Constipation is the passing of hard, dry bowel motions (stools) that may be infrequent or difficult to pass. The most common causes of constipation include a change in routine, not enough fiber in the daily diet, not enough fluids and lack of exercise.
See your doctor for diagnosis and treatment. It is important not to over-treat constipation with laxatives in place of seeking medical advice.
Food nutrients are absorbed in the small intestine. Waste is massaged down the length of the large intestine by waves of muscular contractions (peristalsis). Once the excess water is removed, the waste is temporarily stored in the rectum. The anus is a muscular ring (sphincter) that can be opened at will to allow the removal of feces.
Water makes up about three-quarters of fecal content, while the rest is composed of solids, including undigested fiber, intestinal bacteria, and dietary fats.
Lifestyle-related causes of constipation
Constipation can be caused by many different lifestyle factors that often work in combination, including:
- A change in routine – normal bowel motions depends on the regular and rhythmic contraction of the bowels. This is part of the body’s internal ‘clock’ and is often upset with changes in routine. This type of constipation is often seen in shift workers and travelers.
- Low-fiber diet – as fiber is indigestible, it adds bulk to the feces, making it more easily pushed along the digestive tract. There are two broad types of fiber; soluble and insoluble. Soluble fiber helps to soften the feces. Good sources of soluble fiber include legumes, fruits and vegetables. Insoluble fiber adds bulk to the feces, helping it to move more quickly through the bowel. Good sources of insoluble fiber are in wheat bran, wholegrain bread and cereals.
- Insufficient water – the fiber in feces will only plump up with water. Constipation can occur from a high-fiber diet if insufficient water is consumed.
- Lack of regular exercise – living a sedentary lifestyle or being restricted in movement due to a disability are common causes of constipation.
- A tendency to ‘put off’ going to the toilet – ignoring the urge to go means that more water will be extracted from the stools, making them difficult to pass. Regularly ignoring this urge may make the body less sensitive to normal signals to go to the toilet.
- Some medications – such as narcotics (particularly codeine), antidepressants, iron supplements, calcium-channel blockers (antihypertensives, particularly verapamil) and non-magnesium antacids are known to slow bowel movements.
- Pregnancy – the action of hormones, reduced activity and the pressure of the growing uterus against the intestines means that constipation is common during pregnancy.
- Advancing age – constipation is more common in the elderly. This is due to a number of factors, including reduced intestinal muscle contractions and reliance on regular medications.
- Illness – a period of illness, particularly an illness resulting in hospitalization and bed-rest, typically results in constipation. Factors include the change in routine, shyness, reduced food intake, pain (especially after abdominal surgery), and pain-relief medication such as morphine. Short-term treatment with laxatives is often required but maybe overlooked.
Medical causes of constipation
Constipation is sometimes symptomatic of underlying medical problems, such as:
- ‘Slow transit’ – some people naturally pass motions less often than most people. It seems their bowel ‘pacemaker’ may be less active. These individuals are more likely to become constipated with minor changes in their routine.
- Anal fissure – a tear in the lining of the anus (anal mucosa). The person may resist going to the toilet for fear of pain.
- Obstruction – the rectum or anus may be partially obstructed by, for example, hemorrhoids (piles) or rectal prolapse.
- Rectocele – the rectum pushes through the weakened rear wall of the vagina when the woman bears down or strains.
- Hernia – an abdominal hernia can reduce intra-abdominal pressure, which makes it more difficult to pass a motion.
- Abdominal or gynecological surgery – a combination of the change in routine, strange surroundings, post-operative pain, and codeine-containing analgesics is a potent cause of constipation and often needs preventive care.
- Irritable bowel syndrome – characterized by abdominal pain, bloating, and either constipation or diarrhea or alternating constipation and diarrhea.
- Problems of the endocrine system – such as hypothyroidism, diabetes or hypopituitarism.
- Tumour – pain while trying to pass a stool could be a symptom of rectal cancer.
- Diseases of the central nervous system – such as multiple sclerosis, Parkinson’s disease or stroke are associated with increased susceptibility to constipation.
