The 12 Best Constipation Treatments
Constipation, when things just aren’t moving the way you want them to be. The feeling of fullness or not being able to properly empty your colon is just very uncomfortable. Luckily, there’s often something you can do about it! Read on to find your constipation treatments!
Constipation is quite common, and women seem to suffer from it twice as often as men do. About 10-30% of the world population has constipation at least once in their lifetime. So you’re definitely not the only one.
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Types of Constipation
As mentioned in my post about Irritable Bowel Syndrome (IBS) there are different types of stool consistency according to the Bristol Stool Chart. Usually, type 1 and 2 are the most common in constipation. And type 3 and 4 are the poops you want to have!
To set the diagnosis of constipation, often the ROME IV criteria are used. This takes multiple factors into account to determine whether or not you are constipated.
Diagnostic criteria for functional constipation in Rome IV
|To officially be diagnosed with constipation, your symptoms must include 2 or more of the following for the last 3 months, and have started at least 6 months prior to diagnosis:|
|Straining during more than 25% of defecations|
|Lumpy or hard stools (Bristol Stool Chart 1-2) more than 25% of defecations|
|The sensation of incomplete evacuation of more than 25% of defecations|
|Sensation of anorectal obstruction/blockage more than 25% of defecations|
|Manual maneuvers to facilitate more than 25% of defecations (e.g., digital evacuation, support of the pelvic floor)|
|Fewer than 3 spontaneous bowel movements per week|
|Loose stools are rarely present without the use of laxatives|
|Insufficient criteria for irritable bowel syndrome|
So if you look at the criteria, the constipation is not only dependent on ‘not being able to go’, also straining and the feeling of incomplete stools can be signs of being constipated.
Constipation can either be caused because too many fluids are being extracted from your stools, or because of too little bowel movement. Sometimes you can actually see the difference between the two. Since too dry stools are easily recognizable as rock shaped or tiny balls.
With too little bowel movement the stools might not come as often but they can have a good consistency as Bristol Stool type 4 or can also be very dry because they’ve been in the bowels so long.
Constipation can also be a symptom of IBS. If you experience constipation and have IBS, you probably have the IBS-C type. In that case, I advise you to read my article on IBS first to see if your solution is there.
Symptoms of constipation
Most of the symptoms that are a direct result of the constipation are listed in the ROME IV criteria, but you can start experiencing other symptoms also as a result of being full.
|Dry, hard stools|
|The feeling of incomplete stools or constant need to go|
|Stomach aches or cramps|
|Bloating and gassiness|
|Losing stools or overflow diarrhea|
|Loss of appetite with the sensation of being full|
Constipation Red Flags
The symptoms mentioned above are quite normal (but very inconvenient) symptoms of constipation.
There are also some red flags to be aware of. If you start noticing any of the red flags, please consult your doctor. There could be more going on than just constipation.
|The following symptoms are interpreted as red flags:|
|(Dried) Blood in your stools|
|Fresh blood on your stools, but usually this is a hemorrhoid|
|Consistent constipation, and having no stools for over 5 days|
|Unexplained weight loss, more than 5% of your body weight in 6 months|
|Sudden (and persistent) change in stool consistency|
Are you having constipation and would you like guidance from a specialized dietitian? Then schedule an online consultation at my online dietician’s practice Darm diëtist, and I will help you with all your questions!
Luckily, there’s a lot you can try to relieve yourself from constipation. Of course, there are the medical laxatives you can use. And if nothing else works for you, that would certainly be the way to go.
I do have the opinion that it’s important to look critically at your lifestyle and food choices and check if there’s anything that could be causing your symptoms. Why start using medications, if you can maybe solve it the natural way?
Listed below you find food- and lifestyle options that can help you solve your constipation. Some of them speak for themselves, and some will get their own explanatory articles.
Of course, you can try and find out your triggers yourself, but with some of them, it can become quite hard to keep a nutritionally complete diet. So I would always advise to seek help from a specialized dietitian. The dietitian can help you find your triggers and keep a healthy food pattern that fits your needs.
