Treating constipation

Reading time: 3 min

The main objective of treatment is to improve the patient’s satisfaction. As well as obtaining a greater number or quantity of bowel movements, the objective is to optimise the consistency and volume of the faeces. The aim is to ensure that the evacuation is complete, without making too much effort, and that other associated symptoms such as pain and abdominal distension disappear. 

Treatment for constipation also includes non-pharmacological measures, drugs and other treatments reserved for more specific or serious situations.  

Non-pharmacological measures, related to lifestyle aspects, are fundamental, and are usually the first step in the treatment schedule.  

Laxatives are usually indicated when non-pharmacological measures are not sufficiently effective, and should always be prescribed by a healthcare professional, as self-medicating can lead to side effects and may be counter-productive.  

Non-pharmacological treatment

Person in the toilet for a long time due to constipation

Educational measures. It is advisable to adopt a regular schedule for bowel movements, preferably after meals, and to make the most of the postprandial increase (blood glucose level after meals) of the movement of the colon. Having enough time to defecate and adopting a suitable position (preferably squatting) are also recommended. Regular physical exercise and weight loss can also contribute to regulating the intestinal rhythm. 

Fruit and vegetables providing fibre, kiwi, broccoli and bananas

A diet rich in fibre. Soluble fibre is usually recommended as the first line of treatment due to its low cost, availability and safety profile. Daily consumption of 25-30 grams is recommended. Increasing the intake of foods with a high soluble fibre content (fruits, vegetables, pulses and nuts) may improve symptoms in patients with normal colonic transit. The main side effect is that it may cause abdominal distension and tympanites (gas in the intestines). To prevent this effect, start out with a low dose of fibre, then progressively increase the amount based on tolerance and response. 

Person drinking a standing glass of water

Water intake. Sufficient water intake is recommended, whenever there is no contraindication (patients with certain serious heart, kidney or liver conditions). The daily recommended intake is at least 1.5-2 litres of water.  

Person exercising in the right way

It has been shown that physical exercise such as walking or running can encourage expulsion of faeces due to the increase in intestinal movement. On the other hand, a sedentary lifestyle tends to cause slow transit.  

Drug treatment

Pills with green and white stripes

Laxatives. Medical treatment with laxatives generally begins if dietary and lifestyle changes are not successful. There is currently a wide range of treatment options. The majority of laxatives cause side effects, mainly abdominal pain (cramps), watery diarrhoea and abdominal distension. When choosing the initial treatment, you should consider the efficacy, safety, suitability, cost and clinical response.  

Instruments for performing an enema

Enemas. These are reserved for patients who do not respond to oral laxatives and who have not defecated for several days, normally in cases of low mobility (bed rest or hospitalisation).

Woman training pelvic muscles with a pilates ball

Biofeedback is a specific treatment for patients with functional disorders in defecation, and consists of a learning or rehabilitation method with the aim of the patient learning to relax the pelvic floor muscles during defecation.

Substantiated information by:

Faust Feu Caballé
Francesc Balaguer Prunes
Sabela Carballal Ramil

Published: 21 July 2020
Updated: 21 July 2020

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.


Receive the latest updates related to this content.

Thank you for subscribing!

If this is the first time you subscribe you will receive a confirmation email, check your inbox

An error occurred and we were unable to send your data, please try again later.

Constipation related news