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Patient Instructions

Constipation is when you are not passing stool normally. Your stool becomes hard and dry, and it is difficult to pass. You might feel bloated and have pain, or you might have to strain when you try to go.

Some medicines, and even some vitamins, can make you constipated. You can also get constipated if you are not getting enough water and fiber, using the bathroom as soon as you feel the urge to go, or getting enough exercise. Overusing laxatives can also make you more constipated.

Try to get to know your normal bowel movement pattern, so that you can keep constipation from getting worse.

Exercise regularly. Try to walk, swim, or do something active at least 3 or 4 times a week. Try to move around or walk after you eat.

If you feel the urge to go to the bathroom, go. Do not wait or hold it in.

You can also train your bowels to be more regular. It may help to go to the bathroom every day at the same time. For many people, this is after breakfast or dinner.

Try these things to relieve your constipation:

• Eat small meals.
• Do not skip meals.
• Avoid processed or fast foods, such as white breads, pastries, doughnuts, sausage, fast-food burgers, potato chips, and French fries.

Many foods are good natural "laxatives" that will help you move your bowels. High-fiber foods help waste move through your body. Add foods with fiber slowly to your diet, and drink 4 to 8 cups of liquids every day. Water and other drinks that do not have caffeine are best.

Ask your doctor for the right amount of fiber to take in each day. Males, females, and different age groups all have different daily fiber needs. Too much fiber can cause bloating and gas.

Most fruits will help ease constipation. Berries, peaches, apricots, plums, raisins, rhubarb, and prunes are just some that may help. Do not peel fruits that have edible skins, since a lot of the fiber is in their skins.

Choose breads, crackers, pasta, pancakes, and waffles made with whole grains, or make your own. Use brown rice or wild rice instead of white rice. Eat high-fiber cereals.

Vegetables can also add fiber to your diet. Some high-fiber vegetables are asparagus, broccoli, corn, squash, and potatoes (with the skin still on). Salads made with lettuce, spinach, and cabbage will also help.

Legumes (navy beans, kidney beans, chick peas, soy beans, and lentils), peanuts, walnuts, and almonds will also add fiber to your diet.

Other foods you can eat are:

• Fish, chicken, turkey, or other lean meats. These do not have fiber, but they will not make constipation worse.
• Snacks such as raisin cookies, fig bars, and popcorn.

You can also sprinkle 1 or 2 teaspoons of bran flakes, ground flax seeds, wheat bran, or psyllium on foods such as yogurt, cereal, and soup. Or, add them to your smoothie.

You can buy stool softeners at any pharmacy. They will help you pass stool more easily.

Your doctor may prescribe a laxative to relieve your constipation. It may be a pill or liquid. Do NOT take it if you have severe stomach pain, nausea, or vomiting. Do NOT take it for more than 1 week. It should start to work in 2 to 5 days.

• Only take a laxative as often as your doctor recommends. Usually, you take them with meals and at bed time.
• You can mix powder laxatives with milk or fruit juice to make them taste better.
• Always drink plenty of water (8 to 10 cups a day) when you are using laxatives.
• Store your laxative medicine safely in a medicine cabinet, where children cannot get to it.
• Do not take any other laxatives or medicines before talking with your doctor. This includes mineral oil.

Some people get a rash, nausea, or sore throat while taking laxatives. Women who are pregnant or breastfeeding and children under age 6 should NOT take laxatives.

Bulk-forming laxatives such as Metamucil or Perdiem can help pull water into your intestines and make your stools more bulky. You need to drink at least 4 to 8 cups of fluids a day, or they may make your stool harder and more difficult to pass.

Call your doctor if you:

• Have not had a bowel movement in 3 days
• Are bloated or have pain in your stomach
• Feel nauseous or throw up
• Have blood in your stool

Bleser S, Brunton S, Carmichael B, Older K, Rasch R, Steele J. Management of chronic constipation: Recommendations from a consensus panel. J Fam Pract. 2005 Aug;54(8):691-8.

Rao SS. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastroenterol Clin North Am. 2007;36:687-711.

Wyllie R. Motility Disorders and Hirschsprung Disease. In: Kliegman RM, Jenson HP, Stanton BF, eds. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 329.

Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.