Constipation, Age 12 and Older

Home Treatment

Constipation can be treated at home.

• First:
  • Try gentle exercise. Take a short walk each day. Gradually increase your walking time until you are walking for at least 20 minutes.
  • Make sure you drink enough fluids. Most adults should try to drink between 8 and 10 glasses of water, or noncaffeinated beverages each day. Avoid alcoholic beverages and caffeine, which can increase dehydration. If you have heart failure or kidney failure, talk to your health professional about what amount of fluid is right for you.
  • Include fruits, vegetables, and fiber to your diet each day. Have a bran muffin or bran cereal for breakfast, and try eating a piece of fruit for a mid-afternoon snack.
  • Schedule time each day for a bowel movement (after breakfast, for example). Establishing a daily routine may help. Take your time. Do not be in a hurry.
• Support your feet with a small step stool [about 6 in. (15 cm)] when you sit on the toilet. This will help flex your hips and place your pelvis in a more normal "squatting" position for having a bowel movement.
• If you are still constipated:
  • Add some processed or synthetic fiber—such as Citrucel, Metamucil, or Perdiem—to your diet each day.
  • Try a stool softener, such as Colace, if your stools are very hard.
  • Try a rectal glycerin suppository. Follow the directions on the label. Do not use more often than recommended on the label.
• In difficult cases of constipation, it is better to try a saline (osmotic) laxative, such as Fleet Phospho-Soda or Milk of Magnesia or Lactulose. You should not take these types of laxatives if you are on a sodium-restricted diet or have kidney problems or high blood pressure. Osmotic laxatives do not irritate the colon or cause dependence on laxatives like stimulant laxatives can.
• You may occasionally need to try a stimulant laxative, such as Ex-Lax or Feen-a-Mint. Use these preparations sparingly. Overuse of stimulant laxatives decreases the tone and sensation in the large intestine, causing dependence on using laxatives. Regular use may interfere with your body's ability to absorb vitamin D and calcium, which can weaken your bones. Do not use laxatives for longer than 2 weeks without consulting your doctor.
• If you are still constipated, use the Check Your Symptoms section to determine if and when you need to see your doctor.
• Talk to your doctor before using an enema. Your doctor may need to check your symptoms or may suggest a different way to treat your constipation.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• New constipation occurs or other bowel habit changes continue after one week of home treatment.
• Ongoing (chronic) constipation:
  • Is causing new problems.
  • Has gotten worse.
  • Is accompanied by other bowel habit changes, such as changes in the size, shape, or consistency of your stools.
• Rectal pain develops or increases.
• Blood in the stool develops or increases.
• Abdominal pain develops.
• Fever develops.
• Vomiting develops.
• Uncontrolled leakage of stool occurs.
• Your symptoms become more severe or more frequent.

If you have any of these symptoms, they need to be evaluated by a health professional. You should not continue home treatment alone.

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Author:	Jan Nissl, RN, BS	Last Updated: December 14, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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