Sufficient Fiber and Fluid Intake
Fiber is important for your gut health, as mentioned in my article ‘Are Your Gut Bacteria Keeping You Fat?’. They provide a great nutrition source for your gut bacteria but they also form bulk and hold on to fluids in your intestines. If you drink enough water (about 1,5 – 2 liters a day) the fiber can stay moist and move smoothly through your colon. This can help you relieve your constipation.
The 3 different types of fiber that you can find in foods are soluble fiber, insoluble fiber, and resistant starch. For a healthy stool, it is important to eat all 3 forms of fiber.
Soluble fiber comes from fruit, vegetables, and legumes. This fiber holds on to fluid in the intestine without increasing the amount of stool.
Insoluble fiber comes from grain products. This type of fiber increases the volume of the stool and it holds on to moisture.
Resistant starch is a type of fiber that occurs naturally in products but also forms when you cool down cooked starch products like potato, rice, and pasta. To create resistant starch it is important to cool the product for at least 24 hours.
If you’re looking for fiber in your food, plant-based is the way to go. Basically, all plant-based foods contain a lot of fiber. Examples are:
– Vegetables; raw, baked or boiled
– Legumes, like white and brown beans, lentils and chickpeas
– Dried fruits like plums, raisins, figs, dates, and apricots
– Whole grain products like rye, muesli, whole grain bread, crackers or knäckebröd, muesli
– (Cooled down) potatoes, brown rice, wholemeal macaroni, and spaghetti
– Nuts, peanuts, sesame seeds, linseed, pumpkin seeds, sunflower seeds, chia seed
Studies have shown that flaxseed (link to amazon) is an effective means to reduce constipation symptoms. Daily use of 10-15 grams ground flaxseed is the dose that is proven to be effective. Much more than 15 grams is not necessary, and less than 10 grams is probably not very effective at all.
The ground flaxseed binds water in the intestine, to help moisten the stool and let it pass more easily. So it’s important to also keep drinking enough fluids with the flaxseed use.
The flaxseeds can be combined with basically everything. You could mix it into your yogurt, sprinkle it over your salad, put it on your sandwich or even bake cookies or crackers from it.
Psyllium fiber (click to buy at Amazon) is also proven to be effective with constipation. In a comparative study with dried plums, the plums seemed to be more effective in the treatment of constipation. But everyone is different and it’s wise to trial-and-error what works for you! The effective dose of psyllium fiber is 11g of psyllium fiber with 200-250 ml of water twice a day (breakfast and dinner). Add the water to the psyllium, and mix. Drink it fast, since the psyllium starts binding the water and the liquid will thicken a little.
The use of 2 green kiwi’s a day has been shown to reduce the transit time of the stool in the colon. A faster transit time of the stool leads to lesser constipation complaints.
Probiotics are healthy bacteria you can add to your nutrition to aid your own healthy bacteria.
The bacteria in your gut influence your health in multiple ways (you can read more about that in my article about probiotics). But in terms of constipation, they can help with the movement of your gut (intestinal motility). The composition and the number of intestinal bacteria that you have are of great influence on your intestinal motility. A delayed movement in the intestine is linked to a reduced diversity of intestinal bacteria. A slow gut increases the risk of blockage and keeps your waste products in your body longer.
So adding healthy bacteria could boost your own gut bacteria, and help with the movement of your intestine. In my article about probiotics you can read how to choose a probiotic that is right for you.
Fructan Elimination / NCGS
Fructans are one of the FODMAP groups (click the link for more information on the FODMAP diet). Most FODMAP groups actually attract fluids to your gut and thus stimulate diarrhea. Fructans, on the other hand, can reduce the motility of your gut and this helps create constipation because your stool just gets stuck or moves really slowly. If you want to try and see whether the fructans cause your symptoms, try a 2-3 week elimination of the fructans. You should notice a difference by then if fructans are your triggers.
If you feel like you are responding to gluten (click the link for my article), but don’t have celiac disease, there are studies that show that a low-fructan diet plan actually helps relieve the symptoms better than a gluten-free diet. So the fructan elimination would actually be the most effective in that case.
