Constipation

Health Condition

Constipation

  • Cascara

    Cascara is considered a stimulant laxative because it stimulates bowel muscle contractions. Cascara has a milder action compared to other stimulant herbs.

    Dose:

    20 to 30 mg of cascarosides per day for no more than ten days
    Cascara
    ×

    Only the dried form of cascara should be used. Capsules providing 20 to 30 mg of cascarosides per day can be used. However, the smallest amount necessary to maintain soft stool should be used.2 As a tincture, 1/4 to 1 teaspoon (1–5 ml) per day is generally taken. It is important to drink eight 6-ounce (180 ml) glasses of water throughout the day while using cascara. Cascara should be taken consecutively for no longer than eight to ten days.3

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

  • Flaxseed

    Flaxseed is a mild bulk-forming laxative that’s best suited for long-term use in people with constipation.

    Dose:

    1 Tbsp (15 ml) whole or ground with a full glass of water, one or two times per day
    Flaxseed
    ×

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating. Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include psyllium, flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation.4

  • Glucomannan

    Glucomannan is a water-soluble dietary fiber that has shown to be effective as a bulk-forming laxative.

    Dose:

    3 to 4 grams daily in water, followed by a second glass of water
    Glucomannan
    ×
     

    Glucomannan is a water-soluble dietary fiber that is derived from konjac root. Like other sources of fiber, such as psyllium and fenugreek, glucomannan is considered a bulk-forming laxative. A preliminary trial5 and several double-blind trials6,7,8,9 have found glucomannan to be an effective treatment for constipation. The amount of glucomannan shown to be effective as a laxative is 3 to 4 grams per day. In constipated people, glucomannan and other bulk-forming laxatives generally help produce a bowel movement within 12 to 24 hours.

  • Probiotics

    Research has shown that the probiotic strain Lactobacillus casei Shirota may help relieve chronic constipation after two weeks of supplementation.

    Dose:

    Amount depends on the probiotic strain used
    Probiotics
    ×
    In one double-blind study, 70 people (average age, 44 years) with chronic constipation were randomly assigned to receive 65 ml/day of a probiotic beverage or placebo for four weeks.10 The probiotic beverage provided daily at least 6.5 billion colony-forming units of Lactobacillus casei Shirota. The treatment group began showing statistically significant improvements at the end of the second week. At the end of the treatment period, the proportion of patients having moderate or severe constipation was 34% in the active-treatment group and 83% in the placebo group. Another double-blind trial found that a probiotic supplement taken for 4 weeks significantly increased bowel movement frequency in adults with constipation. The product used in that study provided 200 million colony-forming units of Lactobacillus reuteri DSM 17938 per day, and was taken twice a day after meals.11
  • Psyllium

    Psyllium is a mild bulk-forming laxative that’s best suited for long-term use in people with constipation.

    Dose:

    5 to 10 grams daily in water, followed by a second glass of water
    Psyllium
    ×

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include psyllium, flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation.

    Many doctors recommend taking 7.5 grams of psyllium seeds or 5 grams of psyllium husks, mixed with water or juice, one to two times per day. Some doctors use a combination of senna (18%) and psyllium (82%) for the treatment of chronic constipation. This has been shown to work effectively for people in nursing homes with chronic constipation.12

  • Senna

    Senna is considered a stimulant laxative because it stimulates bowel muscle contractions. Senna is the most popular of these stimulant herbs.

    Dose:

    20 to 60 mg of sennosides per day for no more than ten days
    Senna
    ×

    Senna contains hydroxyanthracene glycosides known as sennosides. These glycosides stimulate colon activity and thus have a laxative effect. Also, these glycosides increase fluid secretion by the colon, with the effect of softening the stool and increasing its bulk.1 Double-blind trials have confirmed the benefit of senna in treating constipation.13,14Constipation induced by drugs such as the anti-diarrhea medicine loperamide (Imodium) has also been shown to be improved by senna in a clinical trial.15

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include psyllium, flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation.

