Constipation occurs when bowel movements become less frequent and stools become difficult to pass. It happens most often due to changes in diet or routine, or due to inadequate intake of fiber.

What are the symptoms of constipation?

Symptoms of constipation include:

• You have fewer than three bowel movements a week.
• Your stools are dry, hard and/or lumpy.
• Your stools are difficult or painful to pass.
• You have a stomach ache or cramps.
• You feel bloated and nauseous.
• You feel that you haven’t completely emptied your bowels after a movement.

What causes constipation?

There are many causes of constipation – lifestyle choices, medications, medical conditions, and pregnancy.

Common lifestyle causes of constipation include:

• Eating foods low in fiber.
• Not drinking enough water (dehydration).
• Not getting enough exercise.
• Changes in your regular routine, such as traveling or eating or going to bed at different times.
• Eating large amounts of milk or cheese.
• Stress.
• Resisting the urge to have a bowel movement.

How is constipation treated?

Self-care

Most cases of mild to moderate constipation can be managed by you at home. Self-care starts by taking an inventory of what you eat and drink and then making changes.

Some recommendations to help relieve your constipation include:

• Drink two to four extra glasses of water a day. Avoid caffeine-containing drinks and alcohol, which can cause dehydration.
• Add fruits, vegetables whole grains and other high-fiber foods to your diet. Eat fewer high-fat foods, like meat, eggs and cheese.
• Eat prunes and/or bran cereal.
• Keep a food diary and single out foods that constipate you.
• Get moving, exercise.
• Check how you sit on the toilet. Raising your feet, leaning back or squatting may make having a bowel movement easier.
• Add an over-the-counter supplemental fiber to your diet (like Metamucil®, Citrucel®, and Benefiber®).
• If needed, take a very mild over-the-counter stool softener or laxative (such as docusate [Colace®] or Milk of Magnesia®). Mineral oil enemas, like Fleet®, and stimulant laxatives, like bisacodyl (Dulcolax®) or senna (Senokot®), are other options. There are many laxative choices. Ask your pharmacist or doctor for help in making a choice. Do not use laxatives for more than two weeks without calling your doctor. Overuse of laxatives can worsen your symptoms.
• Do not read, use your phone or other devices while trying to move your bowels.

Medication/supplement review

In addition to self-care methods, your doctor will review your medications and supplements (if you take any). Some of these products can cause constipation. If they do, your doctor may change the dose, switch to another drug and/or ask that you stop taking the supplement.

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