Although treatment for constipation depends on the cause, severity, and duration of the constipation, in most cases dietary and lifestyle changes will help relieve symptoms and help prevent them from recurring. If an underlying disorder is causing constipation, treatment will be directed toward the specific cause.
Understand also that normal frequency of bowel movements varies widely, from three bowel movements a day to three a week. Above all, it is necessary to recognize that a successful treatment program requires persistent effort and time. Constipation does not occur overnight and it is not reasonable to expect that constipation can be relieved overnight.
Bowel retraining may help persons who have very difficult symptoms. Such training involves sitting on the toilet for 15 to 20 minutes at the same time each day so the body can get into the habit of having regular bowel movements. A good time to set aside time for a regular bowel movement may be after breakfast or any other meal. For severe constipation, enemas may be used occasionally as part of a bowel retraining program.
Biofeedback therapy is sometimes helpful to treat a variety of bowel disorders including constipation. During this procedure, special sensors measure bodily functions of which we are usually unaware of. A therapist helps use this information to modify or change abnormal responses to more normal patterns.
For most people, dietary and lifestyle improvements can lessen the chances of constipation. A well-balanced diet that includes fiber-rich foods, such as unprocessed bran, whole-grain bread, and fresh fruits and vegetables, is recommended. Limit foods that are high in fat and sugar (such as sweets, cheese and processed foods). These foods may cause constipation.
At least 2 cups of fruits and 2 1/2 cups of vegetables per day is recommended. If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink plenty of water, also. Foods rich in fiber include:
Most people who are mildly constipated do not need laxatives. In most cases, stimulant laxatives should be the last resort and taken only under a doctor's supervision. A doctor is best qualified to determine when a laxative is needed and which type is best. These treatments can help retrain a chronically sluggish bowel.
People who are dependent on laxatives need to slowly stop using them. A doctor can assist in this process. For most people, stopping laxatives restores the colon's natural ability to contract.
There are various types of oral laxatives and they work in different ways. Laxatives taken by mouth are available in liquid, tablet, gum powder, and granule forms. Laxatives include:
Bulk-forming laxatives, also known as fiber supplements, bulk forming laxatives are taken with water. They absorb water in the intestine and make the stool softer. Many people also report no relief after taking bulking agents and suffer from a worsening in bloating and abdominal pain.
Chloride channel activators increase intestinal fluid and motility to help stools pass, thereby reducing the symptoms of constipation.
Lubricants grease the stool, enabling it to move through the intestine more easily. Mineral oil is the most common example. Lubricants typically stimulate a bowel movement within 8 hours.
Osmotics cause fluids to flow in a special way through the colon, resulting in bowel distention. This class of drugs is useful for people with idiopathic constipation.
Saline laxatives act like a sponge to draw water into the colon for easier passage of stool and are used to treat acute constipation if there is no indication of bowel obstruction. Electrolyte imbalances have been reported with extended use.
Stimulants cause rhythmic muscle contractions in the intestines.
Stool softeners moisten the stool and prevent dehydration. These products are suggested for people who should avoid straining in order to pass a bowel movement. These laxatives are often recommended after childbirth or surgery. Prolonged use may result in an electrolyte imbalance.
Other changes that may help treat and prevent constipation include drinking enough water and other liquids so as not to become dehydrated, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored. Special exercises may be necessary to tone up abdominal muscles after pregnancy or whenever abdominal muscles are lax.
Surgery is a rare "last resort" for constipation when a surgically remediable cause of constipation can be identified. In some cases, even if a local neuromuscular abnormality can be identified, surgery makes matters worse. Therefore, surgery should be considered only after careful evaluation by physicians and surgeons who are experts in this field and after all other prescribed treatments have been adequately tried and failed. It is important to discuss any recommended surgery thoroughly with the doctors in order to be familiar with the procedure and understand the potential risks as well as proposed benefits. Possible cases when surgery may be appropriate include:
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