Treatments and drugs

By Mayo Clinic Staff

Treatment for chronic constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through your intestines. If those changes don't help, your doctor may recommend medications or surgery.

Diet and lifestyle changes

Your doctor may recommend the following changes to relieve your constipation:

  • Increase your fiber intake. Adding fiber to your diet increases the weight of your stool and speeds its passage through your intestines. Slowly begin to eat more fresh fruits and vegetables each day. Choose whole-grain breads and cereals.

    Your doctor may recommend a specific number of grams of fiber to consume each day. In general, aim for 14 grams of fiber for every 1,000 calories in your daily diet.

    A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly and work your way up to your goal over a few weeks.

  • Exercise most days of the week. Physical activity increases muscle activity in your intestines. Try to fit in exercise most days of the week.
  • Don't ignore the urge to have a bowel movement. Take your time in the bathroom, allowing yourself enough time to have a bowel movement without distractions and without feeling rushed.

Laxatives

Several types of laxatives exist. Each works somewhat differently to make it easier to have a bowel movement.

Examples of laxatives include:

  • Fiber supplements. Fiber supplements add bulk to your stool. Common ingredients include methylcellulose, psyllium, calcium polycarbophil and guar gum. Brand names include FiberCon, Metamucil, Konsyl and Citrucel.
  • Stimulants.
  • Osmotics. Osmotic laxatives help fluids move through the colon. Examples include milk of magnesia, magnesium citrate, lactulose, polyethylene glycol (MiraLax) and sodium phosphate enema (Fleet Enema).
  • Lubricants. Lubricants enable stool to move through your colon more easily. One example of a lubricant is mineral oil.
  • Stool softeners. Stool softeners moisten the stool by drawing water from the intestines. Examples include Colace and Surfak.

Other medications

Prescription medications used to treat chronic constipation include:

  • Medications that draw water into your intestines. The prescription medications lubiprostone (Amitiza) and linaclotide (Linzess) work in different ways to draw water into your intestines and speed up the movement of stool. Your doctor may recommend these medications if over-the-counter laxatives haven't helped you.
  • Medications in clinical trials. Several new medications for treating chronic constipation are being studied in clinical trials. Talk with your doctor about whether any of these drugs may benefit you.

Training your pelvic muscles

Biofeedback training involves working with a therapist who uses devices to help you learn to relax and tighten the muscles in your pelvis. Relaxing your pelvic floor muscles at the right time during defecation can help you pass stool more easily.

During a biofeedback session, a special tube (catheter) to measure muscle tension is inserted into your rectum. The therapist guides you through exercises to alternately relax and tighten your pelvic muscles. A machine will gauge your muscle tension and use sounds or lights to help you understand when you've relaxed your muscles.

Surgery

Surgery may be an option if you have tried other treatment and your chronic constipation is caused by rectocele, anal fissure or stricture.

For people who have tried other treatments without success and who have abnormally slow movement of stool through the colon, surgical removal of part of the colon may be an option. Surgery to remove the colon is rarely necessary.

    Aug. 31, 2013

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