- The almighty prune -- Prunes and prune juice are considered reliable, food-based laxatives, with little risk and few side effects
- Stimulant laxatives, which cause the intestines to contract. Some of these include Correctol, Dulcolax, and Senokot.
- Stool softeners, which help loosen stool. Brand names include Colace and Surfak.
- Lubricants, which help the stool move more easily. These are usually administered internally, as a suppository, or via enema. These include mineral oil, Fleet enemas, and Zymenol.
- Saline laxatives, which attract water into the colon, such as Milk of Magnesia.
- Serotonin agonists, which help the intestines work better if an imbalance in serotonin (a neurotransmitter) is causing the problem.
A number of natural treatments may be helpful:
Probiotic Therapy -- Use of probiotic supplements (such as lactobacillus acidophilus and bifidobacterium) may help with digestive problems and chronic constipation. An excellent probiotic that I use is Enzymatic Therapies' brand Acidophilus Pearls.
Triphala -- Triphala is a popular Ayurvedic remedy in the natural Indian tradition. This herbal laxative formulation can be very effective and gentler than other laxatives. I particularly like the Planetary Formulas Triphala formula developed by Dr. Michael Tierra. (See an article by Dr. Tierra.)
Herbs -- Herbal teas, tinctures, and supplements can have mild or strong laxative properties. Some of the herbs and natural remedies used for laxative purposes include rhubarb, cascara sagrada, dandelion root, and aloe vera juice. (Note: Do keep in mind that some herbal treatments have the same risks as over-the-counter and prescription laxatives and should not be self-prescribed for more than occasional use.)
Yoga -- Some people find stretching and gentle exercise that works the abdominal area (such as yoga or Pilates) especially helpful. Check out this series of yoga postures to help food transit at Yogacards.com.
Hydrotherapy -- Some alternative practitioners recommend regular sitz baths or hot baths to help relax the intestinal area and encourage regular elimination.
Homeopathy -- Homeopathic practitioners recommend Nux Vomica 6c and Sepia 6c for constipation.
Touch Therapy -- Various forms of massage and touch therapy, including lymphatic massage, may help with chronic constipation.
Biofeedback/Hypnotherapy -- Some people have found biofeedback and/or medical hyponotherapy helpful in retraining muscles and relaxation.
Occasionally, chronic constipation can lead to additional complications. The most common are hemorrhoids, rectal prolapse, or fecal impaction. Ideally, your doctor's treatment should help avoid these sorts of serious complications.
If diet, exercise, lifestyle changes, and over-the-counter or prescription medications--and proper thyroid treatment for thyroid patients--are not resolving chronic constipation, then consultation with a gastroenterologist for more extensive testing will likely be recommended.
Tests may include:
- Colorectal transit study, to monitor how well food moves through the colon
- Anorectal function tests, to evaluate abnormal functioning of the anal sphincter or rectal muscles and area
- Defecography--an X-ray that can help identify abnormalities
- Barium enema X-ray to identify obstructions or nerve problems in the rectum, colon, and lower part of the small intestine
- Colonoscopy or sigmoidoscopy, which involve examining the inside of the intestines using a long flexible tube
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthMary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "Living Well With Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," "Living Well With Chronic Fatigue Syndrome and Fibromyalgia," and the "Thyroid Guide to Fertility, Pregnancy and Breastfeeding Success." Click here for more information on Mary Shomon.