There are many causes of constipation, including a lack of fiber in the diet, insufficient liquid intake, stress, medications, lack of exercise, and bad bowel habits, says Paul Rousseau, MD. We take a look at all of these factors that could lead to the problem, and suggest constipation remedies.

Determine If You Are Actually Constipated

Madison Avenue bombards us with laxative advertisements that give the impression that a daily bowel movement is essential to good health, and that just isn’t so, says Marvin Schuster, MD. Many Americans, he says, are subject to perceived constipation —they think they’re constipated when they are not. In reality, the need to defecate varies greatly from individual to individual. For some, a bowel movement 3 times a day may be considered normal, for others 3 times a week may suffice. MORE: Why Some People Poop More Than Others

Fine-Tune Your Fluid And Fiber Intake

Our experts agree that the first thing you should do if you’re constipated is check your diet. The foremost menu items for battling constipation are foods rich in dietary fiber such as fruits, vegetables, beans and other legumes, and liquids, which are essential to keeping the stool soft and helping it pass through the colon. How much liquid and fiber do you need? Let’s start with the liquid. A minimum of 6 glasses of liquid, preferably 8, should be part of every adult’s diet, says Patricia H. Harper, MS, RD, LDN. While any fluid will do the trick, the best is water, she says.

Eat Lots More Fiber

Most Americans don’t get enough fiber in their diets, says Harper. The American Dietetic Association recommends 20 to 35 grams of dietary fiber daily for all adults and at least 30 grams for those who experience constipation. Whole grains, fruits, and vegetables are the best fiber sources, says Harper. It’s not difficult to get 30 grams in your daily diet if you choose foods carefully. A half cup of green peas, for example, gives you 5 grams, one small apple supplies 3 grams, and a bowl of bran cereal has as much as 13 grams. Tops among the fiber heavyweights are cooked dried beans, prunes, figs, raisins, popcorn, oatmeal, pears, and nuts. One word of caution, though: Increase your fiber intake slowly to avoid gas attacks. (Here are the 10 best foods to eat to avoid constipation.)

Work Your Trigger Points

“Animal studies suggest that acupuncture may spur contractions in the colon, moving your bowels,” says Steven Tan, MD. “If your episode is minor, you could be helped by a single treatment; chronic sufferers may need about 10. Acupressure may help, too.” To try acupressure for constipation, it takes only two fingers and less than 2 minutes. Using your index and middle fingers, apply firm pressure on the outside of your leg, about 3 inches below the kneecap, for 5 seconds and then release for 10 seconds. Repeat five times. Search for an acupuncturist near you on the website for the American Association of Acupuncture and Oriental Medicine. MORE: 9Surprising Things An Acupuncturist Can Help You With

Take Time To Go To The Gym

Exercise is good for your heart, but it’s also good for your bowels. In general, regular exercise tends to combat constipation by moving food through the bowel faster, says Edward R. Eichner, MD.

Take A Walk

Any form of regular exercise tends to alleviate constipation, but the one mentioned most often by our experts is walking. This activity is particularly helpful to pregnant women, many of whom experience constipation as their inner workings are compressed to accommodate the growing fetus. Everyone, including mothers-to-be, should walk a hearty 20 to 30 minutes a day, suggests Lewis R. Townsend, MD. Pregnant women should take care not to get too winded as they walk. (These are the incredible results you get from walking 30 minutes a day.)

Learn New Habits

Throughout our lives, many of us condition ourselves to go to the bathroom not when nature calls but when it’s convenient. Ignoring the urge to defecate, however, can eventually lead to constipation. It’s never too late to improve your bowel habits, says Schuster. “The most natural time to go to the toilet is after a meal,” he adds. So pick a meal, any meal, and every day following that meal sit on the toilet for 10 minutes. In time, says Schuster, you will condition your colon to act as nature intended. MORE: 10 Ways To Never Be Constipated Again

Learn To Relax

“Patients with chronic or severe gastrointestinal woes tend to have more anxiety and stress,” says Lin Chang, MD. “Behavioral techniques like relaxation training can decrease symptoms, and calming breaths help regulate the nervous system and relax the digestive tract.” To ease discomfort, focus on how your stomach moves as you inhale for a count of 4 and exhale. Do this twice daily for 15 minutes. Try yoga two or three times a week. The breathing is similar, and exercise helps you clear your bowels.