Symptoms of constipation
The symptoms include:
- needing to open the bowels less often than usual
- hard, dry stools that may be painful to pass
- straining to pass the motion
- having to sit on the toilet for much longer than usual
- the sensation afterward that the bowel hasn’t fully emptied
- bloated abdomen
- abdominal cramps.
In some cases, constipation is caused by more serious illnesses and events, including tumors and systemic diseases.
Complications of chronic constipation
Some of the complications of chronic constipation include:
- Fecal impaction – the lower bowel and rectum become so packed with feces that the muscles of the bowels can’t push any of it out.
- Fecal incontinence – an overfull bowel can result in involuntary ‘dribbling’ of diarrhea.
- Hemorrhoids – constant straining to open the bowel can damage the blood vessels of the rectum.
- Rectal prolapse – the constant straining pushes a section of rectal lining out of the anus.
- Urinary incontinence – the constant straining weakens pelvic floor muscles. This makes the involuntary passing of urine more likely, especially when coughing, laughing or sneezing.
Diagnosis of constipation
The underlying reason for constipation must be found. Diagnosis may include:
- medical history
- physical examination
- detailed questioning about medications, diet, exercise, and lifestyle habits
Treatment for constipation
Treatment depends on the cause, but could include:
- Removal of the impacted feces – which may involve enemas, stool softeners and a short-term course of laxatives.
- Dietary changes – such as increasing the amount of fiber in the daily diet. Dietitians generally recommend about 30g of fiber every day. Good sources of fiber include wholegrain cereals, fruits, vegetables and legumes. The intake of foods such as milk, cheese, white rice, white flour and red meat should be restricted because they tend to contribute to constipation.
- More fluids – liquids help to plump out feces. However, it is important to restrict the intake of diuretic drinks such as tea, coffee, and alcohol.
- Fiber supplements – these may be helpful if the person is reluctant or unable to include more wholegrain foods, fresh fruits or vegetables in their daily diet. As fiber supplements can aggravate or cause constipation, always check with your doctor or dietitian when using them.
- Exercise – one of the many benefits of regular exercise is improved bowel motility. Ideally, exercise should be taken every day for about 30 minutes. People with a condition that affects mobility need to be as active as possible each day, as every little bit of regular exercise helps.
- Treatment for the underlying disorder – such as surgery to repair an abdominal hernia, hormone replacement therapy for hypothyroidism, or anesthetic cream and sitz (saltwater) baths for an anal fissure.
- Laxatives – there are two main types: bowel stimulants and agents that increase the water content of the stool. Bowel stimulants increase bowel contractions but may cause cramps. Agents that increase the water content may interfere with the absorption of water from the bowel, or swell or bulk up the stool with fluid. When used appropriately, laxatives can greatly relieve acute and chronic constipation. There is little evidence that chronic use of laxatives at appropriate doses will lead to a ‘lazy’ or ‘twisted’ bowel.
Best Foods to Relieve Constipation
About 14% of people experience chronic constipation at some point.
Symptoms include passing stools less than three times per week, straining, lumpy or hard stools, a sensation of incomplete evacuation, feeling blocked or being unable to pass a stool.
The type and severity of symptoms can vary from person to person. Some people experience constipation only rarely, while for others it’s a chronic condition.
Constipation has a variety of causes but is often the result of the slow movement of food through the digestive system.
This may be due to dehydration, poor diet, medications, illness, diseases affecting the nervous system or mental disorders.
Fortunately, certain foods can help relieve constipation by adding bulk, softening the stool, decreasing gut transit time and increasing stool frequency.
Here are 17 foods that can help relieve constipation and keep you regular.
Dried plums, known as prunes, are widely used as a natural remedy for constipation.
They contain high amounts of fiber, with 2 grams of fiber per 1-ounce (28-gram) serving, or about three prunes. This is 8% of the American Heart Association’s recommended daily intake of fiber (2, 3).
The insoluble fiber in prunes, known as cellulose, increases the amount of water in the stool, which adds bulk. Meanwhile, the soluble fiber in prunes is fermented in the colon to produce short-chain fatty acids, which also increase stool weight (4Trusted Source).
In addition, prunes contain sorbitol. This sugar alcohol is not absorbed well by the body, causing water to be pulled into the colon and leading to a laxative effect in a small number of people (4Trusted Source, 5Trusted Source).
