Constipation Treatment

How is Constipation Diagnosed?

A general physician or gastroenterologist usually evaluates constipation by reviewing bowel habits, diet, fluid intake, medicines, medical history and associated symptoms. These are followed by a thorough physical examination. Additional diagnostic tests may be advised only when symptoms are persistent, severe, associated with warning signs or suggest a defecatory or underlying medical disorder. These tests can include blood tests, colonoscopy, abdominal imaging, anorectal manometry or colonic transit studies.

How is Constipation Treated Based on Severity?

Constipation treatment can be categorised based on how severe the symptoms are, how long the patient has been experiencing constipation and whether any complications or underlying conditions are present. A summarised table of constipation treatment based on its severity is given below:

Types of Constipation and Their Treatment

Constipation may be categorised into various types depending on its cause. A brief overview of the widely used treatment approaches based on the type of constipation is given in the table below:

Oral Medications for Constipation

Oral medications for constipation treatment are usually prescribed based on the type, severity, other health complications, and response to previous therapy or treatments. The oral medications commonly used for constipation treatment are:

• Isabgol (Psyllium Husk): A soluble fibre supplement that absorbs water and helps form softer, bulkier stools.

• Polyethylene Glycol: An osmotic laxative commonly used for persistent or chronic constipation.

• Lactulose: An osmotic laxative that increases water in the stool and makes it easier to pass.

• Liquid Paraffin: A lubricant laxative that may be prescribed for short-term relief in selected patients.

• Bisacodyl: A stimulant laxative used for short-term or rescue treatment when faster relief is required.

• Senna: A stimulant laxative that increases bowel contractions and helps pass stool.

• Sodium Picosulfate: A stimulant laxative used for short-term constipation relief or bowel preparation.

• Lubiprostone: A prescription medicine used for chronic constipation by increasing fluid secretion in the intestine.

• Linaclotide: A prescription medicine approved in India for chronic idiopathic constipation in adults.

• Prucalopride: A prescription medicine used for chronic idiopathic constipation when standard laxatives do not provide adequate relief.

Other Treatments for Constipation

Other treatment choices available to treat constipation are as follows:

Ayurvedic and Alternative Treatments for Constipation

Alternative therapies can be adopted as supportive approaches along with conventional medicine for the treatment of constipation. These include:

• Triphala can be effective in stimulating bowel movements and increasing stool movements in certain individuals.

• Abhyanga, or oil massage therapy, can be used as a supplementary approach for relaxation and better bowel movements.

• Yoga and stretching exercises can be useful for bowel movements and prevent constipation.

Note: These therapies must work in addition to rather than in place of conventional medical treatment for constipation.

Home Care for Managing Constipation

Individuals suffering from constipation may adopt the following steps for managing their condition at home:

• Increase fibre gradually through vegetables, fruits, pulses, whole grains, or a suitable supplement like isabgol.

• Maintain adequate fluid intake, especially when increasing fibre, unless fluid restriction has been advised.

• Exercise regularly within personal ability.

• Do not repeatedly delay the urge to pass stool.

• Try using the toilet at a regular time as a routine, particularly after meals.

• Allow enough time without excessive straining.

• Use a small footstool to raise the knees above hip level.

• Review medicines or supplements that may cause constipation with a doctor.

If you notice blood in the stool, unexplained weight loss, vomiting, severe abdominal pain, marked swelling or sudden, persistent constipation, seek medical care at the earliest.

Latest Treatment for Constipation

Elobixibat is a newer oral medicine approved and available in India for chronic constipation. It increases the amount of bile acid reaching the colon, which stimulates bowel movement and fluid secretion. It may be prescribed when standard treatments do not provide adequate relief. 

How Long Does Constipation Treatment Take?

An approximate duration of constipation treatment to effect is given below:

Constipation Treatment Side Effects

While constipation relief options are quite safe, they can sometimes trigger some side effects, such as:

• Bloating, gas or abdominal discomfort from fibre supplements

• Abdominal cramps or diarrhoea from osmotic or stimulant laxatives

• Loose stools

• Dehydration or electrolyte imbalance with excessive laxative use

• Headache or dizziness

• Rectal irritation from suppositories or enemas

• Nausea or headache from prucalopride

• Severe allergic reaction (rare)

• Rectal injury or bowel perforation during invasive treatment (rare)

Lifestyle Changes for Managing Constipation

These changes in your lifestyle could be helpful in preventing the recurrence of constipation:

• Eat regular meals and include fibre-rich foods in your meals gradually.

• Maintain adequate fluid intake.

• Remain physically active.

• Establish a consistent bowel routine, preferably after meals.

• Respond promptly to the bowel movement urges.

• Avoid prolonged sitting and excessive straining on the toilet.

• Reduce heavily processed, low-fibre foods.

Triggers That Can Worsen Constipation Symptoms

Some factors that may lead to worsening or more severe constipation symptoms include:

• Low dietary fibre intake

• Inadequate fluid intake

• Physical inactivity

• Repeatedly delaying bowel movements

• Sudden changes in routine or travel

• High intake of heavily processed, low-fibre foods

• Opioids, iron supplements, some antacids, anticholinergic medicines and certain antidepressants

• Pregnancy

• Reduced mobility

• Poorly controlled diabetes or hypothyroidism

• Neurological conditions

• Excessive or inappropriate laxative use

• Pelvic-floor dysfunction

Constipation Treatment Cost

The treatment cost for constipation in India depends on the severity of symptoms, the cause, and the required treatment. Mild constipation with dietary advice, fibre supplementation and use of OTC drugs can cost around ₹500 - ₹3,000 per month. Persistent or chronic constipation requiring prescription medicines, blood tests, imaging, anorectal manometry, colonic transit studies or colonoscopy may cost ₹5,000 - ₹30,000 or more. Hospital treatment for faecal impaction or rare surgical management can increase the total treatment cost.

Does Health Insurance Cover Constipation Treatment in India?

Health insurance covers routine outpatient consultations, fibre supplements, laxatives, and prescription medicines if OPD cover has been opted for. In severe cases, medically required hospitalisation for faecal impaction, bowel obstruction, severe complications or surgery for constipation treatment may be covered depending on the policy and benefits. 

Diagnostic tests, such as colonoscopy or anorectal manometry, may be covered, subject to policy terms and conditions. For pre-existing conditions, waiting periods of up to 3 years may apply before any claim can be made.