Reviewed By: Pramod Kerkar, MD, FFARCSI

About Chronic Constipation

Constipation is having difficulty in moving of the bowels. While most people may experience constipation at least once a month, constipation is considered to be chronic if symptoms tend to persist for at least three times a week for three months or longer. Chronic constipation is quite common and affects nearly 30% of the global population. Chronic constipation can be caused by factors such as diet, stress, and changes in our daily routine. Chronic constipation can also be caused by medications or certain health conditions, such as thyroid disorder, spinal cord issues or even Parkinson's disease. Chronic constipation can also be a direct result of irritable bowel syndrome (IBS). There are many different types of therapy and lifestyle tips for treating chronic constipation. Now let us see what we can do to get relief from chronic constipation.

Therapy Option for Treating Chronic Constipation

Pelvic Muscle Training

If laxatives and lifestyle changes are not providing you with any relief, you can always turn towards therapy. With the help of a physical therapist, you can begin to exercise your pelvic muscles. Constipation may sometimes also occur because the pelvic muscles, which help you pass stool, stop working properly. This is especially true in elderly people. Exercising pelvic muscles will re-train them so that they can function properly again. This sort of physical therapy is known as biofeedback. Your physical therapist will insert a small tube, known as a catheter, into your rectum. This tube will measure muscle tension. While you are performing the exercises, the machine will indicate when you are relaxed and when you are tightening your muscles. This will also help you learn how to relax while passing stool and thus relieve your chronic constipation.

Stool Softeners or Laxatives for Treating Chronic Constipation

You can occasionally take a laxative or stool softener to get things moving. Stool softeners work by drawing water from your intestines to your stool. This prevents your stool from becoming hard, thus making it easier to pass. There are two kinds of stool softeners available:

  • Docusate sodium (brand name Colace)
  • Docusate calcium (brand name Surfak)
  • Stool softeners also take a couple of days to start working and they are primarily going to help you prevent constipation rather than treat it. These are still gentler as compared to some other types of laxatives.

Then there are laxatives known as stimulant laxatives. These stimulants make your intestines contract in order to help the passage of your stool. This is only recommended by doctors if other treatments show no result. Some of the common stimulant laxatives include:

  • Bisacodyl (brand name Ducodyl and/or Dulcolax)
  • Senna-sennosides oral (brand name Senokot)

You have to keep in mind that laxatives are not the right option for everyone suffering from chronic constipation. Only use them for a short period of time, and always with a doctor's recommendation. Apart from fiber supplements, no laxatives are meant to be used for long term.

Another type of laxatives is known as osmotic agents. These osmotic laxatives work by retaining the fluid in your stool. Some of the common osmotic agents include:

  • Sorbitol
  • Sodium phosphates (brand name Fleet Phospho-Soda)
  • Polyethylene glycol PEG (brand name Miralax)
  • Magnesium preparations, commonly known as Milk of Magnesia

Do not become dependent on laxatives for having a bowel movement, because if you take laxatives for too long then you might just have to re-teach your body how to pass stools normally.

Lifestyle Tips For Treating Chronic Constipation

Changes in Daily Routine

In order to achieve any sort of relief in constipation symptoms, one has to begin by making small changes to your daily routine. The two biggest causes of constipation are a poor diet and lack of exercise or physical activity. Therefore, let us begin by adding some amount of movement to our daily routine and begin including high fiber foods in our diet.