Finally, prunes also contain phenolic compounds that stimulate beneficial gut bacteria. This has been hypothesized to contribute to their laxative effect (4Trusted Source, 5Trusted Source).
One study in 40 people with constipation found that eating 100 grams of prunes per day significantly improved stool frequency and consistency, compared to treatment with psyllium, a type of dietary fiber (6Trusted Source).
You can enjoy prunes on their own or in salads, cereals, oatmeal, baked goods, smoothies and savory stews.
Apples are rich in fiber. In fact, one medium-sized apple with the skin on (about 182 grams) contains 4.4 grams of fiber, which is 17% of the recommended daily intake (7).
Approximately 2.8 grams of that fiber is insoluble, while 1.2 grams is soluble fiber, mostly in the form of the dietary fiber called pectin (8Trusted Source).
In the gut, pectin is rapidly fermented by bacteria to form short-chain fatty acids, which pull water into the colon, softening the stool and decreasing gut transit time (9Trusted Source, 10Trusted Source).
One study in 80 people with constipation found that pectin can accelerate the movement of the stool through the intestines, improve symptoms of constipation and increase the number of beneficial bacteria in the gut (11Trusted Source).
Another study found that rats fed a diet of apple fiber had increased stool frequency and weight, despite being given morphine, which causes constipation (12).
Apples are an easy way to boost the fiber content of your diet and alleviate constipation. You can eat them whole, juiced or in salads or baked goods. Granny Smith apples have a particularly high fiber content (13Trusted Source).
Pears are another fruit rich in fiber, with about 5.5 grams of fiber in a medium-sized fruit (about 178 grams). That is 22% of the recommended daily fiber intake (14).
Alongside the fiber benefits, pears are particularly high in fructose and sorbitol, compared to other fruits (15Trusted Source).
Fructose is a type of sugar that is poorly absorbed in some people. This means that some of it ends up in the colon, where it pulls in water by osmosis, stimulating a bowel movement (16Trusted Source).
Pears also contain sugar alcohol sorbitol. Like fructose, sorbitol is not well absorbed in the body and acts as a natural laxative by bringing water into the intestines (15Trusted Source).
You can include pears in your diet in a wide variety of ways. Eat them raw or cooked, with cheese or include them in salads, savory dishes, and baked goods.
You can get about 2.3 grams of fiber per kiwifruit (about 76 grams), which is 9% of the recommended daily intake (17).
In one study, 38 people over age 60 were given one kiwifruit per 66 pounds (30 kg) of body weight per day. This resulted in an increased frequency and ease of defecation. It also softened and increased the bulk of stools (18Trusted Source).
Another study in people with constipation found that eating two kiwifruits daily for four weeks resulted in more spontaneous bowel movements, a reduction in laxative use and overall increased satisfaction with bowel habits (19Trusted Source).
Furthermore, a third study gave 54 people with irritable bowel syndrome two kiwifruits per day for four weeks. At the end of the study, participants reported an increased frequency of bowel movements and faster colonic transit times (20Trusted Source).
It’s not just the fiber in kiwifruit that’s thought to fight constipation. An enzyme known as actinidain is also hypothesized to be responsible for kiwifruit’s positive effects on gut motility and bowel habits (21Trusted Source, 22Trusted Source, 23Trusted Source).
Kiwifruits can be eaten raw. Just peel them or cut them in half and scoop out the green flesh and seeds. They make a great addition to fruit salads and can be added to smoothies for a fiber boost.
Figs are a great way to boost your fiber intake and promote healthy bowel habits.
One medium-sized raw fig (about 50 grams) contains 1.6 grams of fiber. Moreover, just half a cup (75 grams) of dried figs contains 7.3 grams of fiber, which is almost 30% of your daily requirements (24, 25).
A study in dogs investigated the effects of fig paste on constipation over a three-week period. It found that fig paste increased stool weight and reduced intestinal transit time (26Trusted Source).
Another study in 40 people with constipation found that taking 10.6 ounces (300 grams) of fig paste per day for 16 weeks helped speed up colonic transit, improved stool consistency and alleviated stomach discomfort (27Trusted Source).
