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Constipation

Constipation

Constipation is a problem emptying the bowels. This may be from hard and dry stools. Your belly may feel full and have pain and pressure.

Usual care involves changes in the diet, higher fiber supplements, and working out. Medicine may also help to soften stools or stimulate the bowel to move stool. Some medicines can be habit forming.

Natural Therapies

Natural therapies may be an alternative to medicine.

Likely Effective

  • Biofeedback —may help you have more control over the muscles you use to pass stools. It may ease constipation in people who have problems with pelvic floor muscles.C1-C3
  • Probiotics —healthy bacteria that may help to pass stool more often. They are likely more helpful in adults than in children.B1-B5
  • Acupuncture —insertion of fine needles in the body to ease symptoms. It may help stool pass more often.C4-C7

Possibly Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may get in the way of your treatment plan or other health problems. Some Chinese herbal medicines are safe, but others may not be. They are not controlled like prescription and over the counter medicines.

References ►

A. Herbs

A1. Lin LW, Fu, YT, et al. Efficacy of traditional Chinese medicine for the management of constipation: a systematic review. J Altern Complement Med. 2009 Dec;15(12):1335-1346.

A2. Cheng CW, Bian ZX, et al. Efficacy of a Chinese herbal proprietary medicine (Hemp Seed Pill) for functional constipation. Am J Gastroenterol. 2011 Jan;106(1):120-129.

B. Supplements

B1. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials:probiotics for functional constipation. World J Gastroenterol. 2010 Jan7;16(1):69-75.

B2. Tabbers MM, Chmielewska A, Roseboom MG, Crastes N, Perrin C, Reitsma JB,Norbruis O, Szajewska H, Benninga MA. Fermented milk containing Bifidobacterium lactis DN-173 010 in childhood constipation: a randomized, double-blind, controlled trial. Pediatrics. 2011 Jun;127(6):e1392-9.

B3. Dimidi E, Christodoulides S, et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014 Oct;100(4):1075-1084.

B4. Ford, AC, Quigley EM, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547-1561.

B5. Barichella M, Pacchetti C, et al. Probiotics and prebiotic fiber for constipation associated with Parkinson disease: an RCT. Neurology. 2016 Sep20;87(12):1274-1280.

Other therapies

C1. Chiarioni G, Whitehead WE, Pezza V, Morelli A, Bassotti G. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology. 2006 Mar;130(3):657-64.

C2. Rao SS, Valestin J, Brown CK, et al. Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial. Am J Gastroenterol. 2010 Apr;105(4):890.

C3. Woodward S, Norton C, et al. Biofeedback for treatment of chronic idiopathic constipation in adults. Cochrane Database Syst Rev. 2014 Mar 26;(3):CD008486.

C4. Yang LH, Duan PB, et al. Efficacy of auriculotherapy for constipation in adults: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med. 2014 Aug;20(8):590-605.

C5. Xeu QM, Li N, et al. Efficacy of electroacupuncture in the treatment of functional constipation: A randomized controlled pilot trial. Chin J Integr Med. 2015 Jun;21(6):459-463.

C6. Liu Z, Yan S, et al. Acupuncture for chronic severe functional constipation: a randomized trial. Ann Intern Med. 2016 Dec 6;165(11):761-769.

C7. Wu X, Zheng C, et al. Electroacupuncture for functional constipation: a multi-center randomized, control trial. Ev Based Complement Alternat Med. 2017;2017:1428943.

Last reviewed March 2019 by EBSCO NAT Review Board Richard Glickman-Simon, MD
Last Updated: 3/2/2019

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