Let me confess something: My friends and I have a text thread named “Imodium. Or Miralax?” where we talk about our bowel movements (or lack thereof) somewhat regularly. The group chat, which is elegantly named after an over-the-counter antidiarrheal pill and an OTC laxative, was born a few years ago after one of my pals was having trouble pooping during an international work trip.
After a 14-hour flight, my friend developed a stubborn case of constipation that they couldn’t shake. They chugged water, ate veggies, and took shots of espresso—all of which are supposed to help get things moving—but nothing kick-started their bowels. As a last-ditch effort, they popped a laxative, which solved the constipation but ignited an entirely new dilemma: diarrhea. And so, in a failed attempt to avoid missing out on work, this person spent the next week alternating between laxatives and antidiarrheal meds, spending the bulk of their time abroad glued to a toilet, texting about the dreadful experience.
This, dear readers, is a cautionary tale of what not to do when you get backed up. Lisa Ganjhu, DO, a gastroenterologist at NYU Langone Health, tells SELF that people often take too strong of a laxative, or too high of a dose, to treat constipation and wind up swinging hard in the other direction. When you do this, you can get trapped in a vicious cycle where you’re not able to poop, then you can’t stop pooping, and so it goes, until one day your friend exposes your entire saga in a story for SELF.
Some laxatives can certainly help move things along (we’ll get into which ones below), and there are ways to deal with constipation without accidentally opening the floodgates. Here’s some advice about landing in the right place, according to experts.
1. Drink a lot of water.
Typically, when things are running smoothly, your colon sucks water out of your stool as it passes through your bowels. This causes your waste to bulk up, making it easier to go to the bathroom. When you’re constipated, poop moves through your bowels very slowly, but your colon keeps absorbing water at the same pace, Aditya Sreenivasan, MD, a gastroenterologist at Northwell Lenox Hill Hospital in New York City, tells SELF. As a result, the turd (sorry) gets harder and firmer, delaying its journey through your innards. And if you’re dehydrated from, say, a medical condition or simply not drinking enough, this problem’s just going to get worse. (Poop that’s dry and hard as a brick is incredibly hard to push out. You want your feces to be firm, but not totally solid.)
To beat constipation, you need to break that cycle, Dr. Sreenivasan says. One way to do that is to get more fluids into your colon by drinking more water: “Your stool will move through easier at a more normal consistency and you’ll have less constipation,” he says.
Good old-fashioned water (as opposed to sports drinks) is best, he notes. Sports drinks, for example, often contain added sugars that, for the sake of your constipation, aren’t helpful. All you really need is more water reaching your colon. Plain and simple.
So aim for at least 10 cups of water a day when you’re constipated. You might need more or less, depending on what you’ve been eating (usually, about 20% of the fluid you need in a day should come from food) and other factors like your physical activity levels (say, you did a super sweaty run) and the weather (you’re trudging through a scorching or humid day). This might seem like a lot of water, but if you’re super jammed up, “You need to really step up your game and get to 2.5 to 3 liters,” Dr. Sreenivasan says.
2. Get plenty of fiber in the mix.
When it comes to staying regular, fiber is a must. This plant-based carb helps you digest food and poop properly. The United States Department of Agriculture (USDA) notes that women should ideally eat between 22 and 28 grams of fiber a day, depending on their age. For men, that range looks like 28–34 grams daily. Eating a low-fiber diet (anything below your recommended amount) can reduce the frequency and size of your poops. So loading up on more fiber is an effective way to get things feeling right again when constipation hits, studies show.
Dr. Ganjhu says, in general, you should aim to have 25–30 grams of fiber each day. Start with fiber-rich foods like vegetables, fruits (especially pears, grapes, prunes, and apples), potatoes, and whole grains like brown rice, oats, or wheat bread. Some evidence suggests that fruit juices—like apple, prune, and pear juices—can also be helpful.
