What to Do If You Just Can’t Poop

If you’ve ever been constipated, you know it’s a miserable feeling: all that heaviness and bloat, without any relief in sight. When constipation starts to set in, you may find yourself reaching for all of the fibre in sight, chugging water like you’re in the middle of the Sahara, or going for a run to get things moving along. But what causes that constipation, and what is the most effective way to manage it on your own?

Some of the more common causes of constipation are due to the slow movement of waste through the digestive tract or by difficulties expelling waste through the rectum: In both cases, the result is that waste becomes hard and dry. Constipation can hit for a number of reasons, including diet, dehydration, or a medical condition. Depending on the situation, it can either be infrequent, or it can become a chronic issue.

Fibre helps — but increase it slowly

One of the major culprits for constipation is a low-fibre diet, which many of us are guilty of. “The average American still has a pretty low fibre intake,” said Eamonn Quigley, a gastroenterologist at Houston Methodist Hospital. According to the Dietary Guidelines, the recommended amount of daily fibre for adults ranges between 22 grams a day for women over age 51 to 34 grams a day for men between the ages of 19-30.

Although these ranges vary according to age and gender, most of us aren’t eating enough, with the USDA estimating that 90% of women and 97% of men are not consuming the recommended daily amount of fibre. Good sources of fibre include fruits, vegetables, and whole grains. If that still isn’t enough, wheat bran, flax, and fibre supplements can also be helpful.

When it comes to adding more fibre into your diet, though, you want to avoid drastic changes in your eating habits, and to be patient. “Changing your diet can lead to a change in your bowel habits,” Quigley said. Eating more fibre can help in the long-term, but in the short-term, it can lead to feelings of bloating. “If you are going to increase your fibre, you should do it very gradually,” Quigley said.

Prunes and prune juice are also effective at relieving constipation, due to the presence of a sugar, called sorbitol, which has a laxative effect. Some people also swear by coffee to get them moving. Although the evidence is mixed, there is some evidence to suggest that coffee can help.

Exercise can help

If your stool just won’t budge, then it can help to get yourself moving, as regular exercise can help with constipation. Exercise is thought to help by reducing the amount of time it takes for food to pass through the GI tract, which in turns reduces the amount of water that gets reabsorbed. The drier the stool, the harder (and more painful) it is to expel from your body.

Water helps, but only if you are dehydrated

One common myth that Quigley encounters often is the belief that drinking water will help with constipation. Although there is truth to this, it’s a more limited effect than people realise, as its effectiveness depends on whether or not you are dehydrated. “If you are consuming a normal diet, you don’t need to take excess water; it won’t improve constipation,” Quigley said. “On the other hand, if you are dehydrated, that will make a difference.”

Laxatives help, but don’t overdo it

If you’ve been eating fibre, drinking water, and getting regular exercise, but you are still constipated, it might be time for an over-the-counter laxative, of which there are a number of different options. These include:

• Oral osmotics, such as milk of magnesia, which draw water into the colon, softening the stool
• Bulk formers, such as Metamucil, which absorb water to form a softer, bulkier stool
• Stool softeners, such as Colace, which add moisture to the stool
• Oral stimulants, such as Dulcolax, which help with elimination of the stool by triggering contractions of the intestinal muscles

Although laxatives can help with the occasional bout of constipation, “you don’t want to overdo it,” Quigley said. “People can become dependent on laxatives to have a bowel movement.”

When to see a doctor

If the constipation is only occasional, and goes away with these methods, it’s easily treated at home. If your constipation becomes a regular thing to the point that you are reaching for the laxatives more often than not, and all of the usual fibre-prunes-jogging methods don’t help, you should see a doctor, as there are a number of medical issues that can cause chronic constipation. You should also see a doctor if you suddenly become constipated, as that can be a signal that something is wrong.