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Try one of these related symptoms.
Constipation
Hard stools
Passing fewer than three stools a week
Pain when passing stools
Feeling of incomplete bowel emptying
I want to poop, but cannot
I can't defecate
Feel like I still have to poop after having a bowel movement
Cramping rectal pain
Slow bowel movements
Feeling of incomplete defecation
Constipation is defined as having fewer than three bowel movements per week, accompanied by hard, dry, or lumpy stools, difficulty or discomfort in passing stools, or a sensation that not all stool has been eliminated.
Seek professional care if you experience any of the following symptoms
Generally, Constipation can be related to:
Cystic fibrosis (CF) is a genetic disorder that causes severe damage to the lungs, digestive system, and other organs in the body.
Neuromyelitis optica (NMO) is a rare condition in which the immune system damages the spinal cord and the optic nerves.
Acute porphyria is a group of rare genetic disorders that impact the body's ability to produce heme, a vital component of hemoglobin in red blood cells. This disruption can lead to a variety of symptoms, including intense abdominal pain, nervous system issues, and psychiatric symptoms, with episodes often triggered by factors such as certain medications, hormonal changes, or dietary choices.
Sometimes, Constipation may be related to these serious diseases:
A condition where a segment of the intestines "telescopes" into another. This can cause the intestine walls to die, so prompt medical attention is needed. It is associated with certain genetic conditions and growths, but often no clear cause is found.
Your doctor may ask these questions to check for this symptom:
Reviewed By:
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Content updated on Jan 30, 2025
Following the Medical Content Editorial Policy
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Q.
MiraLAX for Women 30-45: Essential Relief Guide & Next Steps
A.
MiraLAX for women 30 to 45 can provide gentle, short-term relief for occasional constipation by softening stools, with a typical dose of 17 g once daily and results in 1 to 3 days, but do not use it longer than 7 days without medical guidance. There are several factors to consider. See below to understand more, including who should talk to a doctor first, red flag symptoms that need urgent care, and lifestyle and evaluation steps that could change your next steps.
References:
* Basson M, Cieza S, Velez A, et al. Systematic Review and Meta-Analysis: Efficacy and Safety of Polyethylene Glycol 3350 for Adults with Chronic Constipation. J Clin Gastroenterol. 2023 Feb 1;57(2):127-137. doi: 10.1097/MCG.0000000000001740. Epub 2022 Sep 20. PMID: 36125032.
* Lacy BE, Patel NK, Brenner DM, et al. ACG Clinical Guideline: Management of Chronic Constipation. Am J Gastroenterol. 2021 May 1;116(5):856-871. doi: 10.14309/ajg.0000000000001221. PMID: 33827941.
* Corsetti M, Tack J. Constipation in women. Best Pract Res Clin Gastroenterol. 2022 Oct-Dec;60-61:101824. doi: 10.1016/j.bpg.2022.101824. Epub 2022 Dec 17. PMID: 36567223.
* Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020 Jan;158(2):297-311.e3. doi: 10.1053/j.gastro.2019.05.059. Epub 2019 Jun 1. PMID: 31160359; PMCID: PMC6921319.
* Markland AD, Palsson OS, Goode PS, et al. Inadequate Dietary Fiber Intake and Other Dietary Factors Are Associated With Functional Constipation: Results From a US National Survey. Neurogastroenterol Motil. 2020 Feb;32(2):e13760. doi: 10.1111/nmo.13760. Epub 2019 Dec 11. PMID: 31828753; PMCID: PMC7056024.
Q.
10 Best Fiber Foods for Women 65+: Better Digestion & Heart Health
A.
The 10 best fiber foods for women 65+ to support digestion and heart health are oats, beans and lentils, berries, chia seeds, apples with the skin, whole grains, sweet potatoes, pears, leafy greens, and ground flaxseed. Most women over 50 should aim for about 21 grams of fiber daily, but needs vary and there are several factors to consider, including adding fiber gradually with plenty of fluids and knowing when to speak to a doctor; see below to understand more and to choose the right next steps.
References:
* Veronese N, Solmi M, Caruso MG, et al. Dietary fibre and health outcomes in older adults: A systematic review and meta-analysis. Ageing Res Rev. 2018 Sep;46:1-11. doi: 10.1016/j.arr.2018.06.007. Epub 2018 Jun 13. PMID: 29908355.
