- Chronic constipation can be caused by stress, a lack of water, or not enough fiber in your diet.
- It may also be from pain medications, a blockage in your colon, nerve damage, and pelvic muscle issues.
- You can treat chronic constipation with lifestyle changes, laxatives, and biofeedback therapy.
Constipation occurs when you have infrequent bowel movements, generally defined as less than three bowel movements per week, says Anil Singh, MD, a gastroenterologist with the Orlando Health Digestive Health Institute.
Occasional constipation is common, but for some people, the condition may persist. If you're constipated for more than three months, it's considered chronic constipation, Singh says.
Chronic constipation can be uncomfortable and disruptive to your life, but there are ways to treat this condition and feel better.
Causes of chronic constipation
Certain lifestyle choices can cause constipation, including:
- A lack of fiber in your diet
- A sedentary lifestyle
- Stress
- Not drinking enough water
If changes to your lifestyle don't relieve constipation, there may be other factors contributing to your discomfort. These can include:
- The use of certain medications, like opioid pain medications. These medications can inhibit some functions of the gastrointestinal system and make stools more difficult to pass.
- A blockage in the colon or rectum. This can have many causes, including bowel obstruction, narrowing of the colon, or cancer.
- Damage to the nerves that control bowel movements.
- An inability to relax the pelvic muscles to allow for a bowel movement.
- Weakness and lack of coordination in pelvic muscles.
Constipation during pregnancy
It is also common to experience constipation in pregnancy due to hormonal changes that can slow the digestive process and make stools more difficult to pass, says Hardeep Singh, MD, Medical Director of GI Endoscopy at Providence St. Joseph Hospital.
You can ease constipation in pregnancy by drinking plenty of fluids, exercising regularly, and eating high-fiber foods, like whole grains, fruits, and vegetables.
How to treat chronic constipation
Treatment for chronic constipation can vary depending on the cause and your medical history.
In general, treatment options can include:
1. Changes to your diet
Your doctor might start by recommending an increase in your fiber intake. Fiber is key to preventing and easing constipation because it helps bulk up your stool and speed its passage through your intestines.
The recommended daily intake for fiber is between 21 and 25 grams per day for women and 30 to 28 grams per day for men. But if you are struggling with chronic constipation, your doctor may suggest increasing this.
Some good sources of fiber are:
- Greens like kale, cabbage, and collard greens
- Whole grains like bulgur and barley
- Beans, like navy, yellow, and lima
2. An increase in physical activity
Exercise can ease constipation because it increases muscle activity in your intestines, which can help move along waste.
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If you are not already exercising most days of the week, talk with your doctor about whether you are healthy enough to start an exercise program and how to work physical activity into your day.
3. Over-the-counter laxatives
A laxative is a drug that helps increase bowel movements. There are several different types of over-the-counter laxatives your doctor might suggest, including:
- Fiber supplements to bulk up your stool
- Stool softeners to help loosen stools
- Lubricants to help your colon move more easily
- A stimulant to help your intestines contract and move along waste
4. Prescription medication
If over-the-counter drugs aren't effectively treating your constipation, your doctor may prescribe a medication, like Amitza or Linzess, Singh says.
These drugs work by drawing water into your intestines, which can increase the movement of stools. These medications can cause certain side effects, like nausea and diarrhea, so your doctor will likely only prescribe them if over-the-counter options have not been effective for you.
5. Biofeedback therapy
If the pelvic muscles that control your bowel movements are weak or dysfunctional, your doctor may recommend biofeedback therapy, Singh says.
Risk factors for developing pelvic floor dysfunction include:
- Pregnancy and childbirth
- Age (you are more at risk the older you are)
- Having undergone pelvic floor surgery
- Enlarged prostate
Biofeedback therapy is a form of physical therapy that aims to help you control some of your bodily functions essentially retraining your body to have a bowel movement.
During biofeedback sessions, a trained physical therapist will coach you on the dynamics of having a bowel movement while monitoring your anal sphincter and abdominal wall through a probe and sticky pads.
The amount of time it takes to see results from biofeedback therapy varies by individual, but in general, you can expect to attend one session a week for about one to two months.
Insider's takeaway
Occasional bouts of constipation are common and can usually be managed by increasing your water and fiber intake or taking an over-the-counter laxative.
But if your constipation does not respond to these treatments and persists for weeks, you may have a case of chronic constipation that requires more intensive treatment, like prescription medication or physical therapy.
Reach out to your doctor who can help determine the cause and suggest treatment.
If your constipation is accompanied by other symptoms, including abdominal pain, fatigue, or blood in your stool, seek medical attention immediately. These could be signs of a more severe health complication, like colon cancer, Hardeep says.