Interestingly, figs contain an enzyme called ficain, which is similar to the enzyme actinidain found in kiwifruit. It is thought this may contribute to its positive effects on bowel function, alongside its high fiber content (21Trusted Source, 23Trusted Source).
Figs are a delicious snack on their own and also pair well with both sweet and savory dishes. They can be eaten raw, cooked or dried and go well with cheese and gamey meats, as well as on pizza, in baked goods and in salads.
Citrus fruits like oranges, grapefruits and mandarins are a refreshing snack and a good source of fiber.
For example, one orange (about 131 grams) contains 3.1 grams of fiber, which is 13% of the recommended daily fiber intake. Meanwhile, one grapefruit (about 236 grams) contains 2.6 grams of fiber, meeting 10% of your daily needs (28, 29).
Citrus fruits are also rich in the soluble fiber pectin, especially in the peel. Pectin can accelerate colonic transit time and reduce constipation (11Trusted Source, 30Trusted Source).
In addition, citrus fruits contain a flavanol called naringenin, which may contribute to the positive effects of citrus fruits on constipation (31Trusted Source).
Animal studies have shown that naringenin increases fluid secretion into the colon, causing a laxative effect. However, more research in humans is needed (31Trusted Source, 32Trusted Source).
It’s best to eat citrus fruits fresh to make sure you get the maximum amount of fiber and vitamin C. Oranges and mandarins are a handy snack food, and grapefruit goes well in a salad or cut in half for breakfast.
Spinach and Other Greens
Greens such as spinach, Brussels sprouts, and broccoli are not only rich in fiber but also great sources of vitamin C, vitamin K and folate.
These greens help add bulk and weight to stools, which makes them easier to pass through the gut.
One cup of cooked spinach contains 4.3 grams of fiber or 17% of your recommended daily intake. To get spinach into your diet, try adding it to a quiche, pie or soup. Baby spinach or tender greens can be added raw to salads or sandwiches for a fiber boost (33).
Though they’re unpopular with some, Brussels sprouts are super healthy, and many people find them tasty. Just five sprouts contain 10% of your daily fiber needs for only 36 calories. They can be boiled, steamed, grilled or roasted and are good hot or cold (34).
Broccoli contains 3.6 grams of fiber in just one stalk (about 150 grams). This is equivalent to 16% of your recommended daily fiber intake. It can be cooked and added into soups and stews, as well as eaten raw in salads or as a snack (35).
Jerusalem Artichoke and Chicory
Jerusalem artichoke and chicory belong to the sunflower family and are important sources of a type of soluble fiber known as inulin (36Trusted Source).
Inulin is prebiotic, which means it helps stimulate the growth of bacteria in the gut, promoting digestive health. It’s particularly beneficial for Bifidobacteria (36Trusted Source, 37Trusted Source).
A review of research on inulin and constipation found that inulin increases stool frequency, improves consistency and decreases gut transit time. It also has a mild bulking effect by increasing the bacterial mass in the stool (37Trusted Source, 38Trusted Source).
A recent study in 44 healthy adults with constipation found that taking 0.4 ounces (12 grams) of inulin from chicory per day increased stool frequency and softness (39Trusted Source).
Jerusalem artichokes are tubers that have a nutty flavor. You can find them in most supermarkets, sometimes under the name sunchokes or topinambur. They can be roasted, steamed, boiled or mashed.
Chicory root is not commonly found in supermarkets but has become a popular coffee alternative in its ground form.
Scientific research shows that artichokes have a prebiotic effect, promoting good gut health and regularity.
Prebiotics are indigestible carbohydrates like inulin that feed the beneficial bacteria in the gut, increasing their numbers and protecting against the growth of harmful bacteria (40Trusted Source).
One study found that people who ate 10 grams of fiber extracted from artichokes every day for three weeks had greater numbers of beneficial Bifidobacteria and Lactobacilli bacteria. It also found that levels of harmful bacteria in the gut decreased (41Trusted Source).
Additionally, prebiotics has been found to increase stool frequency and improve stool consistency in people with constipation (42Trusted Source).