* Reynolds A, Mann J, Liu R, et al. Dietary fibre and cardiovascular disease risk: a systematic review and meta-analysis of prospective studies. BMJ. 2019 Mar 13;364:l1725. doi: 10.1136/bmj.l1725. PMID: 30922933; PMCID: PMC6413242.
* Singh RK, Kumar M, Mahant S, et al. Dietary fiber, gut microbiota, and health in older adults: A narrative review. J Nutr Biochem. 2023 Apr;114:109265. doi: 10.1016/j.jnutbio.2023.109265. Epub 2023 Feb 1. PMID: 36738914.
* Martínez-Gómez MG, Ruiz-Canela M, Martínez-González MA. Dietary patterns and healthy aging: A review of the evidence. Curr Opin Clin Nutr Metab Care. 2021 Mar 1;24(2):166-174. doi: 10.1097/MCO.0000000000000732. PMID: 33534571.
* McRae MP. Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-Analyses. J Chiropr Med. 2018 Mar;17(1):44-53. doi: 10.1016/j.jcm.2017.11.002. Epub 2018 Jan 10. PMID: 29588698; PMCID: PMC5847185.
Q.
High Fiber Foods for Women 65+: Manage Digestion & Symptoms
A.
High fiber foods for women 65+ can improve regularity, ease constipation and bloating, and support cholesterol and blood sugar; aim for 21–25 grams daily from fruits, vegetables, whole grains, legumes, nuts, and seeds. Increase fiber slowly with enough fluids to prevent discomfort, be mindful of medication timing and medical conditions, and watch for red flags that need a doctor’s review; there are several factors to consider, and important details that could change your next steps are explained below.
References:
* Gao R, et al. The Role of Fiber in the Prevention and Management of Constipation in Older Adults: A Systematic Review. J Clin Gastroenterol. 2019 Aug;53(7):499-509. doi: 10.1097/MCG.0000000000001099. PMID: 29979209.
* Xu J, et al. Impact of dietary fiber on gut microbiota and health in older adults: A narrative review. Front Nutr. 2023 Jan 13;9:1062489. doi: 10.3389/fnut.2022.1062489. eCollection 2022. PMID: 36720173.
* Chao AM, et al. Nutrition and digestive health in older women: A review. J Gerontol A Biol Sci Med Sci. 2018 Aug 1;73(8):1028-1036. doi: 10.1093/gerona/glx208. PMID: 28836528.
* Veronese N, et al. Dietary fiber intake and its health consequences in older adults: A systematic review. Adv Nutr. 2022 Mar 23;13(2):494-508. doi: 10.1093/advances/nmab129. PMID: 35150992; PMCID: PMC8944517.
* Anderson JW, et al. Dietary fiber and health in the elderly: Beyond constipation. Nutr Rev. 2016 May;74(5):333-40. doi: 10.1093/nutrit/nuw003. PMID: 27150190.
Q.
How Often Should You Poop? Normal vs. Warning Signs for Women 65+
A.
Normal frequency for women 65+ ranges from three times a day to three times a week, and comfort, consistency, and ease matter more than going daily; every 1-2 days is common, and even every 3 days can be normal if stools are soft and easy. Warning signs that need a doctor include blood or black stools, unexplained weight loss, persistent abdominal pain or bloating, a new change lasting more than 3-4 weeks, severe pain, or regular laxative use. There are several factors to consider, including medications, hydration, fiber, activity, and pelvic floor changes, and simple steps can help; see the complete details below for practical tips and guidance on when to seek care and next steps.
References:
* Choung RS, Harmsen WS, Camilleri M, et al. Normal bowel habits in older adults: A systematic review. J Am Geriatr Soc. 2017 Mar;65(3):616-626. doi: 10.1111/jgs.14693. Epub 2017 Jan 26. PMID: 28124803; PMCID: PMC5346061.
* Bharucha AE, Lacy BE. Management of Constipation in Older Adults: An Evidence-Based Approach. Clin Geriatr Med. 2020 Feb;36(1):15-28. doi: 10.1016/j.cger.2019.09.002. Epub 2019 Nov 1. PMID: 31735235; PMCID: PMC6995079.
