Am Fam Physician. 2022;106(3):online
Related article: Chronic Constipation in Adults
What is constipation?
Constipation is when you feel like you are not able to have a complete bowel movement. You can also have hard stool, stomach pain, bloating, or swelling.
How is it treated and prevented?
When you feel like you need to have a bowel movement, go to the bathroom right away.
Try to have a bowel movement right after a meal.
Try sitting on the toilet with your feet on a short footrest. This position may make it easier to have a bowel movement.
Eat more fiber. Foods that are high in fiber are whole grains, fruits, and vegetables. You can also take fiber supplements, such as psyllium (Metamucil). You should try to eat 20 to 35 grams of fiber each day. If you need to increase fiber in your diet, do it slowly by adding no more than 5 grams per week to avoid bloating and gas. See the table to the right for a list of the fiber content of common foods.
Drink more fluids. Try to drink 6 to 8 glasses of water each day to help the fiber work better.
Exercise. Daily movement helps keep bowel movements regular.
If you still have trouble having a bowel movement, take an over-the-counter laxative, such as polyethylene glycol (Miralax). Follow the package's directions for at least 72 hours before expecting any change in your bowel movements.
| Food | Fiber content |
|---|---|
| Fruits | |
| Raspberries, 1 cup | 8.0 grams |
| Pear | 5.5 grams |
| Apple with skin | 4.8 grams |
| Vegetables | |
| Green peas, 1 cup, cooked | 8.8 grams |
| Lentils, 1/2 cup, cooked | 7.8 grams |
| Black beans, 1/2 cup, cooked | 7.5 grams |
| Broccoli, 1 cup, cooked | 5.2 grams |
| Carrots, 1 cup, cooked | 4.8 grams |
| Grains | |
| Shredded wheat, 1 cup | 6.2 grams |
| Whole wheat spaghetti, 1 cup, cooked | 6.0 grams |
| Bran flakes, 3/4 cup | 5.5 grams |
| Nuts and seeds | |
| Pumpkin seeds, 1 ounce | 5.2 grams |
| Almonds, 1 ounce | 3.5 grams |
| Sunflower seeds, 1 ounce | 3.1 grams |
When should I see the doctor?
If you see blood in your bowel movement, which can be a sign of a more serious problem
If the recommendations listed here do not help
If you have been using an osmotic laxative (lactulose, milk of magnesia, or Miralax) for an extended period of time (at least 3 months) to help you have bowel movements
If you are older than 45 years and have not been screened for colon cancer
Where can I get more information?
National Library of Medicine's Medline Plus
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov/health-information/digestive-diseases/constipation
