Poop Problems: Laxatives Fail

If you're struggling to poop and laxatives don't seem to be working, there could be several reasons why. Firstly, it's important to understand that constipation can be caused by various factors, including diet, lifestyle, and medical conditions. While laxatives can be effective in providing relief, they should not be the first line of treatment. Instead, it's recommended to start with simple dietary and lifestyle changes, such as increasing fibre intake, staying hydrated, and engaging in regular physical activity.

If you've tried these initial remedies without success, it may be time to consult a healthcare professional. Constipation that persists or becomes chronic could indicate an underlying medical issue, such as irritable bowel syndrome (IBS) or certain medications. In such cases, your doctor can recommend further evaluation and suggest alternative treatments or medications to help alleviate your symptoms.

Drink more water

Drinking water is one of the simplest and most effective ways to combat constipation. Water is essential for digestion, keeping food moving through the intestines and ensuring that they remain smooth and flexible.

When the body is dehydrated, the large intestine will absorb water from food waste, resulting in hard stools that are difficult to pass. Drinking plenty of water helps to prevent this by keeping the stool soft and easy to pass. It also helps to regulate your bowels and prevent constipation from occurring in the first place.

The amount of water you should drink each day depends on various factors, including your level of physical activity and any medical conditions you may have. The National Health Service (NHS) in the United Kingdom recommends that an average adult should aim to drink 6-8 glasses of water per day. However, it is always best to consult with your doctor to determine the appropriate amount of water intake for your specific needs.

In addition to drinking enough water, it is also important to ensure you are getting enough fibre in your diet. Fibre helps to regulate digestion and can be found in vegetables, brown rice, whole grains, green beans, broccoli, cabbage, apples, berries, beans, nuts, seeds, and oats.

If you are experiencing constipation, it is important to try natural remedies such as increasing your water and fibre intake, exercising, and making dietary changes before resorting to laxatives. However, if these remedies do not provide relief, it is recommended to consult your doctor, as chronic constipation could be a symptom of a more serious medical condition.

Exercise regularly

Exercise is a great way to combat constipation. According to experts, it is essential for regular bowel movements. In fact, one of the key things that leads to constipation is inactivity.

Exercise helps constipation by lowering the time it takes food to move through the large intestine. This limits the amount of water your body absorbs from the stool, making them less hard and dry, and therefore easier to pass. Plus, aerobic exercise speeds up your breathing and heart rate, which helps to stimulate the natural squeezing (or contractions) of muscles in your intestines.

When to exercise

It is recommended to wait an hour after a big meal before doing any tough physical activity. After eating, blood flow increases to your stomach and intestines to help your body digest the food. If you exercise right after eating, blood flows away from your stomach and to your heart and muscles instead. Since the strength of your gut's muscle contractions depends on how much blood it has, less blood in the GI tract means weaker contractions and the food will move sluggishly through your intestines. This can lead to bloating, gas, and constipation. So after a big meal, give your body a chance to digest it before exercising.

Recommended exercises

Simply getting up and moving can help constipation. A regular walking plan -- even 10 to 15 minutes several times a day -- can help the body and digestive system work at their best. If you are already fit, you might choose aerobic exercise: running, jogging, swimming, or swing dancing, for example. All of these exercises can help keep the digestive tract healthy. Stretching may also help ease constipation, and yoga may, too.

The Centers for Disease Control and Prevention recommends that all adults get 150 minutes of moderate-intensity aerobic exercise per week. If possible, try to do 30 minutes a day at least five times a week.

Yoga poses to try

• Lie flat on your back with your legs fully extended in front of you. Slowly raise your right knee up to your chest and hold it in place with your arms for a count of 20 breaths. Release your knee and let your leg extend fully in front of you again. Perform the same action with your left leg for another 20 breaths. Repeat the process once more, this time holding both legs to your chest.
• Sit comfortably on the floor with your legs fully extended in front of you. Bring your left knee up so that your foot rests flat on the ground close to your buttocks. Twist your core by placing your right elbow on the opposite side of your left knee and look over your left shoulder. Hold this pose for five deep breaths, and then release. Repeat the same action on the opposite side of your body.
• Lie flat on your back and bring both of your knees up to your chest. Stretch your left leg out straight. Keeping your shoulders pressed against the floor, move your right knee across your body to the left and look toward your right. Hold this position for 20 breaths and then release. Repeat the same process on the opposite side of your body.

Eat more fibre

Fibre is a part of some foods (fruits, vegetables, grains, beans, nuts, and seeds) that you do not digest and therefore ends up in your large bowel. It can make your stool bigger and softer and sometimes also looser. It can produce gas. Fibre can be given in pills or powder as a laxative.

Fibre recommendations have not changed much over the years. Organisations serious and careful about the advice they give out have been saying for decades that we need to eat more fibre, obtained from a wide variety of foods, and preferably unprocessed. The reason for this recommendation is that people who consume more fibre are less prone to diseases of the heart and circulation, Type 2 diabetes, and bowel cancer. They are leaner and tend to have lower blood pressure and total cholesterol. Moreover, people who eat more fibre often have longer lives than those who have less fibre in their diet.