Cooked artichokes can be eaten hot or cold. The outer petals can be pulled off and the pulpy part ate with a sauce or dip. The heart of the artichoke can be scooped out and cut into pieces.
Rhubarb is a leafy plant that is well known for its bowel-stimulating properties.
It contains a compound known as sennoside A, more commonly known as Senna, a popular herbal laxative (43Trusted Source, 44).
A study in rats found that sennoside A from rhubarb works by decreasing levels of aquaporin 3, a protein that regulates the movement of water in the intestines (45Trusted Source).
A lower level of aquaporin 3 means less water is moved from the colon back into the bloodstream, leaving stools softer and promoting bowel movements.
Furthermore, 1 cup (122 grams) of rhubarb contains 2.2 grams of dietary fiber, which provides 9% of your recommended daily fiber intake (46).
The leaves of the rhubarb plant cannot be eaten, but the stalks can be sliced and boiled. Rhubarb has a tart flavor and is often sweetened and added to pies, tarts, and crumbles. It can also be added to oats or muesli for a fiber-rich breakfast.
Sweet potatoes contain a good amount of fiber to help alleviate constipation.
One medium-sized sweet potato (about 114 grams) contains 3.8 grams of fiber, which is 15% of the recommended daily intake (47).
Sweet potatoes contain mostly insoluble fiber in the form of cellulose and lignin. They also contain the soluble fiber pectin (48Trusted Source).
Insoluble fiber can aid bowel movements by adding bulk and weight to stools (49Trusted Source).
One study looked at the effects of eating sweet potato on people undergoing chemotherapy (50Trusted Source).
After just four days of eating 200 grams of sweet potato per day, participants experienced improved symptoms of constipation and reported less straining and discomfort, compared to the control group (50Trusted Source).
Sweet potato can be roasted, steamed, boiled or mashed. It can be used in any recipe that calls for regular potatoes.
Beans, Peas, and Lentils
Beans, peas, and lentils are also known as pulses, one of the cheapest, fiber-packed food groups you can include in your diet.
For example, 1 cup (182 grams) of cooked navy beans, the type used for baked beans, contains a whopping 19.1 grams of fiber, which is almost 80% of the recommended daily intake (51).
Furthermore, in just one-half cup (99 grams) of cooked lentils, there are 7.8 grams of fiber, meeting 31% of your daily needs (52).
Pulses contain a mix of both insoluble and soluble fiber. This means they can alleviate constipation by adding bulk and weight to stools, as well as soften them to facilitate passage (10Trusted Source, 37Trusted Source, 49Trusted Source).
To include more pulses in your diet, try adding them to soups, blending them to make healthy dips, including them in salads or adding them into ground-meat dishes for extra bulk and taste.
Chia seeds are one of the most fiber-dense foods available. Just 1 ounce (28 grams) of chia seeds contains 10.6 grams of fiber, meeting 42% of your daily needs (53).
The fiber in chia is made up of 85% insoluble fiber and 15% soluble (54Trusted Source).
When chia comes into contact with water, it forms a gel. In the gut, this can help soften stools and make them easier to pass (55Trusted Source).
What’s more, chia can absorb up to 12 times its own weight in water, which can help add bulk and weight to stools (56).
Chia is very versatile and can be added into many different foods, considerably boosting fiber content without too much effort.
They work perfectly sprinkled onto cereal, oats or yogurt. You can also add them into a smoothie or veggie juice, or mix them into dips, salad dressings, baked goods or desserts.
Flaxseeds have been used for centuries as a traditional remedy for constipation, thanks to their natural laxative effects (57Trusted Source).
In addition to numerous other health benefits, flaxseeds are rich in both soluble and insoluble dietary fiber, making them an ideal digestive aid (57Trusted Source).
Just 1 tablespoon (10 grams) of whole flaxseeds contains 2.8 grams of fiber, meeting 11% of your daily needs (58).
One study in mice found that those fed a flaxseed-supplemented diet had shortened small intestinal transit time and increased stool frequency and stool weight (57Trusted Source).
The researchers suggested that insoluble fiber acts like a sponge in the large intestine, retaining water, increasing bulk and softening the stool. Meanwhile, the soluble fiber promotes bacterial growth, adding mass to the stool (57Trusted Source).
