Constipation

Treatment for constipation

The main goal of treating constipation is to have regular, comfortable bowel movements. What you eat has a big effect on your bowels, so many people start there when managing constipation.

Fiber

Fiber is a type of carbohydrate (or carb) that the body can’t digest. It helps to manage sugar (glucose) levels, lower cholesterol, and promote good digestion.

Insoluble fiber helps move food through the bowels without removing too much water. Good sources of insoluble fiber include wheat bran, quinoa, brown rice, potatoes, fruits with edible skin, almonds, walnuts, seeds, and leafy green vegetables. This type of fiber is best for preventing and managing constipation. Getting 20 to 35 grams of insoluble fiber in your diet every day is one of the best ways to prevent and manage constipation.

Soluble fiber can make constipation worse because it slows the bowels and pulls out more water. Common soluble fiber sources include oats, berries, bananas, flaxseed, chia seeds, and psyllium husk. Soluble fiber is better for preventing and managing diarrhea. 

Laxatives

There are a few types of laxatives. Most of them are taken by mouth (orally).

• Bulk-forming laxatives work by making the stool swell up to be bulky, softer, and easier to pass.
• Stimulant laxatives work by irritating nerve endings in the bowel, which causes bowel muscles to move stool along faster.
• Osmotic laxatives work by drawing water into the bowel, making the stool softer and easier to pass.
• Stool softeners make it easier for water to get into the stool, making it softer.

Laxatives can be habit-forming and shouldn’t be used long-term. Always check with your doctor or cancer care team before starting a laxative, even if they’re over the counter.

Enemas and suppositories

Enemas and suppositories are medicines placed into the rectum through the anus.

• Enemas are liquid and work by softening the stool and lubricating the bowel. Common types include saline, mineral oil, and stimulant enemas.
• Suppositories are soft solids that dissolve or melt at body temperature to soften the stool. Common types include glycerin and bisacodyl suppositories.

Enemas and suppositories are often used for short-term relief of constipation and sometimes work faster than medicines taken by mouth. Always check with your doctor or cancer care team before starting a laxative, even if they’re over the counter.

Medicines

For long-term (chronic) constipation that doesn’t get better with other treatments, prescription medicines are sometimes used. There are also prescription medicines for chronic constipation caused by opioid pain medicines.

Pelvic therapy and biofeedback

Pelvic floor muscle (Kegel) exercises can strengthen the muscles that support the bowel, rectum, and anus.

Biofeedback uses sensors placed near the anus to show on a screen which pelvic muscles are being used. Pelvic therapy done with biofeedback often works better than therapy alone.

Tips for managing constipation

There are also things you can do at home to help with constipation.

• Get more physical activity (such as walking).  Movement stimulates the muscle in the bowel to move as well (called peristalsis).
• Try to have a bowel movement around the same time every day (the bowels are more active after meals and walking).
• Use a footrest to raise your feet 8 to 12 inches above the ground while trying to have a bowel movement. This can make it easier.
• Avoid foods and drinks that cause gas, such as dairy, eggs, apples, avocados, beans, peas, cabbage, broccoli, and fizzy drinks.
• Avoid chewing gum and straws, which can cause gas.

Talk to your doctor or cancer care team

If you have constipation, make sure your doctor or cancer care team knows about it. Constipation can cause serious problems if it isn’t managed.

Tell them if you:

• Haven’t had a bowel movement in 3 or more days
• Notice any blood in your stool
• Have belly pain or vomiting

Ask your doctor or cancer care team what you should call right away for versus what can wait until office hours. Make sure you know who to contact and how to contact them when the office is closed.