Your doctor may also check how well your rectum and anal sphincter muscles work together to move stool along. “In women, constipation can be due to weakening and damage to pelvic-floor muscles or nerves as they age, especially if they’ve had vaginal childbirths or changes in the pelvic anatomy after a hysterectomy,” says Carol A. Burke, MD, a gastroenterologist at the Cleveland Clinic. Pelvic-floor physical therapy can help.
Go over your regular medications with your doctor. Ibuprofen (Advil, Motrin, and generics), antacids with calcium or aluminum, iron supplements, and antihistamines can promote constipation. So can some antidepressants and calcium channel blockers for hypertension. Switching to a different class of drugs may provide some relief. These lifestyle tweaks can also help:
Get fiber. How much fiber you need depends on your age and gender. According to the latest federal dietary guidelines, among adults aged 31 to 50, women should aim for 25 grams of fiber per day, and men should aim for 31. Among people 51 and up, women should try to get 22 grams of fiber per day, and men should aim for 28 grams of fiber per day. Focus on soluble fiber (in fruits and veggies) and psyllium, found in cereals and added to some breads and cereal bars, says Brian Lacy, MD, PhD, a gastroenterologist at the Mayo Clinic in Jacksonville, Fla. (Check for psyllium, psyllium seed husk, or psyllium husk on the ingredients panel.) Kiwifruit may be especially helpful. A study in The American Journal of Gastroenterology found that eating two a day eased constipation about as much as 10 prunes or 12 grams of psyllium, with less bloating.
Have a schedule. “The GI tract goes to sleep at night and tends to awaken early in the morning,” Lacy says, “so getting up at the same time, drinking coffee or tea, having breakfast, and then having scheduled bathroom time often helps get it working on a more regular basis.”
Stay active. While research is limited, “we see less constipation in active people,” says William Chey, MD, a gastroenterologist at the University of Michigan. “Exercise wakes up all of your muscles, including the ones in your colon.” Need help while you wait for these strategies to take effect? Lacy recommends short-term daily use of a laxative like polyethylene glycol (Miralax and generics) between dinner and bedtime.
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