Treatment: What to do if you have no bowel movement in 7 days?
1- Define the cause and complications (if any).
The first step to relieving prolonged constipation is to define your specific cause. Is it diet? a medication? have you been diagnosed with chronic constipation or IBS-C?
Review the causes mentioned in the first part of this article. Ask your doctor or nurse about the possible cause of your constipation if you are unsure.
Detecting the specific cause is critical to determining the best treatment. And it is important to avoid unnecessary medications or treatments.
A week without a bowel movement is frequently seen in people with chronic constipation. However, you have to make sure that no other serious causes of prolonged constipation exist.
The common 2 conditions that can result in no bowel movements for 7 days or more are:
Increasing the amount of fluid you have beyond what your need doesn’t seem to improve constipation.
However, failure to obtain your need from water or fluids, in general, can participate in constipation (ref).
Also, good hydration is needed for soluble fiber to work. Either you take your soluble fiber from your diet or from a supplement, water is needed.
Soluble fiber dissolves in water and forms a gel-like substance. This substance helps to add bulk to the stool. Also, it acts to soften the hard stool.
Actionable tips to stay hydrated:
Aim for at least eight 8-ounce servings per day (8X8).
Increase the amount if you undergo dehydrating activities such as working in hot weather or working out.
Lemon water, sparkling water, and other types of fluid can also help.
Distribute the drinking activity throughout the day.
Drink enough amount of water with dietary fiber or fiber supplement intake.
Avoid too much caffeine (causes diuresis and water loss with urine).
4- Move.
Physical activity appears to be beneficial in fighting constipation (ref). People who have a sedentary lifestyle are at higher risk of constipation.
Gentle exercise (such as brisk walking) appears to be more beneficial than vigorous exercise (such as jogging) (ref).
5- Prunes, Prunes, and prunes.
Prunes and prune juice are proven to improve constipation. Some studies stated that prunes are even more effective than psyllium in relieving constipation.
Tips on taking prunes for constipation:
Start with 4-8 ounces at a time of prune juice for adults. (ref).
You can gradually increase the amount to produce results. But remember that more is not always better.
Drink the prune juice in the morning to produce a bowel movement.
Eating prunes can also help (6 per day).
6- Take a soluble fiber supplement.
Try a soluble fiber supplement if you are unable to obtain the recommended amount of fiber from your diet.
The best soluble fiber supplement for constipation is psyllium (Metamucil). Metamucil is also recommended for people with IBS-C.
A soluble fiber supplement has numerous benefits for constipation:
It forms a stool bulk, This “bulking effect” of Metamucil helps to stimulate and regulate colon movements.
Softens the stool (dissolves in water and forms a gel-like substance).
Act as a nutrient for the good bacteria inside your gut.
Supports gut immunity.
The dose of Metamucil (psyllium) ranges from 1 teaspoon (5.6 g) of powder once daily up to 6 teaspoons per day (2 teaspoons 3 times daily).
It is vital to drink plenty amount of water for Metamucil to work. Each dose of Metamucil powder is mixed with 8 ounces of water (250 CC).
Not all people respond to fiber or bulk-forming laxatives. This is especially more evident in people with severe constipation (as with having no bowel movements for 7 days).
So, if psyllium doesn’t work for you, Try other stronger forms of laxatives (see below).
7- Try an osmotic laxative.
Osmotic laxatives are more effective for constipation than fiber laxatives. Ask your doctor about the best over-the-counter laxative for prolonged constipation.
Osmotic laxatives work by withdrawing water into the colon. This softens the stool, increases its size, and helps increase the bowel movement frequency (ref).
Common examples:
Polyethyeneglycole (such as Miralax). We discussed the dose of MiraLAX for severe constipation HERE.
Lactulose (as Lenulose). But it takes some time to produce its effects (from 1 to 2 days).
Sorbitol. it is an equally effective and less expensive alternative.
Saline laxatives such as Milk of magnesia and magnesium citrate.
8- Suppositories and Enemas can also help with prolonged constipation.
In severe cases such as lack of bowel movements for 7 or more days, enemas and suppositories can be effective.
Enemas and suppositories help to liquefy the hard stools in the last part of the colon and rectum.
Ask your doctor about the best solution.
Examples:
Glycerin suppositories (as Fleet Liquid Glycerin Supp and Sani-Supp Adult) are available OTC.
Bisacodyl Suppositories (also available as an OTC medication).
Lactulose enemas.
Mineral Oil Enemas.
9- Ask your doctor about stronger medications.
In severe Prolonged cases of constipation. Your doctor may prescribe more potent pharmacological drugs.
Examples:
Linaclotide (Linzess): It is an FDA-approved drug to treat chronic idiopathic constipation. It increases colon motility and stimulates intestinal fluid secretion. The usual adult dose is 145 Micrograms once daily.
Lubiprostone (Amitiza): It helps to increase intestinal fluid secretion and improves hard stools. The usual dose for adults is 24 micrograms twice daily (FDA-Approved). It commonly causes some nausea and may cause diarrhea.
Plecanatide (Trulance): It can be used for chronic idiopathic constipation and IBS-C at a dose of 3 mg once daily. (ref)
Prucalopride (Motegrity): A prokinetic drug that can be used in constipation at a dose of 1 to 4 mg per day. It can be used safely in ages older than 65, but at lower doses. (ref)
Too many other pharmacological treatments are available for prescription. Always discuss the issue with your doctor to determine the best option.
When to worry about infrequent bowel movements?
Sometimes, it is normal for constipation sufferers to last for 7 days or more without bowel movements. However, you have to see a doctor if the following signs are present:
Intense or constant abdominal pain.
Vomiting.
Severe bloating or abdominal swelling.
Blood in stool.
Fever.
Unexplained symptoms such as weight loss, palpable mass in your abdomen.
Evidence-based
Written by a doctor.
MD, Associate Lecturer of Gastroenterology and hepatology. An IBS sufferer, gut health enthusiast and witer.