* Camilleri M. Chronic Diarrhea in the Elderly: A Diagnostic Approach. Clin Geriatr Med. 2020 Feb;36(1):47-58. doi: 10.1016/j.cger.2019.09.004. Epub 2019 Nov 1. PMID: 31735237; PMCID: PMC6995077.
* Hamilton W, Round AP, Barraclough K, et al. Identifying and Managing Red Flags for Gastrointestinal Cancers in Primary Care. Br J Gen Pract. 2022 Mar 24;72(717):185-187. doi: 10.3399/bjgp22X718712. PMID: 35338902; PMCID: PMC8954708.
* Enck P, Azpiroz F, Boeckxstaens G, et al. Functional bowel disorders in the elderly: a review. J Gerontol A Biol Sci Med Sci. 2016 Nov;71(11):1511-1518. doi: 10.1093/gerona/glw102. Epub 2016 May 17. PMID: 27190001; PMCID: PMC5067980.
Q.
How to Poop Instantly: Safe, Gentle Relief for Women Over 65
A.
For women over 65 seeking fast, gentle relief, near-instant options include using a footstool and leaning forward, sipping a warm beverage, relaxed belly breathing on the toilet, brief clockwise abdominal massage, hydrating, and if needed using polyethylene glycol or a glycerin suppository without straining. There are several factors to consider, including medication interactions, which laxatives to avoid, foods that can help within hours, routines that prevent recurrence, and red flags that need urgent care; see the complete guidance below to choose safe next steps and know when to talk to a doctor.
References:
* Bharucha, A. E., & Lacy, B. E. (2016). Management of chronic constipation in older adults. *Current Treatment Options in Gastroenterology*, *14*(2), 164-173. PMID: 27040407.
* Gallaway, M. S., & Chey, W. D. (2019). Constipation in the elderly: an update on a common clinical problem. *Current Opinion in Gastroenterology*, *35*(4), 304-309. PMID: 31335446.
* Parra, D., Vella, F., & Sgarlata, M. V. (2018). Constipation in Older People: An Update. *Drugs & Aging*, *35*(11), 949-959. PMID: 30288673.
* Rao, S. S. C., & Prichard, D. (2021). Laxatives in the Older Adult: A Narrative Review. *Journal of Clinical Gastroenterology*, *55*(8), 661-667. PMID: 34215758.
* Chan, S. M. P., Au-Yeung, K. T., Chu, S. H., Fong, V. S., Kwok, C. T., Li, W. P., ... & Wong, L. Y. (2021). Non-pharmacological approaches for managing constipation in older adults: A systematic review. *Age and Ageing*, *50*(4), 1146-1158. PMID: 33979402.
Q.
Magnesium Poop: Is It Safe for Constipation Relief After 65?
A.
Magnesium can help relieve constipation after 65, but safety depends on the type and dose, your kidney function, and hydration; occasional low-dose use may be fine, while frequent or high-dose use increases risks like diarrhea, dehydration, and electrolyte problems. There are several factors to consider; see below to understand more. Important details below explain which forms are more likely to trigger a bowel movement, safer nonmagnesium options and dosing tips, and red flag symptoms such as blood in stool, severe pain, or weight loss that warrant medical advice.
References:
* Li Z, Ma Y, Wu H, et al. Magnesium-containing laxatives for chronic constipation in older adults: A systematic review and meta-analysis. J Clin Gastroenterol. 2023 Sep 1;57(8):796-805. doi: 10.1097/MCG.0000000000001886. Epub 2023 Aug 25. PMID: 37624958.
* Quigley EM, Brierley SM. Pharmacological Management of Chronic Constipation in Older Adults: A Narrative Review. Drugs Aging. 2022 Sep;39(9):679-693. doi: 10.1007/s40266-022-00947-6. Epub 2022 Aug 3. PMID: 35921226.
* Roesler M, Roesler C, Junker B, et al. Adverse events associated with laxatives in the elderly. Aging Clin Exp Res. 2021 Dec;33(12):3269-3277. doi: 10.1007/s40520-021-01962-z. Epub 2021 Oct 6. PMID: 34617300.
* Zhang J, Han B, Zhu R, et al. Magnesium oxide for chronic constipation: a systematic review and meta-analysis. BMC Complement Med Ther. 2021 Oct 5;21(1):249. doi: 10.1186/s12906-021-03417-1. PMID: 34610815; PMCID: PMC8492063.