However, a high fibre diet can make constipation worse, not better, because the fibre bulk up the stool and more stool can’t slip out, it’s too big. A team of researchers in Singapore found that when they prescribed less fibre to a group of constipated patients, bowel movements happened. The patients went from making a poop once every 3.75 days to once a day.

The fibre you want to limit is insoluble fibre, otherwise known as roughage. Think bran, whole grain cereals, wholewheat, brown bread, etc. Keep the soluble fibre, the fibre that comes with vegetables and fruit. This fibre won't bulk up the stool and vegetables and fruits do more than just provide fibre.

Fibre supplements, also called bulk-forming laxatives, work by making stools bulkier and softer, which stimulates the intestines and makes stools easier to pass. It is important to take each dose with a full glass of water (or other liquid). To avoid flatulence (gas) and bloating, it’s best to start with a small dose then gradually increase the amount or frequency.

However, it is important to note that soluble fibre can produce gas and this might cause discomfort and bloating in some people. On the other hand, soluble fibre can be useful if you have loose stools or diarrhoea, as it absorbs water. Insoluble fibre, on the other hand, might worsen diarrhoea by making the bowel secrete more water.

Try caffeine

If you're struggling to go to the bathroom, caffeine may be able to help. Coffee, soda, and caffeinated tea can stimulate the colon and get things moving.

Caffeine is a natural stimulant that increases energy and may trigger contractions in your colon and intestinal muscles, making it easier for food to move through your gut. A 1990 study found that drinking caffeinated coffee increased rectosigmoid motility in 29% of participants within four minutes. A 1998 study found that caffeinated coffee stimulated the colon 23% more than decaf coffee and 60% more than plain water.

However, it's important to note that the effect of caffeine on bowel movements is not solely due to the caffeine itself. Decaf coffee has been found to have the same or an even greater effect on stimulating the colon. Other compounds in coffee, such as chlorogenic acids and N-alkanoyl-5-hydroxytryptamides, may also play a role in stimulating bowel activity. Additionally, the act of drinking any liquid in the morning can stimulate a defecation reflex known as the gastrocolic reflex, which helps jump-start your bowels.

While caffeine can be effective in stimulating bowel movements, excessive consumption of caffeinated drinks may cause loose stools or diarrhea. It's important to be cautious and not rely too heavily on caffeine as a laxative. If you're experiencing constipation, it's always a good idea to consult your doctor or a healthcare professional for advice. They may recommend increasing your fiber and water intake, regular physical activity, or trying a gentle over-the-counter laxative.

See a doctor

If you are experiencing constipation and laxatives are not working, it is important to see a doctor. Constipation is a common issue, but it is not "normal" and can be a symptom of a more serious underlying condition. While it can often be resolved with dietary and lifestyle changes, it is important to seek medical advice if your symptoms persist or are accompanied by other concerning symptoms.

When to See a Doctor

It is recommended that you see a doctor if your constipation does not improve within three weeks of trying home remedies such as increasing water intake, exercise, and dietary fibre. Additionally, if you are constantly needing to take laxatives, it is advisable to consult a doctor.

• Sudden Onset: If you have always had regular bowel movements and suddenly develop chronic constipation, it could indicate an underlying condition that requires treatment.
• Long-lasting Constipation: Constipation is typically temporary. If it persists for several weeks or longer and interferes with your daily life, it is important to seek medical advice.
• Blood in Stool: The presence of blood in your stool can be indicative of serious conditions such as Crohn's disease or colorectal cancer.
• Unexplained Weight Loss: While constipation may reduce your appetite, noticeable and unexplained weight loss could be a sign of celiac disease or cancers of the gastrointestinal tract.
• Severe Abdominal Pain: Intense abdominal pain accompanied by constipation can be a sign of intestinal obstruction, diverticulitis, or bowel perforation.
• Vomiting: Vomiting with constipation may indicate a bowel obstruction or a blockage in the colon due to impacted stool.
• Bloating: Painful bloating with constipation could be a sign of bowel obstruction, irritable bowel syndrome (IBS), or gastroparesis (a condition where the stomach does not digest and move food properly).
• Racing Heart: Experiencing a racing heart along with constipation could indicate fecal impaction, a dangerous condition where hard stool becomes stuck and blocks the passage of new stool.
• Inability to Pass Gas: Constipation accompanied by an inability to pass gas may suggest a bowel obstruction in the small or large intestine.
• No Bowel Movements for More Than a Week: While this may not be an immediate emergency, seeking medical help can prevent the situation from becoming more serious.

Medical Evaluation and Treatment

When you see a doctor about your constipation, they will likely ask about your symptoms, medical history, and family history. They may perform a physical examination and recommend screening tests to rule out any serious underlying conditions. Depending on the cause and severity of your constipation, your doctor may suggest dietary and lifestyle changes, prescribe medications, or recommend other treatments.

Frequently asked questions