Have A Hearty Laugh

It may sound funny, but a good belly laugh can help with constipation in two ways. It has a massaging effect on the intestines, which helps foster digestion, and it’s a great stress reliever, says Alison Crane, RN.

Reconsider Using Laxative Tablets

Chemical laxatives often do what they’re intended to do, but they’re terribly addicting, warns Rousseau. Take too many of these chemical laxatives, and your bowel gets used to them, and your constipation can get worse. When should you take laxatives from a bottle? “Almost never,” he says. MORE: 8 Foods To Eat When Fiber’s Just Not Getting The Job Done

Know That Not All Laxatives Are The Same

In most drugstores, right next to the chemical laxatives, you’ll find another category of laxatives, often marked “natural” or “vegetable” laxatives, whose main ingredient is generally crushed psyllium seed. This is a concentrated form of fiber, which, unlike the chemical laxatives, is nonaddictive and generally safe, even if taken over long periods, says Rousseau. He cautions, however, that these must be taken with lots of water (read the instructions on the package), or they can gum up inside you.

Try This Special Recipe

Psyllium-based laxatives can be expensive. So make your own by buying psyllium seeds in a health food store and crushing them yourself. Grind 2 parts psyllium with 1 part flaxseed and 1 part oat bran (also available in health food stores) for a high-fiber concoction. Mix the ingredients up with water, and have it as a little mash every night around 9 PM. Psyllium absorbs liquid in the intestines, making a softer stool that’s easier to pass.

Review Your Medications And Supplements

There are a number of medications that can bring on or exacerbate constipation, says Rousseau. Among the common culprits are antacids containing aluminum or calcium, antihistamines, anti-Parkinsonism drugs, calcium supplements, diuretics, narcotics, phenothiazines, sedatives, and tricyclic antidepressants.

Beware Of Certain Foods

Some things may constipate one person but not another. Milk, for example, can be extremely constipating to some, while causing diarrhea in others. Foods that tend to produce gas, such as beans, cauliflower, and cabbage, can be problematic for people whose constipation is the result of a spastic colon, says Schuster. You should suspect a spastic colon and avoid gas-producing foods if your constipation is sharply painful. MORE: 11 Highly Effective Solutions For IBS

Use Dietary Oils Sparingly

By avoiding dietary oils, such as vegetable, olive, or soy oil, you may be less constipated, says Grady Deal, PhD, DC. “It’s not oil per se, but eating it in its free state causes constipation and many other digestive problems,” says Deal. He bases his theory on the work of the turn-of-the-century health reformer John Henry Kellogg, MD. The problem with these oils, Deal explains, is that they form a film in the stomach, which makes it difficult to digest carbohydrates and proteins there and in the small intestine. Adequate digestion is delayed up to 20 hours, causing putrefaction, gas, and toxins, which back up the colon and large intestine, he says. But oils eaten in their natural form found in whole nuts, avocados, and corn are released slowly into the body, so no oil slicks occur to block digestion and create constipation problems. These oils, as opposed to the separated kind, are “a wholesome and nutritious element of food,” he says.

Tune In To Your Body

“In biofeedback, sensors display the activity of your pelvic floor muscles on a screen as you learn to relax them, making it easier for you to pass your stool,” says Jeannette Tries, PhD. A recent study found that in some cases, biofeedback may be more effective than laxatives. Find a licensed biofeedback practitioner in your area on the website of the Biofeedback Certification Institute of America. You may need 8 to 10 visits over the course of 3 to 4 months to get relief.