* Sumi Y, Ichimura H, Shiraishi Y, et al. Hypermagnesemia in patients with chronic kidney disease taking magnesium oxide for constipation: An analysis of case reports. J Pharm Health Care Sci. 2019 Jul 19;5:16. doi: 10.1186/s40780-019-0145-8. PMID: 31338271; PMCID: PMC6642055.
Q.
Best Fiber Foods for Women: Simple Ways to Stay Full
A.
Top fiber foods that help women stay full include beans and lentils, plenty of non-starchy vegetables, 100% whole grains, fruits with edible skins and seeds, and small portions of nuts and seeds, with a general target of about 25 grams of fiber per day. There are several factors to consider; the mix of soluble and insoluble fiber, gradual increases with enough water, and life stages or conditions like pregnancy, menopause, PCOS, or IBS can change what works best, and persistent constipation or red-flag symptoms should prompt medical care. See the complete guidance, simple swaps, and when to check in with a doctor below.
References:
* Solymár M, et al. The role of dietary fiber in the prevention and treatment of obesity and its metabolic complications. Crit Rev Food Sci Nutr. 2021;61(19):3338-3351. doi: 10.1080/10408398.2020.1806306. Epub 2020 Aug 26. PMID: 32847427.
* Wanders L, et al. The impact of dietary fiber on human health with a focus on appetite regulation, immunity and the gut microbiome. Eur J Nutr. 2020 May;59(4):1327-1342. doi: 10.1007/s00394-019-02111-w. Epub 2019 Nov 14. PMID: 31730071; PMCID: PMC7235552.
* Rebello CJ, et al. Dietary fiber and energy balance: how fiber works to promote weight loss. J Am Coll Nutr. 2021 Jul;40(5):401-412. doi: 10.1080/07315724.2021.1895420. Epub 2021 Mar 22. PMID: 33752319.
* Vitaglione P, et al. Whole-grain consumption and satiety: a review of the evidence. J Nutr. 2015 Feb;145(2):339-44. doi: 10.3945/jn.114.202580. Epub 2014 Dec 24. PMID: 25540375.
* Makki K, et al. The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease. Cell Host Microbe. 2018 Jun 13;23(6):705-715. doi: 10.1016/j.chom.2018.05.003. PMID: 29890362.
Q.
Fiber Rich Foods for Seniors: Heart & Gut Protection
A.
Fiber-rich foods help older adults protect heart and gut health by lowering LDL cholesterol, smoothing blood sugar, promoting regularity, and feeding a healthy microbiome; top choices include fruits with skin, vegetables, whole grains, legumes, and, if safe to chew, nuts and seeds. There are several factors to consider, including daily targets around 21 g for women and 30 g for men, the roles of soluble versus insoluble fiber, how to increase intake slowly with plenty of fluids, and when to seek care or consider supplements that can interact with medicines. See the complete guidance below for details that could shape your next steps.
References:
* Reynolds A, Mann J, Cummings JH, Winter N, Atkinson FS, Humphries J, Kendall R, Maki KC, Mashur S, Wolever TMS, Chiavaroli L, Zurbau A, Jenkins AL, Jenkins DJA, Sievenpiper JL. Dietary fibre and risk of cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. BMJ. 2019 Dec 11;367:l6617. doi: 10.1136/bmj.l6617. PMID: 31826845.
* O'Grady J, O'Connell M, Shanahan F, Stanton C, Ross RP. The Role of Dietary Fiber and Prebiotics in Modulating the Gut Microbiota in the Elderly to Promote Health: A Systematic Review. Adv Nutr. 2022 Jul 27;13(4):1199-1216. doi: 10.1093/advances/nmab141. PMID: 35080066; PMCID: PMC9325996.
* Chen S, Xu Y, Zhang X, Tian Y, Guo F, Zheng Y, Zhao K, Cui W, Song J, Pan X, Han Y. Dietary fiber and gut microbiota in age-related diseases: A review. Food Res Int. 2023 Jul;169:112891. doi: 10.1016/j.foodres.2023.112891. Epub 2023 Apr 20. PMID: 37248060.
* Guo J, Li X, Fan S, Li C. Dietary Fiber and Risk of Metabolic Syndrome in Older Adults: A Systematic Review and Meta-Analysis. J Nutr Health Aging. 2021;25(1):108-115. doi: 10.1007/s12603-020-1502-0. PMID: 33433887.
