifestyle changes to prevent and treat constipation

Try these lifestyle changes to prevent and treat constipation.

• Go to the bathroom at the same time every day. Your body will get used to going at that time. But if you feel like you need to go, don’t put it off.
• Try to use the bathroom 5 to 15 minutes after meals. After breakfast is a good time to go. That’s when the reflexes in your colon are strongest.
• Exercise, if you can. Walking is a great type of exercise that can help prevent and manage constipation. Exercise helps your body move food through your large intestines (colon), which can make it easier to have a bowel movement.
• Drink 8 to 10 (8-ounce) cups (2 liters) of liquids daily, if you can. Choose water, juices (such as prune juice), soups, and milkshakes. Limit liquids with caffeine, such as coffee and soda. Caffeine can pull fluid out of your body.
• Slowly increase the fiber in your diet to 25 to 35 grams per day. If you have an ostomy or recently had bowel surgery, ask your healthcare provider before changing your diet. Foods high in fiber include:
  • Bran
  • Whole-grain cereals and bread
  • Unpeeled fruits and vegetables
  • Mixed green salads
  • Apricots, figs, and raisins
  • Nuts and beans

Read A Guide to High Fiber Foods to learn more about the amount of fiber found in many foods.

Medicines for constipation

You can also use medicines to treat constipation and help you have a bowel movement. Both over-the-counter medicines (medicines you get without a prescription) and prescription medicines are available to treat constipation. It’s important to talk with your healthcare provider about which medicines are right for you before taking any over-the-counter medicines.

Laxatives are medicines that help you have a bowel movement in different ways. Below is a list of some common over-the-counter laxatives.

Start by taking 1 of these medicines after talking about it with your healthcare provider.

Common over-the-counter laxatives

Stool softeners

Stool softeners, such as docusate sodium (Colace^®), increase the amount of water in your stool, making it softer and easier to pass. They also cause few side effects. Take stool softeners as often as instructed by your healthcare provider. Do not take any stool softeners while taking mineral oil.

Osmotic laxatives

Osmotic laxatives, such as polyethylene glycol (MiraLAX^®), use water in your body to soften your stool and ease it through your colon so you can have a bowel movement. Side effects are not common, but osmotic laxatives may cause nausea (feeling like you’re going to throw up), bloating, and gas.

Stimulant laxatives

Stimulant laxatives, such as senna (Senokot^®), make you have a bowel movement by speeding up muscle movement in your colon. Stimulant laxatives may cause cramping. They’re best to take at bedtime.

Bulk-forming laxatives

Bulk-forming laxatives, such as psyllium (Metamucil^®, Fiberall^®, Perdiem^®), make a more liquid-like stool that’s softer and easier to pass. Other types include polycarbophil (Fibercon^®) and methylcellulose (Citrucel^®). You should take these with 8 ounces of liquid, such as water. Bulk-forming laxatives may cause bloating and gas.

• Talk with your healthcare provider before using bulk-forming laxatives if you:
  • Can’t get out of bed.
  • Can only have a small amount of liquids every day.
  • Have strictures (sections in your intestine that are narrower than others) or a partial blockage in your intestine.
  • Are constipated because of pain medicine.

Suppositories and enemas

• Do not use suppositories unless your healthcare provider tells you to. A suppository is a medicine you put in your anus.
• Do not use enemas unless your healthcare provider tells you to. An enema is when liquid is put into your rectum (the bottom of your colon) through your anus to cause a bowel movement.

Follow the instructions on the label or given by your healthcare provider when taking any of these medicines.

If these medicines don’t help, talk with your healthcare provider. They may change the medicine, suggest other medicines, or recommend prescription medicine.

When to call your healthcare provider

Call your healthcare provider if:

• You have not had a bowel movement for 3 days.
• You have diarrhea (loose or watery bowel movements) after taking any of the medicines listed above. Do not take any medicine to manage your diarrhea without talking to your healthcare provider first.
• You have any questions or concerns.