Nonpharmacologic management of chronic constipation
| Increase physical activity (most beneficial in early orning) |
| Toilet training. Instruct patients to: Not ignore urges to defecate Use correct posture, ie, “brace-pump” technique: sit on the toilet and lean forward, with knees higher than hips and with feet supported on a step to straighten the anorectal angle Do deep-relaxation techniques while defecating Avoid straining when passing stool Not stay on the toilet for more than 5–10 minutes |
| Dietary changes Drink a hot caffeinated beverage after waking up Eat breakfast within 1 hour of waking up Increase fluid intake to 1.5–2 L daily Increase dietary fiber to 25–30 g daily; do this slowly to avoid abdominal cramps and bloating |