* Makki K, Deehan EC, Neuendorff J, Bäckhed F, Walter J. Dietary fibre and the gut microbiota in health and disease. Nat Rev Gastroenterol Hepatol. 2024 Feb;21(2):77-94. doi: 10.1038/s41575-023-00854-w. Epub 2023 Nov 22. PMID: 37996503.
Q.
High Fiber Foods for Women: Weight & Digestive Health
A.
High fiber foods help women reach the recommended 25 grams per day to support regularity, weight control, blood sugar stability, and heart health, with key sources like whole grains, legumes, fruits, vegetables, and nuts or seeds. There are several factors to consider. See below to understand soluble vs insoluble fiber, how to increase intake without bloating, a simple high fiber day, when supplements may help, symptoms that require medical care, and a free constipation symptom check.
References:
* Makki K, Deehan EC, Walter J, Bäckhed F. The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease. Cell Host Microbe. 2018 Dec 12;23(6):705-715. doi: 10.1016/j.chom.2018.05.012. PMID: 30157422.
* Veronese N, Solmi M, Caruso MG, Giannelli G, Osella AR, Fornaro M, Larsson P, Galvano F, Woolf K, Koyanagi A, Thompson T, Smith L, Santini F, Capogrosso C, Firth J, Stubbs B, Schofield P, Trevizol F, Dragioti E, Favalli G, O'Connor M, Rief W, Grabovac I, Pizzol D. Dietary fiber intake and body weight: A systematic review and meta-analysis of prospective studies. Eur J Clin Nutr. 2019 Jun;73(6):872-884. doi: 10.1038/s41430-019-0391-y. Epub 2019 Feb 19. PMID: 30787353; PMCID: PMC6535565.
* Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013 Apr 22;5(4):1417-35. doi: 10.3390/nu5041417. PMID: 23609775; PMCID: PMC3705355.
* Anderson JW, Baird P, Davis RH Jr, Ferreri S, Knudtson M, Koraym A, Waters V, Williams CL. Health benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x. PMID: 19335713.
* Christodoulides S, Dimidi E, Loosemore A, Whelan K, Scott SM. Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults. Aliment Pharmacol Ther. 2016 Jan;43(1):15-32. doi: 10.1111/apt.13460. Epub 2015 Oct 19. PMID: 26477928.
Q.
Psyllium Husk for Women: Bloating & Digestion Relief
A.
Psyllium husk is a gentle soluble fiber that can ease bloating and support regularity in women by softening and bulking stool, improving stool consistency, and supporting healthy gut bacteria; start low, mix with at least 8 oz of water, and increase slowly. There are several factors to consider, including IBS-specific benefits, timing it at least 2 hours from medications, who should avoid it, common side effects, and warning signs that need medical care. For dosing tips, safety details, and next-step guidance, see the complete answer below.
References:
* Jalalian S, Shahrokh S, Ghasemi-Nezhad F, Esmaili M, Faraji A. Impact of fibre-enriched diet on symptoms of constipation-predominant irritable bowel syndrome (IBS-C): a randomised clinical trial. World J Gastroenterol. 2021 Jul 21;27(27):4485-4497. PMID: 34321946.
* Grundmann O, Truter I. Systematic review: the management of irritable bowel syndrome in women. Aliment Pharmacol Ther. 2012 Nov;36(10):915-32. PMID: 23009403.
* Gill SK, Rossi M, Whelan K, Seidu L, Cardoso L, Powell JJ. Fiber supplements and their effects on bowel function, gastrointestinal symptoms, and gut microbiota in adults: A systematic review. Nutr Rev. 2022 Nov 9;80(12):2400-2415. PMID: 35850937.
* Patel J, Sharma J, Pathak M, Prajapati B, Mistry K. Effect of ispaghula husk (psyllium) on gut microbiota and gut health in healthy volunteers and patients with functional gastrointestinal disorders: a systematic review. Ther Adv Gastroenterol. 2023 Feb 1;16:17562848231154563. PMID: 36761066.
* Juckett G, Trivedi R. Psyllium: a natural therapeutic agent for treatment of constipation and other conditions. World J Gastroenterol. 2017 Jul 14;23(26):4922-4933. PMID: 28740336.
Q.
