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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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In this Article

• What is constipation?
• What causes constipation?
• When should a doctor be consulted for constipation?
• What natural remedies can a person take for constipation?
• What over-the-counter preparations can be used for constipation?
• Bulk-forming laxatives
• Stool softeners (emollient laxatives)
• Lubricant laxatives
• Stimulant laxatives
• Saline laxatives and osmotic laxatives
• Enemas and suppositories
• How is constipation treated in infants and in children?
• How is constipation treated during pregnancy?
• Laxatives for Constipation At A Glance
• Patient Comments: Constipation - Possible Causes
• Find a local Gastroenterologist in your town
• Laxatives For Constipation Index

Rectally administered enemas and suppositories are commonly used to cleanse the rectum and the sigmoid colon (the part of the colon closest to the rectum) prior to surgery, childbirth, and flexible sigmoidoscopy. Enemas and suppositories are used to relieve constipation and rectal fecal impaction (blockage of the rectum by hard, compacted stool). They can also be used in conjunction with oral laxatives in cleansing the colon in preparation for barium enema studies. Some suppositories contain stimulant laxatives.

Enemas and suppositories include  docusate (Microenema), bisacodyl (Dulcolax Suppository), and sodium phosphate (Fleet Enema). These products are intended for occasional use and are not recommended as a chronic laxative regimen unless directed by a physician.

Individuals should carefully follow instructions in using enemas. The person should lie on the left side with the knees bent. The enema solution should be inserted slowly into the rectum. The person should retain the solution in the rectum until definite rectal pressure and the urge to have a bowel movement are felt. Evacuation usually occurs within minutes to an hour.

Precautions

• Soapsuds enemas can cause rectal irritation and sometimes rectal gangrene. Therefore, soapsuds enemas are not recommended.
• Enema solutions can cause fluid and electrolyte disturbances in the blood if used on a chronic basis.

If an infant is younger than four months old and seems constipated, it should be discussed with the pediatrician. For older children, home remedies may help relieve constipation. If a child has been constipated for a short time, changing the diet may be the only treatment needed.

The following natural treatments may be used for infants older than four months of age, or children with constipation:

• Dark corn syrup (Karo syrup) contains complex sugar proteins that keep water in the bowel movement. One teaspoon per four ounces of formula or expressed breast milk until the infant has a bowel movement.
• Prune or apple juice work best to treat constipation in children. Four ounces/day for children 4 months to 1 year of age.
• High-fiber foods. If your infant is eating solid foods, barley cereal may be used. Other high-fiber fruits and vegetables (or purées), including apricots, sweet potatoes, pears, prunes, peaches, plums, beans, peas, broccoli, or spinach can be fed to the child.
• Your doctor may recommend increased fiber in the child's diet, through supplementation.

Parents caregivers should contact the physician immediately if the child has severe abdominal pain, swollen or bloated abdomen, rectal pain, or bleeding. If there are any concerns about the child's bowel habits or questions about diet, parents or caregivers should talk to their pediatrician.