Frequently Asked Questions: Causes and Treatments of Constipation

Constipation is a decrease in the frequency of bowel movements, difficulty in passing stool, hard stools, incomplete emptying of the bowel, or any combination of these. It is an uncomfortable yet common side effect of medications for pain, nausea, or certain chemotherapy medications. Other causes of constipation include:

  • Ignoring the urge to have a bowel movement
  • Not having enough time or privacy to use the toilet
  • Decreased activity or mobility
  • Decreased fluid intake
  • Not eating enough fiber from sources such as whole grains, fruits, and vegetables
  • Illnesses such as diabetes, depression, diverticulosis, Parkinson’s Disease, hypothyroidism, or hypercalcemia
Tips to Help Prevent or Treat Constipation

Use the suggestions below to help you prevent or treat constipation:

  • Establish a pattern of using the bathroom to promote regularity
  • Respond to the urge to have a bowel movement immediately
  • Exercise as tolerated; walking is an excellent form of exercise
  • Drink eight, 8-ounce glasses (64 ounces) of fluid daily. Water, juices, soups, and non-caffeinated beverages may be used to satisfy the daily fluid requirements.
  • Gradually increase the daily amount of fiber in your diet to a total of 25-35 grams. Foods such as fruits, vegetables, whole grains, and cereals contain fiber. If you have an ostomy or have had recent abdominal surgery, please check with your doctor or nurse before making any changes in your diet.
Over-the-Counter Medications to Prevent or Treat Constipation

Bulk-forming laxatives:
Avoid these laxatives if your constipation is due to pain medications.

  • Psyllium (brand names Metamucil, Fiberall, Perdiem)
  • Polycarbophil (brand name Fibercon)
  • Methylcellulose (brand name Citrucel)

Saline Laxatives:
If you have kidney problems, please check with your doctor or nurse before starting a saline laxative.

  • Magnesium hydroxide (brand name Milk of Magnesia)
  • Magnesium citrate

Stool Softeners:
Stool softeners cause few side effects. Do not take docusate sodium with mineral oil. The maximum daily dose is 300mg of docusate sodium per day.

  • Docusate sodium (brand name Colace)

Stimulant Laxatives:
This is a stimulant laxative similar to bisacodyl (brand names Dulcolax, Correctol, Feen-a-Mint). Stimulant laxatives can cause abdominal cramping. Start with 2 tablets senna at bedtime. If you do not have a bowel movement after one day on this regimen, add 2 tablets of senna each morning. The maximum daily dose is 6 tablets of senna per day. If you have diarrhea (liquid stools), stop taking senna for one day, then resume taking it at one-half of your previous dose. If you experience severe abdominal cramping, please contact your doctor or nurse.

  • Senna (brand name Senokot)
Important Points
  • Carefully read and follow instructions on the label of all over-the-counter medications.
  • Notify your doctor or nurse if you have not had a bowel movement for two days.
  • If you have diarrhea after taking any of the medications listed above, do not take an anti-diarrheal medication until you speak to your doctor of nurse.
  • Do not use rectal suppositories or enemas unless directed by your doctor or nurse.
  • Please contact your doctor or nurse if you have any questions about this information.