Additionally, short-chain fatty acids are produced during the bacterial fermentation of soluble fiber, which increases motility and stimulates bowel movements (57Trusted Source).
You can eat flaxseed on cereal or yogurt and use it in muffins, bread, and cakes.
However, not everyone should use flaxseed. Pregnant and lactating women are often advised to avoid it because it may stimulate menstruation (59Trusted Source).
Whole-Grain Rye Bread
Rye bread is a traditional bread in many parts of Europe and rich in dietary fiber.
Two slices (about 62 grams) of whole-grain rye bread contain four grams of dietary fiber, meeting 15% of your daily requirements. Some brands contain even more than this (60, 61Trusted Source).
Research has found rye bread to be more effective at relieving constipation than regular wheat bread or laxatives (61Trusted Source).
One study in 51 adults with constipation investigated the effects of eating 8.5 ounces (240 grams) of rye bread per day (61Trusted Source).
Participants who ate rye bread showed a 23% decrease in intestinal transit times, on average, compared to those who ate wheat bread. They also experienced softened stools and increased frequency and ease of bowel movements (61Trusted Source).
Rye bread can be used in place of regular white wheat bread. It’s usually denser and darker than regular bread and has a stronger flavor.
Oat bran is the fiber-rich outer casing of the oat grain.
It has significantly more fiber than the commonly used quick oats. In one-third cup (31 grams) of oat bran, there are 4.8 grams of fiber, compared to 2.7 grams in quick oats (62, 63).
Two studies have shown the positive effects of oat bran on bowel function.
First, a study from the UK showed that eating two oat-bran biscuits per day significantly improved the frequency and consistency of bowel movements and reduced pain in participants aged 60–80 (64Trusted Source).
A different study in nursing home residents in Austria found that adding 7–8 grams of oat bran to the diet per day resulted in a significant reduction in laxative use (65Trusted Source).
Oat bran can easily be combined with granola mixes and baked into bread or muffins.
Kefir is a fermented milk beverage that originated in the Caucasus mountains in West Asia. The word kefir is derived from a Turkish word meaning “pleasant taste” (66Trusted Source).
It is a probiotic, which means it contains bacteria and yeasts that benefit your health when ingested. Kefir contains various species of microorganisms, depending on the source (66Trusted Source).
One four-week study had participants drink 17 ounces (500 ml) of kefir per day after their morning and evening meals. At the end of the study, participants used fewer laxatives and experienced improvements in stool frequency and consistency (66Trusted Source).
Additionally, a study in rats fed kefir showed increased moisture and bulk in the stool, which would make it easier to pass (67Trusted Source).
Kefir can be enjoyed plain or added to smoothies and salad dressings. It can also be mixed in with cereals and topped with fruits, flaxseeds, chia seeds or oat bran to add some fiber.
Frequently Asked Questions about Constipation
What is a normal consistency for a bowel movement?
Bowel movements should be soft and formed. They should pass easily like toothpaste flowing out of a tube.
How often should I move my bowels?
The standard time frame for normal bowel movement (BM) frequency ranges from as many as three bowel movements per day to as few as three bowel movements per week. This is a wide range. Our program usually gives patients suffering from constipation a rescue drug to use if no bowel movement has occurred in 3 days’ time. The colon draws water from stool, the longer stool sits in the colon, the harder the stool becomes. What is more important is whether you are comfortable with your bowel movement frequency or whether there has been a significant change from your typical bowel movement frequency.
What self helps things can I do if I suffer from constipation?
Body position can help you to move your bowels. While sitting on the toilet, placing your feet on a small step stool can position the rectum at an angle which makes it easier to pass stool. Bowels like a routine, so eating the same amounts around the same time of day helps to regulate the bowels. Bowels also like regular exercise to keep them moving. Eat a fiber-rich diet (refer to our high fiber diet teaching sheet on the web site). Plenty of decaffeinated fluid (if you are not on fluid restrictions) also helps to keep bowel movements soft.
How much fiber should be in my diet? How much should I add at a time?
