How to manage constipation

Treatment for constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through the colon. Also, your health care professional may change the medicines you take if they may be causing or worsening constipation. If those changes don't help, other treatments may be necessary. 

Source: www.mayoclinic.org

Eat a high-fiber diet.

Fiber adds bulk to stool and helps the stool hold fluids. These factors give stool the right shape and weight to move through the colon. Fiber-rich foods include fruits, vegetables, beans, and whole-grain bread, cereal and rice. Increase dietary fiber slowly to prevent bloating and gas. The Dietary Guidelines for Americans recommend 25 to 34 grams of fiber a day depending on recommended daily calories. 

Drink plenty of water.

Drink water and beverages without caffeine. This keeps stools soft and prevents bloating and gas that can happen with increased dietary fiber. 

Exercise most days of the week.

Regular physical activity helps improve the movement of stool through the colon. Try to exercise most days of the week. If you do not already exercise, talk with your health care professional about safe ways to start. 

Use good bowel habits.

Don't avoid the urge to pass stool. Keep a schedule for passing stool. For example, try to pass stool 15 to 45 minutes after a meal because digestion helps move stool through the colon. 

Prunes, also called dried plums, have long been used to treat or prevent constipation. Prunes are a good source of fiber, but they also have naturally present agents that draw fluids into the colon. 

Source: www.mayoclinic.org

Laxatives are medicines that help move stool through the colon. Each laxative works somewhat differently. The following are available without prescriptions: 

Fiber supplements.

Fiber supplements help stool retain fluids. The stool is then softer and easier to pass. Fiber supplements include psyllium (Metamucil, Konsyl, others), calcium polycarbophil (FiberCon, Equalactin, others) and methylcellulose (Citrucel). 

Osmotics.

Osmotic laxatives help stool move through the colon by increasing the amount of fluids released into the intestine. Examples include oral magnesium hydroxide (Phillips' Milk of Magnesia, Dulcolax Liquid, others), magnesium citrate, lactulose (Generlac) and polyethylene glycol (Miralax). 

Stimulants.

Stimulants cause the walls of the intestine to tighten, forcing the movement of stool. These include bisacodyl (Correctol, Dulcolax Laxative, others) and sennosides (Senokot, Ex-Lax, Perdiem). 

Lubricants.

Lubricants such as mineral oil enable stool to move through the colon more easily. 

Stool softeners.

Stool softeners such as docusate sodium (Colace) and docusate calcium allow more fluids to be drawn into the stool. 

Source: www.mayoclinic.org

 An enema is a fluid gently pumped into the rectum to help pass stool. An enema may be used when other treatments don't work. Your health care professional may use one of these if the rectum is blocked with stool. Some are also available without prescription. The fluid may be:

• Tap water.
• Tap water with mild soap.
• Mineral oil.

A suppository is a small tube-shaped object placed in the rectum to deliver a medicine. The suppository melts at body temperature and releases the medicine. Suppositories for constipation may have one of the following:

• Osmotic laxative.
• Stimulant laxative.
• Lubricant laxative.

Source: www.mayoclinic.org

 Your health care professional may prescribe other medicines if other treatments don't work. These include:

• Lubiprostone (Amitiza).
• Linaclotide (Linzess).
• Plecanatide (Trulance).
• Prucalopride (Motegrity).

If constipation is caused by opioid pain medicine, you may take a prescription medicine that blocks the effect of opioids on stool movement through the colon. These include:

• Methylnaltrexone (Relistor).
• Naldemedine (Symproic).
• Naloxegol (Movantik).

Source: www.mayoclinic.org

Biofeedback training involves working with a therapist who uses devices to help you learn to relax muscles and coordinate the use of muscles in your pelvis, rectum and anus. These exercises may correct problems with chronic constipation.

Sensors in the rectum and on the skin provide feedback as sound or light on a device as the therapist helps you go through various exercises. These cues help train you to control the muscles needed to pass stool.

Source: www.mayoclinic.org

Surgery may be necessary to correct damage or irregularities in the tissues or nerves of the colon or rectum. Surgery is usually done only when other treatments for chronic constipation haven't worked. 

Source: www.mayoclinic.org