Treatment for constipation will vary, depending on the cause, severity and how long you have suffered.
In most simple cases it is possible to relieve the symptoms through simple dietary and lifestyle changes. For example:
- Increasing your daily fibre intake.
- Add bulking agents such as wheat bran.
- Drink plenty of water to avoid dehydration.
- Resting your feet on a low stool when on the toilet so that your knees are above the hips (this can make it easier to pass stools).
If these lifestyle choices aren’t sufficiently adequate then you may wish to try a laxative. Laxatives are medicines designed to help you pass stools. There are several different types of laxatives available, which all work in a different way.
Stimulant laxatives are best suited if your stools are soft but you still experience difficulty passing them. These laxatives work by stimulating the muscles in your digestive tract, which helps progress the stool through the large intestine and into the anus. The most common example of stimulant laxatives are Senna (Senokot, ExLax), Bisacodyl (Dulocolax), Sodium Picosulphate (Picolax, Dulcolax Pico). These laxatives are fairly fast acting and usually take effect within 6-12 hours. This form of laxative is ideally suited for short-term use only.
Bulk-forming laxatives contain high levels of fibre which swells when in comes into contact with water in the gut. This will increase the volume of the faeces, making them easier for the digestive to push through the system and pass. The absorbed fluid also helps to keep them soft, again making them easier to pass. Examples of bulk-forming Laxatives include; Ispaghula Husk (Fybogel) and Sterculia (Normacol).
It’s important when taking bulk-forming laxatives to drink plenty of fluids. It’s also advised not to take them immediately before going to bed, as it may solidify and get stuck in the throat if taken when lying down. The effects take a little longer to take effect in comparison to stimulant laxatives, usually between 2-3 days. Bulk-forming laxatives are usually a GP’s first line of treatment for most cases of constipation and are particularly useful where problems are caused by low faecal volumes. They should not be used in cases of faecal impaction as they can make the problem worse due to adding extra bulk to an already blocked system.
Osmotic laxatives have a similar effect to bulk-forming laxatives; they increase the amount of fluid in the bowels. This helps to stimulate the bowel and soften the stools. Osmotic laxatives are usually used if bulk-forming laxatives have been tried without success. Common examples of Osmotic Laxatives include Lactulose and Macrogol (Movicol, CosmoCol). As with the bulk-forming laxatives it usually takes 2-3 days to have an effect. Osmotic laxatives are a popular first choice for people suffering with occasional constipation due to their more ‘gentle’ effects.
Suppositories and enemas (Micralax, Cleen) are usually used to treat faecal impaction where osmotic and stimulant laxatives have been unsuccessful or where bowel cleansing is required, for example before a medical procedure. They are generally a more serious intervention and usually act very quickly.