Keep this in mind: Fiber can have vastly different effects on people, so you’ll need to experiment with the amount of fiber you eat and the types of foods you try. Some people, for example, don’t have enough of the digestive enzymes that help break down specific sources of fiber, so they can become bloated and gassy. Gradually add fiber into your diet if you haven’t been eating many foods rich in it lately—for example, start by adding a whole grain to each meal: “If you go from not eating a lot of fiber to [far more of it], you can have a lot of temporary bloating and discomfort,”—not to mention diarrhea, Dr. Sreenivasan says.
It’s best to make what you eat your main source of fiber, but it’s not always easy to get enough of it through your diet alone (fiber-rich foods can be expensive, for one, and the average American diet tends to lack the amount of fiber we need), which is why Dr. Sreenivasan says it’s okay to go the supplement route if slamming prune juice just isn’t helping. (Metamucil and Benefiber are popular picks, according to Dr. Ganjhu.)
Before you play around with fiber supplements, talk to a doctor or registered dietitian. These pills and powders can impact how well some medications work, and some health conditions, like celiac disease, can flare up as a result of some fiber sources (like those involving wheat).
If you try a supplement, Dr. Sreenivasan recommends increasing the dosage very gradually, given that going from zero to a hundred can cause diarrhea and other discomfort. His advice: Take a third of whatever the package recommends then, after a day or two, increase it to a half, and after a day or two try the full recommended amount. (Talk to a doctor about whether you should keep taking the supplement regularly after a given bout of constipation passes.) Again, everyone’s bodies react to fiber differently, so go slow to find the dose that works for you, Dr. Sreenivasan says.
3. Move your body.
Parking yourself in a chair for hours on end is also thought to bring your bowels to a screeching halt. “I always tell people: If you’re sitting around all day and not moving, your intestines are sitting around all day and not moving,” says Dr. Sreenivasan.
To combat this, move your body as much as you can throughout the day. (Research indicates that physical activity stimulates your abdominal muscles and speeds up your poop’s journey through your rectum.) You don’t need to do an hour-long HIIT class at the gym or go on a five-mile jog (though vigorous activity will surely help, evidence shows). Standing up and moving around every hour or so, going on 20- to 30-minute walks each day, or stretching a bit as you watch TV can wake up your bowels, says Dr. Sreenivasan.
4. Give laxatives a shot—but approach with caution.
If the above tips don’t make a difference, it might be time to head to the pharmacy, says Dr. Sreenivasan. There’s a time and a place for laxatives, you just want to be careful about what you use—especially if you want to avoid the runs. Many over-the-counter laxatives, including natural stimulants like senna and drugs like bisacodyl, are harsh on your colon—they can potentially irritate and inflame your bowels, causing them to cramp up and spew out whatever’s inside, says Dr. Ganjhu. (If you’ve taken these, you know they have the power to set off particularly intense diarrhea). It’s always a good idea to talk to your doctor and get their two cents before experimenting with laxatives.
From there, Dr. Sreenivasan recommends using a gentler laxative, like polyethylene glycol (a.k.a. Miralax, my group chat’s namesake). This “adds extra water to the colon and gently stimulates the colon to contract and relax to move the stool,” he explains. Glycerin and magnesium citrate, both of which Dr. Ganjhu also recommends, similarly draw more water into the colon to soften things up.
If you can’t shake the constipation no matter what you try, a doctor might want to run some tests to see if you have a more serious health condition (such as hypothyroidism or pelvic floor dysfunction) that could be slowing down your gut. They might also suggest another intervention, like adding probiotics to your diet or prescription medications, to bring things back up to speed.
Whatever you do, don’t freak out and overdo it with supplements or laxatives—starting with lots of water and fiber-rich foods is your best bet, and taking it slow with OTC remedies is key if you want to avoid a hellish case of the runs. The constipation won’t last forever! (You might, however, get permanently trapped in a text thread dedicated to your bowel movements—and, sadly, there is no cure for that.)
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