    Many doctors recommend taking 7.5 grams of psyllium seeds or 5 grams of psyllium husks, mixed with water or juice, one to two times per day. Some doctors use a combination of senna (18%) and psyllium (82%) for the treatment of chronic constipation. This has been shown to work effectively for people in nursing homes with chronic constipation.16

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

  • Alder Buckthorn

    Alder buckthorn is considered a stimulant laxative because it stimulates bowel muscle contractions.

    Dose:

    20 to 30 mg of anthraquinone glycosides (calculated as glucofrangulin A) per day
    Alder Buckthorn
    ×

    Only the dried form of alder buckthorn should be used. Capsules providing 20 to 30 mg of anthraquinone glycosides (calculated as glucofrangulin A) per day can be used; however, the smallest amount necessary to maintain regular bowel movements should be used.17 As a tincture, 5 ml once at bedtime is generally taken. Alder buckthorn is usually taken at bedtime to induce a bowel movement by morning. It is important to drink eight six-ounce glasses of water throughout the day while taking alder buckthorn, and to consume plenty of fresh fruits and vegetables. Alder buckthorn should be taken for a maximum of eight to ten days consecutively or else it can lead to dependence on it to have a bowel movement.17 Some people take peppermint tea or capsules with alder buckthorn to prevent griping, an unpleasant sensation of strong contractions in the colon sometimes induced by the herb.

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

  • Aloe

    Aloe is considered a stimulant laxative because it stimulates bowel muscle contractions. Aloe is very potent and should be used with caution.

    Dose:

    Refer to label instructions
    Aloe
    ×

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating. Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn(Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).18

  • Basil

    Basil seed has been found to relieve constipation by acting as a bulk-forming laxative in one preliminary study.

    Dose:

    Take as tea (2 tsp in 2 cups of water), or as a tincture or capsules (follow label instructions)
    Basil
    ×
     

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Basil (Ocimum basilicum) seed has been found to relieve constipation by acting as a bulk-forming laxative in one preliminary study.19 A similar study showed the seeds to be useful following major surgery for elderly people with constipation.20Alginic acid, one of the major constituents in bladderwrack (Fucus vesiculosus), is a type of dietary fiber that may be used to relieve constipation. However, human studies have not been conducted on the effectiveness of bladderwrack for this condition.

  • Buckthorn

    Buckthorn is considered a stimulant laxative because it stimulates bowel muscle contractions.

    Dose:

    20 to 30 mg of anthraquinone glycosides (calculated as glucofrangulin A) daily
    Buckthorn
    ×

    Only the dried form of buckthorn berries and bark should be used. Capsules providing 20 to 30 mg of anthraquinone glycosides (calculated as glucofrangulin A) per day can be used; however, the smallest amount necessary to maintain regular bowel movements should be used.21 As a tincture, 5 ml once at bedtime is generally taken. Usually buckthorn is taken at bedtime, so it will have time to act and by morning a bowel movement is induced. It is important to drink eight six-ounce glasses of water throughout the day while taking buckthorn, and to consume plenty of fresh fruits and vegetables. Buckthorn should be taken for a maximum of eight to ten days consecutively or else it can lead to dependence on it to have a bowel movement.21 Some people take peppermint tea or capsules with buckthorn to prevent griping, an unpleasant sensation of strong contractions in the colon sometimes induced by buckthorn.

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn(Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

  • Rhubarb

    Rhubarb is considered a stimulant laxative because it stimulates bowel muscle contractions.

    Dose:

    Follow label instructions
    Rhubarb
    ×

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

  • Bladderwrack

    Alginic acid, one of the major constituents in bladderwrack, is a type of dietary fiber that may be used to relieve constipation.

