“So, how do we treat constipation? The mainstay of treatment always starts with increasing your fluid intake as well as increasing fiber in the diet. The average American diet actually only has about 10 grams of fiber per day. And the amount that you would like to get to is about 25 to 35 grams per day, to really adequately address constipation. When we talk about foods with fiber, we’re mentioning things like vegetables, fruits, whole grains, the addition of prunes and bran have been shown in small studies to actually give clinical benefit as well. Now, if you try these mainstays of treatment and they don’t create an improvement, we ask to move to laxatives or stool softeners. So there are kind of natural types of bulking agents, such as psyllium. These help bring water in, bulk up the stool, improve the body’s natural contraction of the colon and allow for a more bulky and soft evacuation.
The second type of laxative is what we call an osmotic laxative. And these are very safe. You can use them long-term, they tend to bring water from the outside into the colon, allow the stools to be softer and looser and provide for better evacuation. And then finally, there’s a third category of stimulant laxatives. So stimulant laxatives generally should only be used for short periods of time. They are meant to contract the colon and allow the stimulation of the colon to produce a bowel movement. And again, it’s really a short term therapy that we advise patients to use. Now, if these general over the counter measures really don’t give you much effect, there are prescription medications that have now been approved for chronic constipation, as well as IBS with constipation. And there are also other methods that can help with things like pelvic floor disorders. And then again, just remember if there are underlying causes of constipation, it’s best to make sure those are treated. Definitely talk to your physician if these other measures don’t work. And there are many things that we can do to provide relief for patients.”