Be Cautious About Herbs

Herbal constipation remedies abound. Among those touted are aloe juice, senna, medicinal rhubarb, cascara sagrada, dandelion root, and plantain seeds. Some, such as cascara sagrada, can be very effective, but you need to be careful. Herbal laxatives, just as chemical ones, should be carefully chosen and not overused.

Don’t Strain

Forcing a bowel movement is unwise. You risk giving yourself hemorrhoids and anal fissures, which are painful and can aggravate your constipation by narrowing the anal opening. Straining can also raise your blood pressure and lower your heartbeat, which can be dangerous, especially in the elderly. MORE: 6 Things Proctologists Want You To Know

Get Fast Relief—Once In A While

If you’re really miserable, nothing works faster to move your bowels than an enema or a suppository. For occasional use as a constipation remedy, they are perfectly all right, says Rousseau. Use them too often, however, and you risk creating a lazy colon, exacerbating your constipation problem. Use clear water only or saline-solution enemas, never soapsuds, which can be irritating, says Rousseau. And when shopping for a suppository, stick with glycerin, avoiding the harsher chemical selections on the market.

Apples Are An Easy Constipation Remedy

If you’re constipated, apples are a great food choice because they contain both insoluble fiber and soluble fiber. Insoluble fiber is found in the skin of apples, which contains most of their fiber. Soluble fiber forms a coating inside your digestive tract to help things move through easily. Soluble fiber in apples is good roughage and also helps prevent other digestive disorders, such a diverticulitis and possibly even colon cancer. Insoluble fiber soaks up water as it passes through your intestines, helping to bulk up and weigh down your stool, helping gravity do its job. For a good clean-out, eat three or four small apples a day until your constipation clears. But be sure you eat them with the skins on. (Try these 3 simple apple recipes.)

Should You See A Doctor?

Constipation itself usually isn’t serious, says Schuster. However, you should call your doctor when symptoms are severe, last longer than 3 weeks, are disabling, or if you find blood in your stool, he says. Although it’s rare, constipation can signal a serious underlying disorder. In addition, contact your doctor if your constipation accompanies an enlarged or bulging abdomen, which may signal an intestinal obstruction, says Rousseau.

Panel Of Advisors

Lin Chang, MD, is codirector of the center for neurovisceral sciences and women’s health at the University of California in Los Angeles. Alison Crane, RN, is the founder of the Association for Applied and Therapeutic Humor.  Grady Deal, PhD, DC, is a nutritional chiropractor in Koloa, Kauai, Hawaii. He is founder and director of Dr. Deal’s Hawaiian Wellness Holiday Health Spa in Koloa. Edward R. Eichner, MD, is a former professor of medicine and team internist at the University of Oklahoma Health Sciences Center in Oklahoma City. Patricia H. Harper, MS, RD, LDN, is senior research manager in the department of health and physical activity at the University of Pittsburgh School of Education. Paul Rousseau, MD, is chief of the department of geriatrics at the Carl T. Hayden Veterans Adminstration Medical Center in Phoenix. Marvin Schuster, MD, is the former director and namesake of the Marvin M. Schuster Center for Digestive and Motility Disorders at the Hopkins Bayview Medical Center and former professor of medicine and psychiatry at Johns Hopkins University School of Medicine, both in Baltimore. Steven Tan, MD, is chair of the California State Board of Acupuncture in Beverly Hills. Lewis R. Townsend, MD, practices obstetrics and gynecology at Contemporary Women’s Healthcare in Bethesda, Maryland, and Sibley Memorial Hospital in Washington, DC. He is former clinical instructor of obstetrics and gynecology at Georgetown University Hospital and former director of the Physicians’ Group at the Columbia Hospital for Women Medical Center, both in Washington, DC. Jeannette Tries, PhD, is director of therapy services in the Pelvic Floor Center at the University of Illinois Hospital in Chicago. She is a clinical assistant professor in the department of surgery at the University of Illinois College of Medicine, also in Chicago.