Foods containing fructans are: wheat, rye, garlic, onion, mushrooms, ripe bananas, dried plums, and this list can go on and on. To get yourself a full list of fructan containing foods, check out the Monash University FODMAP app. You can set a filter for oligo’s to see the fructan containing foods. Be aware of the nutritional value of your diet once you start eliminating foods though! Seek help from a dietitian if you have any questions.
Lactose intolerance is usually connected to diarrhea symptoms. But in less frequent cases the lactose intolerance actually stimulates constipation. If you consume a lot of dairy products, it could be worth trying a 2-week elimination of lactose-containing dairy products. Do make sure to properly replace the lactose-containing products to keep your diet nutritionally whole. If you want my full article on lactose intolerance, you can read that here.
Magnesium is a mineral that can help moisten the stools. If it’s chemically bound in a certain way, your body can’t absorb it and it will attract fluids.
It is often prescribed by doctors in the form of magnesium hydroxide, but it can also be bought in supplement form in the store. If you do decide on buying it (after discussing this with your doctor or dietitian), make sure to buy a form you can’t absorb (anorganic) like magnesium oxide, magnesium chloride, magnesium hydroxide and magnesium sulfate. There is not really a recommended dose for the magnesium, but if you take it do make sure to stay within the RDA of 300-400 mg. Also, magnesium could cause cramps or bloating.
Bowel-training may sound like something you only do with kids. But it can actually be very effective for adults. Often with constipation, we have lost track of the signs our body gives us. If you ignore the signals of your body when it tells you to go to the toilet, it won’t send you signals anymore after a while. With bowel-training you can train your body to go to the toilet at your desired time.
This works as follows:
– Choose a moment of the day when you normally have some time to yourself and are usually not stressed.
– Now every day for the coming 2 weeks (at least) this will be your ‘toilet time’, you will go to the toilet for 10-15 minutes (not much longer) and just sit there, relax and don’t strain.
– If nothing happens, that’s fine. Try again tomorrow. If you do get a stool, good for you! And also try again tomorrow.
– Repeat this cycle for at least 2 weeks. If after 2 weeks you don’t get a regular stool at that time, the poop-training was not for you and you can try another intervention. But If you do get a daily (or every other day) stool, keep up the good pattern!
While doing the bowel-training, it is very important to have a good posture on the toilet. Ideally, your knees are higher than your hips. This allows the muscle of your anus to relax and let the stools through. If your toilet is too high to do this, a Squatty Potty (link to Amazon) could do the trick for you! Put your feet on top of the squatty potty, and your knees will be high enough!
Physical Activity and Yoga
If you move, your gut moves with you. So especially if you lead a sedentary life (work behind a desk and little exercise in your free time) some extra physical activity can help reduce your constipation.
The physical activity will increase your gut motility and thus reduce the time your stools are in your colon.
Yoga will help reduce constipation since the twists in yoga actually massage your internal organs and your intestines. The massaging of your intestine relaxes your muscles and helps to move the stool through the intestine.
Stress Relief and Meditation
Stress can reduce the activity of the muscles in the intestines, and thus increase transit time (stimulating constipation). So if you can learn ways to relieve your stress, your PDS could improve!
Stress relief could be anything that helps you get relaxed. Just see whatever feels good to you. It could be anything from a walk in the park, reading your favorite magazine, taking a shower or practicing yoga. Try to take at least 15 minutes each day to yourself. You can only flourish if you take care of yourself!
Meditation can help you relax. Since meditation helps you focus on one thing, your breathing. Breath is your source of life, and deep breathing (into your stomach) helps you and your intestines relax.
You could try any type of meditation. Use an app or guided meditation if you’ve never done it before. Just 10 minutes a day can make a difference!
What has worked for you to reduce your constipation? Have you tried anything else that has helped you? Let me know!
Hi there, I’m Manon.
In my daily life I work as a registered dietitian in the Netherlands with a special interest in gut health.
During my workday I get loads of questions about healthy food, recipes and lifestyle to make it a little easier to get healthy. On Positive Gut I collect my best recommendations, tips and recipes to make your healthy lifestyle a little easier!