Improving constipation – what you can do
There are four main ways of dealing with constipation:
- change your diet
- avoid dehydration
- take more exercise
- use a laxative.
Change your diet
Increasing your fibre intake can sometimes (but not always) be effective in constipation. Fibre is not digested and absorbed in the intestines, so the stools are softer and more bulky, and it is easier for the bowel muscles to push them along. There are two kinds of fibre: soluble and insoluble. Soluble fibre, as its name suggests, dissolves in water; insoluble fibre does not. Soluble fibre forms a gel whilst insoluble fibres absorb water and form bulk. Both forms of fibre ferment and produce gas, which can cause bloating and/or pain. Insoluble fibre is found in whole wheat, whole grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, courgettes, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, green beans, dark leafy vegetables, raisins, grapes, fruit, and root vegetable skins. Soluble fibre is found in oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran, strawberries, nuts, flax seeds, beans, dried peas, blueberries, psyllium, cucumbers, celery and carrots.
- change to wholemeal bread, and eat 2–4 extra slices a day
- eat 2–3 extra helpings of fruit and vegetables a day
- change to a wholewheat cereal (the packet will tell you)
- add some raw bran to your cereal or yoghurt.
Fibre content (in grams)
|Bowl of All Bran||9.8|
|Bowl of muesli||6.2|
|Bowl of Bran Flakes||5.2|
|2 slices of wholemeal bread||4.1|
|1/2 large can of red kidney beans||12.4|
|1/2 large can of baked beans||7.6|
|Medium jacket potato||4.2|
|4 tablespoons of peas||4.1|
|5 dried apricots||5.8|
|100 g of Quorn||4.8|
|Bowl of Fruit’n Fibre||2.8|
|2 slices of ordinary brown bread||2.5|
|2 slices of white bread||1.1|
|3 tablespoons of cooked sprouts||3.1|
|2 tablespoons of cooked broccoli||2.3|
|3 tablespoons of cooked carrots||1.9|
|Apple (with skin)||3.1|
|1 tablespoon of peanuts||1.6|
|1 tablespoon of mixed nuts and raisins||1.1|
|Source: MeRec Bulletin 1999;10 (No 9).|
Increasing your fluid intake will not always improve constipation. In the past, doctors advised drinking lots of water to help constipation. Research has now shown this will not help (Prescriber 2010;21(11):24–9). Also, if you have a medical condition, such as heart failure, it may not be advisable to take too much fluid. Check with your doctor.
Think about your lifestyle
Toilet training (for adults)
Do you need a laxative?
- you have piles, and they bleed if you strain to pass faeces
- you have bad angina, and your doctor has told you to avoid straining to pass faeces
- you are elderly, and your tummy and pelvic muscles are weak, so passing faeces is difficult.
Types of laxative
Osmotic laxatives retain fluid in the bowel, which then softens the faeces. They may take several days to work. Examples of this type of laxative are: milk of magnesia, which is magnesium hydroxide; Epsom salts or Andrews Liver salts, which are magnesium sulphate; and laxatives containing polyethylene glycol. If you have kidney or heart failure problems talk to your doctor before taking this type of laxative, as they may not be suitable.
If laxatives don't work
Written by: Mr Andrew Ramwell
Edited by: Mr Andrew Ramwell
Last updated: Thursday, November 7th 2013
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Improving constipation – what you can do
- How the bowels and anus work
- Causes of constipation
- Constipation in children
- Constipation - when to see your doctor
- Are you constipated?
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- Anal itching
- Anal pain
- Irritable bowel syndrome
- Seeing your doctor about an anal problem
- Doc Spot – Laxatives
- Doc Spot – Strange faeces
- Dr Phil – Anal itching (video)
- Dr Phil – Ask me, I'm a doctor
- Dr Phil – Bowel cancer (video)
- Dr Phil – Cheeky bowel syndrome (poem)
- Dr Phil – Pile driver (poem)
An average person on a typical Western diet passes about 150 g (5 oz) of faeces each day. Faeces consist of about one-third solids and two-thirds water
The solid matter in faeces is cellulose from vegetables, dead cells cast off from the lining of the gut, bacteria, some salts and pigment from bile (which gives the brown colour)
Most of the waste matter from food is passed out in the faeces within 72 hours, but in healthy people up to 30% may remain in the colon for a week or more
Defecation is a very efficient process, normally taking only 10 seconds. Presumably it has to be quick - animals (and primitive man) cannot run from a predator easily if they are in the middle of defecating. This is probably why it is even quicker when we are frightened
In the USA, more than $800 million is spent on laxatives each year
Constipation results in more than 2–5 million visits to doctors in the USA each year
About 4,500,000 people in the USA say they are constipated most or all of the time (National Health Interview Survey)
In a UK survey, 6% of people said they had suffered from constipation in the past year, 13% had some difficulty in passing their faeces at least once a month, and 19% took laxatives at some time