Sometimes the most important health questions are the ones you’re too mortified to ask. You know your doctor’s a professional who’s heard it all before, but there’s just no way you’re bringing up that foul odor or that weird burning sensation after sex. We hear you. In our “Too Embarrassed to Ask” series, we’ll tackle your most uncomfortable questions. (And when you’re done reading, just clear your browser history. We’ll never tell.)

Having trouble getting the troops moving? You’re not alone! Almost everyone will experience constipation at one time or another, especially as they get older.

How often you “go” varies from person to person. However, constipation is usually signaled by:

• Passing fewer than three bowel movements a week
• Difficulty passing stools
• Hard stools
• A feeling of being unable to completely empty your bowels

While occasional constipation is common, some people have chronic constipation, which negatively affects their daily lives. On occasion, they may develop impaction, when they are unable to naturally pass stool. Yet there are good treatments for constipation, whether it is infrequent or long-lasting.

Constipation and age

Almost a third of older people have occasional constipation, according to the National Institute on Aging. This can happen for several reasons. For one thing, activity levels often drop as people get older.

As people age, their metabolism slows and their muscle contraction strength diminishes, which slows down the passage of stool. People over 65 are also more likely to be taking medications that can slow things down. Drugs that commonly lead to constipation include:

• Pain relievers, including narcotics as well as over-the-counter (OTC) nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen sodium
• Antacids containing calcium or aluminum
• Iron supplements
• Antidepressants, including both SSRIs like Prozac and tricyclic antidepressants like Elavil
• Blood pressure medications, including calcium channel blockers and beta-blockers

Likewise, constipation can be associated with certain medical conditions, such as diabetes, underactive thyroid, and neurologic disorders like Parkinson’s disease. Pelvic floor or digestive disorders like irritable bowel syndrome and diverticular disease can also lead to constipation.

Treatment

There are a variety of medications and other remedies to alleviate constipation. Here are some common options:

OTC remedies

Fiber supplements

These add bulk to stool, making it easier to pass through your colon. Psyllium (Metamucil, etc.), calcium polycarbophil (FiberCon, etc.), and methylcellulose (Citracel) are some of the choices.

Stimulants

Stimulant drugs work by causing intestines to contract. Look for bisacodyl (Ducolax, Correctol, etc.) or sennosides (Senokot, Ex-Lax, etc.).

Osmotics

Osmotics draw fluid from the intestines, allowing stool to move through the colon and producing a bowel movement. They include magnesium hydroxide (milk of magnesia), lactulose (Cholac, Constilac, etc.), and polyethylene glycol (Miralax, etc.)

Lubricants

Lubricants (mineral oil) help stool move more easily through the colon.

Stool softeners

Products like docusate sodium (Colace) and docusate calcium (Surfak) extract water from the intestine to soften stool and stimulate bowel movements.

Enemas and suppositories

Tap water enemas can be used to soften stool. Suppositories made of glycerin or bisacodyl provide lubrication and stimulation to move bowels.

Prescription medications

Some prescription medications can help if constipation is chronic or your constipation is part of IBS.

• Lubiprostine (Amitiza), linaclotide (Linzess), and plecanatide (Trulance). These drugs work by drawing water into the intestines.
• Prucalopride (Motegrity). This drug works by stimulating movement in the colon.
• Naloxegol (Movantik) and methylnaltrexone (Relistor). These drugs help when constipation is caused by opioid pain medications.

Pelvic floor therapy

Relaxing your pelvic floor muscles at the right time is key to passing stool. If you aren’t moving your bowels regularly, you may benefit from pelvic floor physical therapy and biofeedback, which involves using a special tube that measures muscle tension in your rectum. As the therapist guides a patient through exercises to tighten and relax the pelvic floor muscles, they receive feedback (auditory or visual) to let them know when they are using the correct muscles.

Prevention

To keep things moving, follow these preventive steps:

Eat a healthy diet with plenty of fiber

Load your plate with fruits, vegetables, and whole grains to stay regular. Try to eat whole foods—fiber is mostly found in the skins and seeds of fruits, for instance. Bran is an especially good fiber source.

Drink plenty of fluids

Constipation worsens when you aren’t getting enough water and other fluids. Check out our article, 7 Ways to Drink More Water, for easy ways to increase your fluid intake.

Get moving

Find activities you enjoy and make exercise a habit. Exercise “will help move food contents, gas, and stool along the digestive tract," gastroenterologist Sophie Balzora, MD, clinical professor of medicine at NYU Langone Health in New York City said in an interview with Yahoo! Sports.

Getting past embarrassment

If constipation has become a recurring or chronic problem, you should discuss it with your healthcare provider. Your doctor may want to rule out serious causes for your constipation, such as a blockage in your GI tract. Plus, the sooner you ask for help, the faster the problem will be resolved.

It can be hard to talk about your bowel habits to anyone, even to a physician, but, trust us, your doctor has heard it all before. If you’re not comfortable saying that you’re having trouble with constipation, think about a different way to say it. “I’m having trouble staying regular” will probably prompt your doctor to respond, “Regular with your bowel movements?” Then all you have to do is say yes.

Other options? “My bowel has gotten really sluggish lately.” “I’m finding I need laxatives all the time these days.” “Over the last couple of months, I’ve been getting backed up a lot.”

Brainstorm until you find the words that work for you, and then make that appointment. Don’t let embarrassment keep you from getting the help you need!

Medicare and constipation

Original Medicare covers medically necessary treatment for constipation, such as pelvic floor therapy. And you’ll find coverage for prescription medicines under Part D plans.

A Medicare Advantage plan may offer even more help, such as a discount or allowance that can offset the cost of OTC treatments like Miralax. Exercise programs that can help keep your digestive tract moving are also often discounted, and you may even find coverage for nutrition consultations. Check out all your Medicare Advantage options with our easy-to-use Find a Plan tool.

Additional resources

• ClearMatch Medicare: Find a Medicare Plan
• Yahoo! Sports: 6 Ways Your Workout Can Change Your Poop