What to do if you're constipated : Life Kit We've got a step-by-step guide for that SOS moment when you haven't pooped in days and days.

What to do when you're constipated

What to do when you're constipated

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Sarah Oh for NPR
3D illustration: a cartoon poop relaxes on a cloud, an angelic pink and gold sky behind them. Objects with wings float around it: a toilet, toilet paper, and a glass of water.
Sarah Oh for NPR

Here's the scenario: You haven't pooped in days. You feel full and uncomfortable. You're starting to wonder if you'll ever go again.

If you've pooped fewer than three times in the past week and have hard, lumpy stools that you're straining to push out, you're probably constipated. And you're probably looking for a solution.

Here's a guide for that SOS moment to help you poop.

Limit your time on the toilet

If you're having trouble pooping, you'll probably be on the toilet for long stretches.

But if it's been more than five minutes, it's time to get up, says Dr. Lin Chang, a gastroenterology professor at UCLA's David Geffen School of Medicine.

If you're in the habit of sitting and straining, you can develop swollen veins in your rectum called external hemorrhoids. These can be painful, itchy and cause bleeding, she says. And over long periods of constipation, you could develop pelvic floor dysfunction, where your muscles get weaker and it gets even harder to poop.

Chang says you should wait to sit on the toilet until you feel an urge in your rectum. And if after five minutes and a couple of gentle pushes, you haven't had any luck, then get up and try again later.

Drink liquids, especially warm ones

You may have already thought of this, but: Drink some liquids, especially warm ones. "Warm liquids tend to stimulate the contraction of the intestinal wall muscles," says Dr. Kumkum Patel, a gastroenterologist at Providence St. Joseph and St. Jude Heritage Medical Group in California.

So sip on some coffee, tea or warm water while you wait.

Get a toilet stool

If you feel like time is on your side and you have the patience, you can try a physical intervention — one that doesn't involve medication.

You can start by getting a toilet stool, often known by the brand name Squatty Potty, says Patel.

Toilet stools allow you to squat over the toilet, and that works because "when you lift up your legs closer to your chest, you're actually easing up the angle at which your poop can come out." Patel says. "So your poop now has a straight and narrow pathway."

If you don't want to buy a toilet stool or you're not at home, get creative, says Kelly Peterson, who has a doctorate degree in physical therapy and specializes in the pelvic floor. Rest your elbows on your knees and lean forward. Or use a step stool or a trashcan to get your feet higher.

Try some stretches or massage

It might also help to stretch your pelvic floor because pelvic muscle spasms are one possible cause of constipation.

Peterson has a few go-to stretches: child's pose, happy baby, and a deep squat.

You could also try an abdominal massage, which research has shown can help you poop when constipated.

One method is known as the "I love you" stretch, because your hand will look like it's spelling out the letters I, L, and U, says Patel.

Using firm pressure with your hands, you'll lay on your back and then trace the letter I, then L, and then a U, in a half circle around your belly button, she says.

Take a laxative

If you don't have the patience for all of this or you've been constipated for more than a few days, you may need an oral laxative, says Chang.

A gentler approach, and the one you probably want to start with, is called an osmotic laxative, "which means that it pulls water in and makes it smoother for that poop to slide out," says Patel. MiraLax is one of the most popular brands, but there are generics too. These can take two or three days to work.

If you're still constipated, try a stimulant laxative, which will tell your intestines to start contracting. Senokot and ExLax are two popular brands. And stimulant laxatives tend to work within six to 12 hours, Patel says.

A stimulant laxative might give you cramps or diarrhea, "because it's irritating the hell out of the wall of the intestine," Patel says. But it can be a short-term fix.

Keep in mind: laxatives can be helpful in a pinch, but some of them, particularly the stimulant kind, can cause long-term problems, says Chang. You might build a tolerance to them and need higher doses over time. Also, if laxatives give you severe diarrhea and you're using them over a long period, you could end up with electrolyte imbalances, she says. So if you find yourself using laxatives regularly, talk to a doctor.

Consider a suppository or an enema

Sometimes an oral laxative alone doesn't do the trick because your rectum might be blocked at this point by hard stool, says Chang.

In these instances, she recommends a suppository, which is like a medication bullet that dissolves in your rectum and stimulates it to release the poop.

If that doesn't work, you might consider an enema. You can buy an enema kit over the counter. They typically contain water or a saline laxative. Sometimes they'll come in a bag, sometimes in a bottle, and they'll have a tapered tip. You put that in your rectum and squeeze.

Some people will do this while lying on their side, Chang says. Others will lift their leg up, put their knee over the toilet, and then insert it. Either way, you'll probably want to do an enema close to the bathroom, she says.

Once you've squirted the liquid in your rectum, "you hold it for as long as you can," she says. "And when you have the urge to go, then you evacuate."

Chang does not recommend that people use enemas regularly though, because patients sometimes start to feel like they need them in order to poop. Think of enemas as a helpful tool when you're really stuck.

Try to relax

This may not solve your constipation on its own, but it can help.

I know, it's easier said than done when it feels like your abdomen is going to explode. But still, try. Because one of the many causes of constipation is stress.

When we are under stress, we release hormones that put our body into fight or flight mode, says Patel. Researchers have different theories on why this results in constipation.

One is that your body is basically saying: uh, I'm kind of busy running away from a tiger right now. There's no time to poop! "And so it kind of holds it all in until you're relaxed enough to poop it out," she says.

You may experience stress-related constipation when you travel because you're getting on a flight, you're in an unfamiliar place, or you're changing your everyday routine. "That produces a stress response in a lot of people," Patel says.

One way to relax is with breathing exercises. Patel suggests the four, seven, eight technique: take a deep breath over the count of four, hold for seven, and exhale for eight. "That actually helps a lot by calming the nerves down. And by calming the nerves down, you can get yourself out of that fight or flight mode," she says.

You could also try a warm bath or exercise, which has been shown to lower levels of the body's stress hormones.

Lastly, there are medical guidelines for what's considered chronic constipation. A couple of examples: having fewer than three bowel movements per week and straining at least 25% of the time when you poop.

If you find that you are constipated often, drink more water, eat more fiber and consider making a doctor's appointment to investigate the cause.

The audio portion of this episode was hosted and reported by Marielle Segarra, produced by Clare Marie Schneider and edited by Meghan Keane.

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