Trouble pooping? Anyone can have difficulty from time to time, and for some people it can be a chronic issue. But many times all it takes are some simple dietary and lifestyle adjustments (and maybe a run to the medication or supplement aisle of your pharmacy) for welcome constipation relief.
“Some of it is going back to the basics,” such as boosting water and fiber intake to improve fecal output, explains Michael Komar, MD, director of the division of gastroenterology at Geisinger in Danville, Pennsylvania.
Constipation can mean different things to different people, Dr. Komar observes. To some folks, it’s straining to have a bowel movement, and to others, it’s passing hard, lumpy stools. Some people have the feeling of incomplete evacuation of stool, or they have fewer than three bowel movements in a week. Each problem can be a symptom of constipation.
What causes constipation really varies from person to person. But knowing why you can’t empty your bowels may help you find a constipation treatment that works. (If you’re dealing with an infant or child’s constipation, consult your pediatrician for appropriate treatment.)
Some people have difficulty pooping because their bowel movement process is altered. They may have a form of pelvic floor dysfunction, known as dyssynergic defecation, meaning the “muscles that should be relaxing are, instead, contracting,” Dr. Komar explains. Simply put, “they can’t poop normally,” he says.
For these folks, biofeedback therapy, a type of neuromuscular training aimed at correcting the biomechanics of going No. 2, can be an effective constipation treatment.
Many other constipation sufferers have stools that are hard or difficult to pass, or they have “slow transit” of stool through the colon. People diagnosed with irritable bowel syndrome (IBS), a chronic GI problem, also can have slow-transit constipation.
Lots of things can interfere with your daily (or every-other-day) constitutional. If you’re consuming a diet low in fiber or leading a sedentary lifestyle, you might have difficult or infrequent BMs. Or, maybe you get constipated when you travel because your usual bathroom routine is disrupted.
Constipation can be a side effect of taking certain medications, such as iron, opioids, antidepressants, and calcium channel blockers. It can also be a consequence of having diabetes, hypothyroidism, or neurologic conditions, like multiple sclerosis or Parkinson’s disease.
Less commonly, a bowel blockage can prevent stool from passing normally. If you’re over 50 and haven’t had a colon cancer screening, or if you have rectal bleeding, anemia, unexplained weight loss, or severe pain, see a doctor for your constipation to rule out colon or rectal cancer or some other bowel blockage.
What helps constipation depends on its cause, severity, and duration. In some cases, you may need an over-the-counter product like Miralax, an osmotic laxative that draws water into the colon, or Colace, a stool softener that boosts the water content of your poo.
If dietary and lifestyle indiscretions are to blame, do-it-yourself treatments and natural remedies may do the trick. Here are a few home remedies for preventing and treating constipation symptoms.
The longer it takes you to have a bowel movement, the more water your colon absorbs from your stool. So, if your body is poorly hydrated, you’re bound to have hard, dry stools.
How much water should you be drinking, ideally? As a general rule of thumb, women should consume about 2 liters throughout the day, while men should aim for about 3 liters, says integrative medicine and digestive health specialist Amy Burkhart, MD, RD.
She suggests filling water bottles in the morning and sipping half by midday and the rest by dinnertime. (Just don’t chug it all at once.)
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Eat more fiber
Aim for 20 to 35 grams of fiber a day to prevent and relieve constipation, says Erin Peisach, RDN, a food and nutrition expert specializing in digestive health.
Including whole grains, fruits and veggies, nuts and seeds, and legumes in your diet will amp up your fiber intake. Fiber adds bulk to your stool to keep it moving smoothly.
Try topping your morning oatmeal with 2 tablespoons of chia seeds and 15 raspberries, she suggests. For dinner, whip up fiber-rich chickpea pasta with ground turkey and marinara and fold in sautéed spinach, mushrooms, and onion.
Lack of physical activity is considered a risk factor for constipation, particularly among older adults. Does than mean adopting a regular fitness routine will ease or prevent the problem?
The evidence is mixed, but doctors recommend exercise anyway since it’s good for overall health.
In one small study, inactive middle-aged folks suffering from constipation were divided into two groups. Each group received dietary advice, but the one that completed a 12-week physical activity program had quicker colon transit time and fewer constipation symptoms.
The acronym FODMAP, short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, refers to sugars in your diet that can provoke gut symptoms in some people.
Going on a low-FODMAP diet means eliminating and then slowly reintroducing potentially troublesome foods, like beans, milk, and certain fruits, to figure out which ones are causing your GI distress. You can do the diet at home, but it’s usually supervised by a doctor or registered dietitian. Studies suggest it can be useful in treating irritable bowel syndrome.
Dr. Burkhart says she’ll try it on patients “only after more conservative approaches have failed” because it’s not easy to follow. That being said, “the diet is incredibly helpful in many cases,” she adds.
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Probiotic supplements and foods like yogurt, kefir, and kimchi contain good-for-your-gut bacteria that may help ease constipation.
“Studies have shown that probiotics can help soften stools and increase the number of bowel movements,” Dr. Burkhart notes.
But they’re probably not a cure-all. “In my practice, I’ve never run into a person saying, ‘Well, since I started taking the probiotic, my constipation’s better,” Dr. Komar says.
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Eat prunes or drink prune juice
It’s true what they say about prunes and prune juice: They do make you go.
Some studies suggest that prunes (aka dried plums) are more effective than psyllium (a type of soluble plant fiber–more on that next) in easing constipation.
Prunes may get their laxative effect from a dose of fiber (3 grams in a serving of four to five dried plums) and sorbitol, a type of sugar alcohol.
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Psyllium, a soluble fiber that comes from the husks (or seed coat) of some flowering plants, has a key advantage over other types of fiber that you might consume, say, in a bowl of cereal.
Wheat bran can be “too irritating” for some people, Peisach explains. “Psyllium fiber is more gentle and still helps bulk the stool,” she says.
Psyllium is found in over-the-counter products such as Metamucil. Other bulking agents include methylcellulose, another type of plant fiber and the main ingredient in Citrucel.
Stress is a risk factor for developing IBS, which can cause constipation, and is associated with symptom flare-ups.
Using relaxation techniques to ease stress and anxiety in your life may be good for the gut. The colon, after all, is partly controlled by the nervous system, which responds to stress, notes the Anxiety and Depression Association of America.
A small study by researchers at the University of California, Los Angeles, found young adults with IBS who participated in a twice-weekly yoga program experienced notable relief from constipation and other symptoms after the six-week intervention and at the two-month follow-up.
Stimulant laxatives, taken by mouth or as a suppository, work by increasing water content in the gut and increasing intestinal activity. They include senna, an herbal laxative (sold as Senokot, for example) and bisacodyl (Dulcolax).
These products make quick work of resolving occasional bouts of constipation by speeding up your BMs. But doctors say they should not be your first choice for dealing with chronic constipation. Only use these medicines for severe constipation or if other treatments haven’t worked, cautions the National Institute of Diabetes and Digestive and Kidney Diseases.
If you’re pregnant, talk to your doctor before using any laxatives, especially stimulant laxatives.