  • Making big lifestyle changes all at once is difficult to maintain in the long term. Therefore, add a few of the below-mentioned lifestyle tips to your daily schedule to treat chronic constipation until the time you are able to establish and follow a good daily routine.
  • Drink a glass of water immediately after waking up. If you can manage to drink lukewarm water, it is even better.
  • Try to eat your meals at the same time every day.
  • Switch your regular cereal to bran cereal for breakfast.
  • Practice some light exercises after breakfast. Walking is a good choice.
  • Take a 20-minute break and do some walking during your lunch break. You can even just walk around your office itself.
  • While parking, park at the end of the parking lot so that you will sneak in a little walk to get inside your office, your apartment building or even the shopping complex.
  • Try out a new recipe every day using high fiber foods such as legumes and beans to treat chronic constipation.
  • Chuck out those unhealthy snacks and opt for a piece of fruit to snack on.
  • Change your bread. This cannot be stressed upon enough. Substitute white bread with whole wheat bread. Same goes for rice - start using brown rice instead of white.
    Get plenty of sleep to treat chronic constipation.
  • Don't hold your bowel movements. If you get the urge 'to go', then use the bathroom right away.
  • Try to schedule in some uninterrupted time every day in the morning for bowel movements. Studies have shown that people who have a regular bowel movement empty their bowels at more or less the same time every day.
  • If you are unable to exercise yourself, then sign up for a class at your local gym to fall into a regular routine and to treat chronic constipation.
  • Keep a bottle of water handy at all times.
  • Steer clear of fizzy drinks or preservative-laden beverages to treat chronic constipation.

Fiber Supplements to Treat Chronic Constipation

Fiber supplements are also an excellent choice to opt for if you are experiencing chronic constipation. Fiber supplements work by bulking up your stool and are often referred to as bulk-forming agents. Bulky stool makes your bowel contract, thus helping in pushing out the stool and relieve constipation. Fiber supplements are available in powder formulations or in the form of capsules. Chewable tablets or gummies are also available. Apart from bulking up your stool, fiber supplements also help in lowering your cholesterol levels and controlling your blood sugar. In fact, a fiber supplement known as inulin also helps in boosting the growth of the friendly gut bacteria known as bifidobacteria. Some commonly used fiber supplements include:

  • Inulin (brand name Fiber Choice)
  • Methylcellulose (brand name Citrucel)
  • Polycabophil (brand name FiberCon
  • Wheat Dextrin (brand name Benefiber)

While taking a fiber supplement, you need to drink plenty of water. Otherwise, these supplements will only make your constipation worse.

Consume High-Fiber Foods for Treating Chronic Constipation

If taking fiber supplements does not appeal to you, then you can ease your chronic constipation by consuming more high-fiber foods. Dietary fiber is made up of a mix of complex carbohydrates and can be found in nuts, seeds, fruits, and vegetables. Start to introduce high fiber foods to your diet in a gradual manner and not overnight. Some foods that are high in dietary fiber include:

  • Shredded wheat
  • Whole wheat bread
  • Popcorn
  • Bran flakes
  • Beans and lentils
  • Legumes
  • Oatmeal
  • Flaxseed
  • Nuts
  • Fruits such as apples, berries, bananas, pears, oranges, raisins, prunes, and figs
  • Vegetables such as spinach, broccoli, carrots, avocados, peas, squash, and sweet potatoes.

Meat and dairy products do not contain any fiber. Neither do fruit juices. So eat a whole fruit rather than having fruit juices. Do keep in mind that you need to increase your intake of water alongside the increase in fiber-rich food. You should at least drink 1.5 liters of water every day to treat chronic constipation.

Turn Towards Probiotics to Treat Chronic Constipation

Probiotics may also help in relieving chronic constipation. Probiotics are live microorganisms that are consumed usually in the form of yogurt to help with digestion. Some strains of these microorganisms are known to be helpful in reducing the symptoms of IBS, including constipation. In particular, the probiotic strain B. lactis has been found to be helpful in reducing gut transit time, improve stool consistency and frequency, and also improve bowel symptoms. Probiotics are safe to have for most adults and you can always talk to your doctor about which one to take and what will be a safe and effective dose for treating your chronic constipation.

Conclusion

It is indeed difficult to live life with chronic constipation. In order to get relief, you have to think about modifying your lifestyle to include a high-fiber diet, drink plenty of water, exercise regularly, etc. By making small changes to your diet and your daily routine, you will be able to aid your digestion and get rid of chronic constipation. Otherwise, medications such as laxatives and stool softeners can also help. Do remember that nothing is going to change overnight. Give these options some time to start showing effect. Otherwise, you can always talk to your doctor about your concerns and get help in relieving your chronic constipation.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 24, 2018

This article does not provide medical advice. See disclaimer

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