This information describes the symptoms, causes, prevention, and treatment of constipation.

The normal length of time between bowel movements varies from person to person, but generally going 3 days without a bowel movement is too long. If you are having fewer bowel movements than what is normal for you, you are constipated. Other symptoms include having difficulty passing stool (feces), hard stools, and being unable to empty your bowel completely.

Causes of Constipation

  • Medications, such as:
    • Pain medication
    • Chemotherapy
    • Antiemetics (medications to control nausea)
    • Antidepressants
    • Anticonvulsants
    • Blood pressure medication
    • Antihistamines (allergy medicine)
    • Antacids
    • Dietary supplements, such as iron and calcium
  • Ignoring the urge to have a bowel movement
  • Not having enough time or privacy to use the toilet
  • Not moving around or walking enough
  • Not drinking enough liquids
  • Not eating enough fiber
  • Age
  • Illnesses, such as:
    • Diabetes
    • Depression
    • Diverticulosis
    • Parkinson disease
    • Hypothyroidism
    • Hypercalcemia
    • Spinal cord compression
    • Intestinal obstruction

Preventing and Treating Constipation

  • Go to the bathroom at the same time everyday. Your body will get used to going at that time.
  • If you feel the urge to go, do not put it off. Try to use the bathroom 5 to 15 minutes after meals.
  • After breakfast is a good time to move your bowels because the reflexes in your colon are strongest then.
  • Exercise if you can; walking is an excellent form of exercise.
  • Drink eight, 8-ounce glasses (2 liters) of liquids daily, if you can. Drink water, juices, soups, ice cream shakes, and other drinks that do not have caffeine. Beverages with caffeine, such as coffee and soda, pull fluid out of the body.
  • Slowly increase the fiber in your diet to 25 to 35 grams per day. Fruits, vegetables, whole grains, and cereals contain fiber. If you have an ostomy or have had recent bowel surgery, check with your doctor or nurse before making any changes in your diet.
  • Both over the counter and prescription medications are available to treat constipation. Start with 1 of the following over the counter medications first:
  • Docusate sodium (Colace®) 100 mg. Take _____ capsules _____ times a day. This is a stool softener that causes few side effects. Do not take it with mineral oil.
  • Polyethylene glycol (MiraLAX®) 17 grams daily.
  • Senna (Senokot®) 2 tablets at bedtime. This is a stimulant laxative, which can cause cramping.
  • Bulk-forming laxatives, such as psyllium (Metamucil®, Fiberall®, Perdiem®), polycarbophil (Fibercon®), and methylcellulose (Citrucel®) can also helpful when taken with 8 ounces of fluid. Do not use these if your constipation is due to pain medication. Use caution if you are unable to get out of bed or if you are only able to have a limited amount of liquids everyday. If you have strictures or a partial blockage in your intestines, talk with your doctor before trying bulk-forming laxatives.
  • If these medications do not help, talk with your doctor or nurse. He or she may adjust the medication, suggest others, or your doctor might recommend prescription medication.
  • Do not use suppositories or enemas unless your doctor or nurse tells you to.

Call your doctor or nurse if

  • You have not had a bowel movement for 2 days.
  • You have diarrhea after taking any of the medications listed above. Do not take any medication to manage the diarrhea without speaking to your doctor or nurse first.
  • You have any questions or concerns.