Constipation Treatment Options

• Increase daily fiber intake: Consume more fruits, vegetables, whole grains, bran cereals and legumes to add bulk to your stool to prevent constipation.
• Stay hydrated: Drink an adequate amount of water and avoid excessive caffeine or alcohol, as dehydration can contribute to constipation.
• Regular exercise: Engage in physical activity regularly, as it helps stimulate bowel movements.
• Establish a regular bathroom routine: Try to use the bathroom at the same time every day to encourage regularity.

• Bulk forming agents: Increase food bran from wheat, oat or rice. These fiber products absorb and hold large amounts of water which results in larger and bulkier stools that are soft and easy to pass. Psyllium husk or methylcellulose, also work by absorbing water and increasing stool bulk. Examples of over-the-counter bulking agents include Metamucilâ, Citrucel, and Benefiber. There are also generics available.
• Osmotic laxatives: Examples include polyethylene glycol and magnesium citrate, which help to draw water into the colon making stool easier to pass. Brands include: MiraLax or Phillips’ Milk of Magnesia and their generics.
• Stimulant laxatives: These laxatives, like senna or bisacodyl, stimulate the muscles in the intestines, promoting bowel movements. They are typically used as needed and for short periods to treat refractory symptoms. Brands include: Dulcolax and Senokot and their generics.
• Stool softeners: These medications, such as docusate sodium, help soften the stool, making it easier to pass. Brand names include Colace and generics.
• Rectal suppositories: These are small, medicated capsules or applicators that are inserted into the rectum. Once inside, the suppository dissolves, releasing the medication that helps stimulate bowel movements or soften the stool. They are typically used when dietary changes and oral laxatives have been ineffective. They can provide relief by lubricating the rectum, stimulating the muscles in the intestines, or softening the stool, making it easier to pass.

If over-the-counter options are ineffective, your gastroenterologist may prescribe stronger laxatives or medications that help regulate bowel movements, such as lubiprostone (Amirizaâ), linaclotide (Linzessâ), Plecanatide (Trulanceâ) and Tenapanor (Ibsrela). They are usually used for patients who have chronic idiopathic constipation and/or IBS-C.

• Enemas or suppositories: These rectal treatments can provide short-term relief by stimulating bowel movements directly.
• Biofeedback therapy: This technique helps train the muscles used during bowel movements and can be helpful for certain types of constipation. This is often performed in conjunction with pelvic floor physical therapy.

Bowel retraining is a therapeutic approach used to establish regular and predictable bowel movements in individuals with chronic constipation or bowel control issues. It involves a structured program aimed at improving bowel function and restoring normal bowel habits. Bowel retraining can be beneficial for various conditions, such as chronic constipation, fecal incontinence, or bowel dysfunction due to neurological disorders.

Key components and strategies commonly used in bowel retraining:

• Setting a regular time for bowel movements. The ideal time is after meals when the colon is more active.
• Allow yourself 15 minutes to sit on the toilet to encourage the body’s natural reflexes for bowel movements.
• Practice stress reduction techniques including deep breathing exercises or meditation.
• Sitting in a squatting position or using a footstool to elevate your feet while on the toilet can help align the rectum and make it easier to pass stool.
• Consuming a balanced diet rich in fiber, including fruits, vegetables, whole grains, and legumes, and adequate water intake can promote regular bowel movements.
• Regular exercise can stimulate bowel motility and promote regular bowel movements.

It’s important to note that bowel retraining programs should be personalized to meet individual needs and may require guidance from gastroenterologist. They can provide proper assessment, guidance, and support throughout the process to optimize the effectiveness of the program and address any concerns or challenges you may encounter.