Psyllium Husk Over 65: Maintaining Senior Gut Health
A.
Psyllium husk can help adults over 65 maintain regular bowel habits by softening hard stools or bulking loose stools, and it may also aid heart and blood sugar health when started low, taken with ample water, and separated from medicines by 1 to 2 hours. There are several factors to consider, including who should avoid it and when to see a doctor for symptoms like sudden changes, abdominal pain, weight loss, or bleeding. See the complete guidance below for dosing steps, fluid targets, timing with medications, side effects, and lifestyle tips that could shape your next healthcare decisions.
References:
* Liu M, Zhang C, Wu Q, et al. Effect of psyllium on bowel habits in elderly people: a systematic review and meta-analysis. Front Pharmacol. 2022;13:1016892. Published 2022 Sep 19. doi:10.3389/fphar.2022.1016892
* Yang Y, Yu N, Wu Y, et al. Fiber for the treatment of constipation in older adults: an updated systematic review and meta-analysis. J Am Geriatr Soc. 2022;70(8):2409-2420. doi:10.1111/jgs.17893
* Tian Y, An R, Zhang H, et al. Impact of dietary fiber on gut microbiota and short-chain fatty acids production in healthy elderly people: a systematic review. J Gerontol A Biol Sci Med Sci. 2023;78(1):79-88. doi:10.1093/gerona/glac173
* Wefer J, Kautz U, Schmid S, et al. Effect of psyllium fibre on faecal microbiota and short-chain fatty acids in patients with chronic constipation: a randomized, controlled trial. Nutrients. 2021;13(10):3455. Published 2021 Sep 30. doi:10.3390/nu13103455
* Jatwa R, Mishra S, Joshi K. Health benefits of psyllium consumption. J Complement Integr Med. 2023 Feb 1;20(1):65-74. doi: 10.1515/jcim-2022-0056. PMID: 36728562
Q.
Top Fiber Foods for Seniors: Preventing Constipation
A.
Top fiber foods for seniors to help prevent constipation include fruits with the skin and prunes, cooked vegetables like broccoli, Brussels sprouts, and sweet potatoes, whole grains such as oatmeal and brown rice, beans and lentils, and nuts and seeds like chia or ground flax; breakfast is a great time to add them. Aim for about 21 g of fiber daily for women and 30 g for men, increase slowly, and drink plenty of fluids to avoid worsening constipation; there are several factors to consider, and important details on hydration, daily routines, reading labels, using supplements, and when to seek care are explained below.
References:
* Xu L, et al. Dietary fiber and prebiotics in the prevention and treatment of constipation in adults: an evidence-based approach. Nutrients. 2021 Dec 22;14(1):32. doi: 10.3390/nu14010032. PMID: 34960018.
* Camilleri M. Management of Chronic Constipation in Older Adults. Drugs Aging. 2017 Aug;34(8):575-585. doi: 10.1007/s40266-017-0475-6. PMID: 28555431.
* Yang J, et al. Dietary fiber in the management of constipation: a clinical review. Ther Clin Risk Manag. 2018 Nov 13;14:2029-2042. doi: 10.2147/TCRM.S178124. PMID: 30464426.
* Barberio B, et al. Dietary fiber intake and functional constipation: a review. World J Gastroenterol. 2021 Mar 7;27(9):789-798. doi: 10.3748/wjg.v27.i9.789. PMID: 33716551.
* Horiuchi R, et al. Foods and Dietary Patterns Associated with Constipation in Older Adults: A Systematic Review. Nutrients. 2020 Jul 9;12(7):2028. doi: 10.3390/nu12072028. PMID: 32650505.
Q.
Colace: 5 important things doctors want you to know
A.
Colace, or docusate sodium, is an over-the-counter stool softener that draws water into stool to make bowel movements easier without cramping; doctors recommend it for short-term constipation or to prevent straining, typically 50 to 400 mg daily (often 100 mg twice daily) with a full glass of water for no more than 7 days. There are several safety factors and red flags to consider, including diarrhea or cramps at higher doses, dehydration risk in older adults, special guidance in liver disease, avoiding mineral oil near dosing, and seeking care for severe pain, vomiting, blood or black stools, fever, weight loss, or symptoms lasting more than a week; see the complete guidance below for when Colace may not be enough and what to try next.