    Dose:

    Refer to label instructions
    Bladderwrack
    ×
     

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Basil (Ocimum basilicum) seed has been found to relieve constipation by acting as a bulk-forming laxative in one preliminary study.22 A similar study showed the seeds to be useful following major surgery for elderly people with constipation.23Alginic acid, one of the major constituents in bladderwrack(Fucus vesiculosus), is a type of dietary fiber that may be used to relieve constipation. However, human studies have not been conducted on the effectiveness of bladderwrack for this condition.

  • Chlorophyll

    Chlorophyll, the substance responsible for the green color in plants, has been shown to ease chronic constipation in elderly people.

    Dose:

    Refer to label instructions
    Chlorophyll
    ×
     

    Chlorophyll, the substance responsible for the green color in plants, may be useful for a number of gastrointestinal problems. In a preliminary trial, chlorophyll supplementation eased chronic constipation in elderly people.24

  • Dandelion

    The bitter compounds in dandelion leaves and root are also mild laxatives.

    Dose:

    Refer to label instructions
    Dandelion
    ×
     

    The unprocessed roots of fo-ti possess a mild laxative effect. The bitter compounds in dandelion leaves and root are also mild laxatives.

  • Fenugreek

    Fenugreek is a mild bulk-forming laxative that’s best suited for long-term use in people with constipation.

    Dose:

    Refer to label instructions
    Fenugreek
    ×
     

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include psyllium, flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation.

  • Fo-Ti

    The unprocessed roots of fo-ti possess a mild laxative effect.

    Dose:

    Refer to label instructions
    Fo-Ti
    ×
     

    The unprocessed roots of fo-ti possess a mild laxative effect. The bitter compounds in dandelion leaves and root are also mild laxatives.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Holistic Options

Anecdotal reports have claimed that acupuncture is beneficial in the treatment of constipation.25,26,27,28 However, a small, controlled study of eight people with constipation concluded that six acupuncture treatments over two weeks did not improve bowel function during the course of the study.29 Placebo-controlled trials of longer duration are needed to determine whether acupuncture is a useful treatment for constipation.

Biofeedback techniques have been shown to significantly increase the frequency of bowel movements among women with chronic constipation.30

References

1. Dukas L, Platz EA, Colditz GA, et al. Bowel movement, use of laxatives and risk of colorectal adenomatous polyps among women (United States). Cancer Causes Control 2000;11:907-14.

2. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 104-5.

3. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 52-4.

4. Cockerell KM, Watkins AS, Reeves LB, et al. Effects of linseeds on the symptoms of irritable bowel syndrome: a pilot randomised controlled trial. J Hum Nutr Diet 2012;25:435-43. doi: 10.1111/j.1365-277X.2012.01263.x.

5. Passaretti S, Franzoni M, Comin U, et al. Action of glucomannans on complaints in patients affected with chronic constipation: a multicentric clinical evaluation. Ital J Gastroenterol 1991;23:421-5.

6. Marzio L, Del Bianco R, Donne M, et al. Mouth-to-cecum transit time in patients affected by chronic constipation: effect of glucomannan. Am J Gastroenterol 1989;84:888-91.

7. Marsicano LJ, Berrizbeitia ML, Mondelo A. Use of glucomannan dietary fiber in changes in intestinal habit. G E N 1995;49:7-14 [in Spanish].

8. Signorelli P, Croce P, Dede A. A clinical study of the use of a combination of glucomannan with lactulose in the constipation of pregnancy. Minerva Ginecol 1996;48:577-82 [in Italian].

9. Staianno A, Simeone D, Giudice ED, et al. Effect of the dietary fiber glucomannan on chronic constipation in neurologically impaired children. J Pediatr 2000;136:41-5.

10. Koebnick C, Wagner I, Leitzmann P, Stern U, Zunft HJF. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol 2003;17:655-9.

11. Ojetti V, Ianiro G, Tortora A, et al. The effect of Lactobacillus reuteri supplementation in adults with chronic functional constipation: a randomized, double-blind, placebo-controlled trial. J Gastrointestin Liver Dis 2014;23:387–91.

12. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

13. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and Lactulose in elderly patients with chronic constipation. Pharmacol 1993;47(suppl 1):249-52.

14. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacol 1993;47(suppl 1):253-5.

15. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre+senna on colonic transit in loperamide-induced constipation. Pharmacol 1993;47(suppl 1):242-8.

16. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

17. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998:95-8.

18. Weiss RF. Herbal Medicine. Hippokrates Verlag GmbH, Stuttgart, Germany, 1988:105-111

19. Kocharatana P, et al. Clinical trial of maeng-lak seeds used as a bulk laxative. Maharaj Nakornratchasima Hosp Med Bull 1985;9:120-36.

20. Muangman V, Siripraiwan S, Ratanaolarn K, et al. A clinical trial of Ocimum canum Sims seeds as a bulk laxative in elderly post-operative patients. Ramathibodi Med J 1985;8:154-8.

21. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998:95-8.

22. Kocharatana P, et al. Clinical trial of maeng-lak seeds used as a bulk laxative. Maharaj Nakornratchasima Hosp Med Bull 1985;9:120-36.

23. Muangman V, Siripraiwan S, Ratanaolarn K, et al. A clinical trial of Ocimum canum Sims seeds as a bulk laxative in elderly post-operative patients. Ramathibodi Med J 1985;8:154-8.

24. Young RW, Beregi JS Jr. Use of chlorophyllin in the care of geriatric patients. J Am Geriatr Soc 1980;28:46-7.

25. Kangmei C, Shulian Z, Ying Z. Auriculoacupuncture therapy—a traditional Chinese method of treatment. J Tradit Chin Med 1992;12:308-10.

26. Xuemin S. Clinical observations on 50 cases of obstipation treated with acupuncture. J Tradit Chin Med 1982;2:162.

27. Fischer MV, Behr A, Reumont J. Acupuncture—a therapeutic concept in the treatment of painful conditions and functional disorders. Report on 971 cases. Acupunct Electrother Res 1984;9:11-29.

28. Shuli C. Clinical application of acupoint tianshu. J Tradit Chin Med 1992;12:52-4.

29. Klauser AG, Rubach A, Bertsche O, Muller-Lissner SA. Body acupuncture: effect on colonic function in chronic constipation. Z Gastroenterol 1993;31:605-8 [in German].

30. Heymen S, Wexner SD, Vickers D, et al. Prospective, randomized trial comparing four biofeedback techniques for patients with constipation. Dis Colon Rectum 1999;42:1388-93.

31. Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow's milk and chronic constipation in children. N Engl J Med 1998;339:1100-4.

32. Daher S, Solé D, de Morias MB. Cow's milk and chronic constipation in children. N Engl J Med 1999;340:891.

33. Shah N, Lindley K, Milla P. N Engl J Med 199918;340:891-2.

34. Morais MB, Vítolo MR, Aguirre ANC, Fagundes-Nteo U. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. J Pediatr Gastroenterol Nutr 1999;29:132-5.

35. Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. BMJ 1988;296:615-7.

36. Marcus SN, Heaton KW. Effects of a new, concentrated wheat fibre preparation on intestinal transit, deoxycholic acid metabolism and the composition of bile. Gut 1986;27:893-900.

37. Oettl GJ. Effect of moderate exercise on bowel habit. Gut 1991;32:941-4.

38. Bingham SA, Cummings JH. Effect of exercise and physical fitness on large intestinal function. Gastroenterology 1989;97:1389-99.

Copyright © 2024 TraceGains, Inc. All rights reserved.

Learn more about TraceGains, the company.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.

drug Image
Check Pricing on Drugs Commonly Used to Treat constipation:

Select drug name to view medication information and pricing.

Log In

You need to log into the site to use this feature

Create A Free Account To Use Medicine Chest

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use Medicine Chest

Create A Free Account To Use this feature

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use this feature

You will be redirected to your program in 5 seconds.

Hi there.

Our Terms and Conditions and Privacy Policy have recently been updated.

Learn More


I Accept

By declining you will be logged out of your account

;