Dietary fiber is the part of plants that cannot be digested. Eating foods with high fiber content is usually the first-line of treatment for individuals with constipation. There is evidence to suggest that people who eat high fiber diets are less likely to become constipated.

People who live in developing countries where high fiber diets are common experience less constipation and tend to have several large bowel movements a day.

Foods that are rich in fiber include whole grains, and fresh fruits and vegetables. Wheat bran is a very effective natural source of fiber and acts as a laxative, and some experts recommend 2 to 6 tablespoons of bran with each meal followed by a glass of water as a way to increase fiber intake.

High fiber diets may not be recommended for people with very severe constipation (impaction), any type of bowel obstruction, or who are at bed rest.

Fluids keep the stool soft and easy to pass. An average of eight glasses of water/fluids a day are generally recommended (but this recommendation is based on data for the average size man). Avoid fluids that contain caffeine or alcohol since they dry out the digestive system.

Check with your physician about the safety of increasing your fluid intake, especially if you have any condition that requires a fluid restriction such as heart, kidney, lung, or liver disease, or high blood pressure.

Lack of exercise can cause constipation. People who are on bed rest (because of an illness or injury) commonly develop constipation. Exercise may stimulate the bowels and is recommended by most experts for constipation problems.

Daily walks (20-30 minutes), swimming, biking, etc. are generally recommended.

Delaying or putting off bowel movements can worsen constipation problems. The body will eventually stop signaling the urge to have a bowel movement if bowel movements are often delayed.

Fiber in the stools absorbs water and makes the stools soft and bulky. Big stools stimulate the muscles of the intestine to contract and push more effectively.

Fiber laxatives may work within 12 hours but may take up to 2-3 days.

Because fiber laxatives have to be taken with lots of fluids, they should be used with caution in people who are on fluid restrictions.

Fiber laxatives may interfere with absorption of some medications. Be sure to tell your doctor about ALL of your medications before starting a laxative.

Docusate softens stools, making them pass more easily with less straining. Docusate stool softeners are often prescribed after surgery, childbirth, heart attacks, etc. to decrease straining with bowel movements.

They are not recommended for long-term use.

Study data is not available but many constipation-sufferers and experts find bran and prunes helpful in stimulating bowel movements.

Stimulant laxatives are very powerful. They cause the muscles of the intestines to contract more forcefully to push out stool. Stimulant laxatives should only be considered if other measures fail since chronic use can damage the bowel muscles.

Castor oil is sometimes preferred over other stimulant laxatives when complete bowel emptying is required (for example, before a colonoscopy)

Stimulant laxatives commonly cause side effects including diarrhea, nausea and cramps.

They are usually taken at bedtime.

Glycerine and sorbital suppositories work by drawing water into the bowel. They may cause local irritation to the bowels and rectum and are not recommended for long-term use.

Water-Adding (Salt) Laxatives attract water into the bowels, softening stools and making bowel movements easier.

Some water-adding laxatives contain a substance called magnesium which can be dangerous for children and for those with kidney disease.

Water-adding laxatives can be taken by mouth, by suppository, or as an enema.

Stimulant laxatives are the most powerful laxatives. They cause the muscles of the intestines to contract more forcefully to push out the stool. Stimulant laxatives should only be considered if other measures fail since chronic use can eventually damage the muscles of the bowel.

Chronic use of Cascara Sagrada can also cause a darkening of the bowel wall (Melanosis coli).

Stimulant laxatives commonly cause side effects including diarrhea, nausea and cramps.

They are usually taken at bedtime.

Mineral oil can interfere with the absorption of vitamins A, D, E, and K, and should be taken between meals.

Mineral oil can cause a serious pneumonia if accidentally inhaled into the lungs. This can happen when the stomach contents "come up" for any reason (such as with vomiting or with reflux problems/GERD, or in people for whom food often "goes down the wrong way" - the elderly, those who are severely ill, or people who eat while lying down).

To decrease the risk of mineral oil going "down the wrong way" and entering the lungs, it should not be taken at bedtime.

Caution - arachis oil is made from peanuts. Do not use if you have a peanut allergy.

Stimulant laxatives are very powerful. They cause the muscles of the intestines to contract more forcefully to push out stool. Stimulant laxatives should only be considered if other measures fail since chronic use can damage the bowel muscles.

Stimulant laxatives commonly cause side effects including diarrhea, nausea and cramps.

They are usually taken at bedtime for a morning bowel movement.

Stimulant laxatives are very powerful. They cause the muscles of the intestines to contract more forcefully to push out stool. Stimulant laxatives should only be considered if other measures fail since chronic use can damage the bowel muscles.

Bisacodyl types of laxatives are coated to prevent irritation of the stomach lining and, therefore, pills should not be chewed or broken.

Stimulant laxatives commonly cause side effects including diarrhea, nausea and cramps.

Chronic use of senna-type laxatives can cause a darkening of the bowel wall (Melanosis coli).

They are usually taken at bedtime with the expectation of a morning bowel movement.

Lactulose and sorbitol are nonabsorbable sugars that attract water into the bowel and soften stools. Studies suggest that these laxatives may not be as effective as some others and may cause somewhat more side effects.

Polyethylene glycol is a very powerful laxative that is most often used to clean the bowel prior to a procedure called a colonoscopy (insertion of a scope into the rectum to check the bowel for cancer or other conditions). There have been cases in which polyethylene glycol has been used in small doses to treat severe constipation but this should only be attempted under a physician's supervision.

Enemas involve inserting a tube into the rectum and placing fluid and medicine into the rectum through the tube. Enemas may be used for severe constipation or for those who are not able to take other medications by mouth. Frequent use of enemas can weaken the muscles of the lower bowel and rectum.

A stimulant laxative. Studies suggest that danthron may increase the risk of cancer in animals. Therefore, danthron is no longer recommended. It has been removed from the market in the USA.

There is no evidence that combination laxatives (that contain more than one type of drug) are any more effective than using a single drug alone. Using more than one drug may increase the chance of side effects.

Without reading the labels carefully, it may be hard to tell which products contain more than one type of laxative.

Studies have failed to prove bethanecol effective for individuals with severe constipation. Bethanecol and other drugs of its type typically cause numerous side effects. A related drug, neostigmine (Prostigmin), may cause fewer side effects but has not proven effective as a constipation treatment.

Study data suggests that metoclopramide (Reglan) may not be effective for treating constipation.

Do not use this drug. It has been removed from the market.

Misoprostol (Cytotec, others) is a drug that is used to treat certain people with stomach or duodenal (peptic) ulcers. Its effectiveness for treating constipation is being evaluated. There have been reports of successful results in individuals with severe constipation.