References:
Shamliyan TA, Wyman JF, Bliss DZ, & Kane RL. (2015). Treatment of constipation in older adults: a systematic review of pharmaceutical and nonpharmaceutical interventions. Journal of the American Geriatrics Society, 25623390.
European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 28934759.
Cassinotto C, Lapuyade B, Mouries A, et al. (2015). Liver stiffness measurement for non‐invasive assessment of advanced fibrosis and cirrhosis in alcoholic patients. Hepatology, 24732915.
Q.
Why take colace at night
A.
Take Colace at night to sync its 12 to 72 hour stool softening effect with a morning bowel movement, build a consistent routine, and limit daytime cramps or interactions with other medications. There are several factors to consider; see below for important details on hydration timing, liver disease considerations, combining with fiber or laxatives, practical dosing tips, and when to seek medical care so you can choose the right next steps.
References:
Vijayvargiya P, Camilleri M, Shin A, & Saad RJ. (2015). Systematic review: efficacy of licensed therapies for chronic idiopathic… Neurogastroenterol Motil, 25849562.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver disease. Hepatology, 11157951.
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis. Lancet, 24279923.
Q.
Constipation During Chemotherapy: Causes and what you can do
A.
Constipation is common during chemotherapy and often stems from opioid pain medicines, anti-nausea drugs, dehydration, low fiber intake, reduced activity, electrolyte imbalances, nerve changes, or bowel narrowing from tumors or prior surgery. There are several factors to consider; see below to understand more. Relief usually comes from fluids, gradual fiber, gentle movement, a regular toilet routine and positioning, plus OTC laxatives like polyethylene glycol or senna, with prescription options such as lubiprostone or PAMORAs for opioid-related cases; seek urgent care for severe pain, vomiting, bleeding, or no bowel movement for 5 to 7 days, and see complete steps below.
References:
Larkin PJ, & Cherny NI. (2013). Management of constipation in palliative care: EAPC positio… J Pain Symptom Manage, 23537633.
Chey WD, Webster L, & Sostek M. (2014). Lubiprostone for opioid-induced constipation in patie… Am J Gastroenterology, 24935227.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for th… Journal of Hepatology, 29562927.
Q.
Is it safe to use laxatives every day?
A.
Using laxatives every day can be safe in certain situations, but it's important to choose the right type and follow medical advice. See below to understand more.
References:
de Azevedo RP, Freitas FG, Ferreira EM, Pontes de Azevedo LC, & Machado FR. (2015). Daily laxative therapy reduces organ dysfunction in .... Critical care (London, England), 26373705.
https://pubmed.ncbi.nlm.nih.gov/26373705/
Tack J, van Outryve M, Beyens G, Kerstens R, & Vandeplassche L. (2009). Prucalopride (Resolor) in the treatment of severe chronic .... Gut, 18987031.
https://pubmed.ncbi.nlm.nih.gov/18987031/
Tuteja AK, & Rao SS. (2008). Lubiprostone for constipation and irritable bowel syndrome .... Expert review of gastroenterology & hepatology, 19090733.
Q.
When should I start worrying about constipation?
A.
If you haven't had a bowel movement for more than 5-7 days and also have pain, nausea or even vomiting, please seek further medical attention.
References:
Dorfman L, El-Chammas K, Mansi S, Kaul A. Gastrocolonic Response. Curr Gastroenterol Rep. 2022 Nov;24(11):137-144. doi: 10.1007/s11894-022-00849-2. Epub 2022 Nov 3. PMID: 36324042.
Burr RL, Jarrett ME, Cain KC, Jun SE, Heitkemper MM. Catecholamine and cortisol levels during sleep in women with irritable bowel syndrome. Neurogastroenterol Motil. 2009 Nov;21(11):1148-e97. doi: 10.1111/j.1365-2982.2009.01351.x. Epub 2009 Jul 1. PMID: 19573081; PMCID: PMC2820403.
Burr RL, Jarrett ME, Cain KC, Jun SE, Heitkemper MM. Catecholamine and cortisol levels during sleep in women with irritable bowel syndrome. Neurogastroenterol Motil. 2009 Nov;21(11):1148-e97. doi: 10.1111/j.1365-2982.2009.01351.x. Epub 2009 Jul 1. PMID: 19573081; PMCID: PMC2820403.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Constipation
https://www.nhs.uk/conditions/constipation/