From the Guidelines
For constipation with no bowel movement for 10 days, immediate medical attention is recommended as this represents severe constipation that could indicate a bowel obstruction or other serious condition. While waiting for medical care, treatment options can be considered to help stimulate bowel function.
Treatment Options
- An over-the-counter osmotic laxative like polyethylene glycol (MiraLAX) at a dose of 17 grams mixed in 8 ounces of water once daily can be tried, as supported by recent guidelines 1.
- Adequate hydration with 8-10 glasses of water daily and physical activity can also help stimulate bowel function.
- A glycerin or bisacodyl suppository might provide faster relief, as these can act as rectal stimulants 1.
Important Considerations
- If these measures don't produce a bowel movement within 24 hours, or if you experience severe abdominal pain, vomiting, or bloating, it is crucial to go to an emergency room immediately.
- Ten days without a bowel movement can lead to impaction, where hardened stool becomes lodged in the rectum, potentially causing tissue damage, electrolyte imbalances, or even perforation of the bowel in severe cases.
Additional Measures
- In some cases, manual evacuation under anesthesia may be necessary if disimpaction does not occur after oral and rectal treatment, or if there is a megarectum, as outlined in management guidelines for severe chronic small intestinal dysmotility 1.
- The use of other agents like methylnaltrexone for opioid-induced constipation or naloxegol may be considered in specific contexts, but these should be used under medical supervision 1.
From the FDA Drug Label
USE • relieves occasional constipation (irregularity) • generally produces a bowel movement in 1 to 3 days The treatment for constipation with no bowel movement for 10 days is polyethylene glycol (PO), which generally produces a bowel movement in 1 to 3 days 2.
- Key points:
- Relieves occasional constipation
- Produces a bowel movement in a short period However, it is crucial to consult a healthcare professional for proper evaluation and guidance, as the situation may require more specific or intense treatment.
From the Research
Treatment Options for Constipation with No Bowel Movement for 10 Days
- Abdominal massage and laxative use can be effective in treating constipation, as shown in a pilot study 3 that found significant improvements in the number of evacuations, need for enemas, and appetite.
- Polyethylene glycol (PEG) laxative has been shown to provide safe and effective relief from constipation within a 24-hour period, with a 68-g dose being the most satisfactory 4.
- A Cochrane Review found that PEG preparations may be superior to placebo, lactulose, and milk of magnesia for childhood constipation, although the overall quality of the evidence was low or very low due to sparse data and high risk of bias 5.
- Liquid paraffin (mineral oil) has also been shown to increase the frequency of bowel motions in constipated children and is safe, with common side effects including abdominal pain, distention, and watery stools 5.
- Abdominal massage is a viable alternative to laxatives and enemas in chronic constipation, and can be taught to informal carers in the community 6.
Considerations for Treatment
- The treatment of constipation should take into account the underlying cause of the condition, as well as any underlying medical conditions or psychiatric issues that may be contributing to the constipation 7.
- A diagnostic evaluation should be performed to rule out any underlying conditions that may be causing the constipation, such as neurologic disorders or pelvic floor dysfunction 7.
- The use of laxatives and other treatments should be carefully monitored to avoid complications and ensure effective treatment outcomes 3, 4, 5.