Doctors classify constipation as chronic when it lasts at least 3 months. Understanding chronic constipation symptoms can help you find the right treatment.
Doctors may diagnose chronic constipation by asking about your medical history and symptoms, including:
- a sensation of incomplete emptying
- hard or lumpy stool
- infrequent bowel movements (less than three per week)
- difficulty moving your bowels, such as straining
Other chronic constipation symptoms may include the following:
- abdominal pain or discomfort
- bloating
- blood in your stool
- lower back pain
- nausea or vomiting
- rectal bleeding
- unintended weight loss
Some of these causes can occur from other gastrointestinal conditions. Talking with your doctor is the first step toward finding a treatment plan to improve symptoms.
Your doctor can perform a physical exam, which may involve a rectal exam. Depending on what they find, doctors may order lab tests or other testing such as:
- imaging exams, such as X-ray or ultrasound
- colonoscopy to view the inside of the colon (large intestine)
- stool movement tests that track how food moves through the colon
- tests that check the anus and rectum’s functions
Doctors usually treat chronic constipation in steps. The first step in treatment is considering making practical lifestyle changes. These can focus on diet and physical activity, including:
- drinking more fluids, especially water and other drinks that do not contain caffeine. Water can help keep stools soft.
- eating more fiber-rich foods, such as fresh vegetables, fresh or dried fruits, beans, and whole grains. Fiber helps stool hold on to water and stay soft. It also gives stool the right bulk to move through the colon.
- getting regular exercise, such as walking, biking, or other moderate activity most days of the week. Regular exercise helps move stool through the colon.
- practicing good bowel habits by not ignoring bathroom urges and developing a routine for having a bowel movement
You can consider talking with a registered dietitian to learn more about ways to add fiber-rich foods to avoid gas and bloating.
Current chronic constipation treatment guidelines also recommend using a fiber supplement. Examples include psyllium or methylcellulose. These products work like fiber in food to help stool retain fluid, which softens them.
Over-the-counter remedies
If lifestyle changes alone do not relieve constipation, your doctor may suggest over-the-counter (OTC) remedies as the next treatment step. These can include:
- osmotic laxatives, which increase water in your intestines to help stool move. Examples include polyethylene glycol and magnesium preparations. Lactulose may work for some people.
- stimulant laxatives, which cause the intestine to contract and move stool. Examples include bisacodyl for short-term use and senna for longer use.
If your constipation continues despite making lifestyle changes and using OTC remedies, it may be time to talk with your doctor about prescription medications.
There are several options you and your doctor can explore, including:
- prosecretory drugs that increase water in your intestines, such as linaclotide (Linzess), lubiprostone (Amitiza), and plecanatide (Trulance)
- serotonin 5-HT4 receptor agonists, such as prucalopride (Motegrity), which increase intestinal movement
Your doctor may recommend using these prescription drugs along with OTC remedies. However, they may want you to stop using OTC products, especially if side effects are a concern. The most common side effects of these prescription drugs are nausea and diarrhea.
Talk with your doctor to learn more about these chronic constipation treatment options. Ask if a prescription medication is right for you.