Most Americans eat only 12 grams of fiber a day. The recommended amount is between 25-35 grams of fiber a day. To find out how much fiber you are eating, read the nutrition label of your foods and add the grams of fiber together. When you add fiber to your diet, you will initially be gassy. This gas will decrease over time. For this reason, we recommend adding only 5-6 grams of fiber to your diet every two weeks.
Is there a difference between whether I eat fiber or use a supplement?
No there is no difference whether you eat fiber or take a supplement. Some patients feel that the supplement makes them have less gas.
My doctor told me to try fiber but my symptoms are worse. How can this be?
There are different types of constipation. Not all types of constipation are best treated with additional dietary fiber. For instance, our program has found that people with dyssynergia defecation or slow transit constipation may experience worsening symptoms with increased dietary fiber.
Does Activia yogurt help constipation as they say in the commercial?
Activia can improve mild constipation. Studies have shown initial improvement in 2 weeks. Most patients eat 2 Activia a day to receive the best benefit.
Do stool softeners really help?
Medications for the colon are specific to the person. Stool softeners are safe and relatively inexpensive but work only for people with very mild constipation.
Will the chronic use of laxatives hurt me or become addicting?
No, this is a myth. Some people will need to take something to move their bowels. Just like someone who needs to take medication for their stomach or for their heart.
What is the difference between osmotic laxatives and stimulant laxatives?
Osmotic laxatives, such as Miralax or magnesium, are poorly absorbed substances that remain in the bowels and as a result, pull water into the colon to make stools soft. Stimulant laxatives, such as Dulcolax and Senna, stimulate the muscles of the colon to squeeze or contract. As a result of this increased squeezing, the stool is pushed through the colon. The increase in muscle squeezing is why stimulant laxatives may cause abdominal cramping.
What does the Michigan Bowel Control Program (MBCP) do that is different from other programs?
The MBCP is a multidisciplinary program designed for patients suffering from bowel disorders, meaning that doctors from different specialties see patients together to set a plan of care that is personalized to the individual patient. We coordinate appointments so patients are coming to us infrequently. We have nurse coordinators that help the patient from the moment they schedule their appointment until the patient is successful. We perform appropriate and timely testing.
Are our physicians board-certified?
Our Urogynecologists and Gastroenterologists are board-certified.
Do you have a support group?
The Michigan Bowel Control Program has an electronic communication board for patients enrolled in the program. You must sign a consent form giving us your e-mail address for this purpose.
Are there different types of constipation?
There are four types of constipation:
- Diet and Medication Controlled Constipation: The colon moves stool along within 24 -72 hours. The muscles of the pelvic floor move properly. Usually, most people respond to fiber or laxative treatment.
- Dysynergic Constipation: The muscles of the pelvic floor do not work properly and may even perform the opposite function of what they are supposed to do. Sometimes muscles are in spasm. Patients usually complain of not being able to fully empty or having to use their fingers to pass stool. Dysynergic constipation may be coupled with outlet obstruction. An outlet obstruction is where a structure such as a rectocele or an enterocele is in the way of stool coming out.
- Slow Transit Constipation: The colon moves slowly, as a result, bowels move very infrequently sometimes only once every 2-3 weeks.
- Combined dysynergic and slow transit constipation.
What testing is appropriate to evaluate constipation?
There are a variety of tests for constipation offered at the University of Michigan Medical Procedures Unit. Testing may include a colonoscopy, anal-rectal manometric, the Smart pill wireless motility capsule or defecography. These are specialized tests that evaluate the colon for any structural problems or problems with muscle function that may be contributing to constipation.
How can physical therapy help constipation?
If the muscles of the pelvic floor are not working properly, then physical therapy (PT) will help to retrain those muscles. We are not used to having to think about the muscles of the pelvic floor. PT assists you in connecting the mind and body to enable these muscles to work properly when having a bowel movement. PT can also help with strengthening muscles and to decrease spasm.
Are there surgeries that can resolve my constipation?
Surgery is always a last resort. Most constipation can be resolved with diet, lifestyle changes, and laxative therapy. Surgery is recommended if you have a slow-moving colon that has failed all medical treatments or if you have a structure blocking the way that is causing your constipation. Structures blocking the way of stool moving through the anal canal can also be lifted by strengthening the pelvic floor through physical therapy.
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