Constipation

What is constipation? 

Constipation is  a common digestive problem. It may be difficult for you to have a bowel movement,  or your bowel movements may be infrequent. Your stools may be very hard, making them so difficult to pass that you have to strain. Or you may feel like you still need to have a bowel  movement even after you've had one. 

How often should I have  a bowel movement? 

Not everyone has bowel movements once a day. It's not true that you must have a daily bowel movement to  be considered "regular." A normal range is anywhere between 3 times a day  to 3 times  a week. You may be getting constipated if you start having bowel movements much less often than you usually do. 

What causes constipation? 

As the food you eat passes through your digestive tract, your body takes nutrients  and water from the food. This process creates a stool, which  is moved through your intestines with muscle contractions (squeezing motions). 

A number of  things can affect this process. These include not drinking enough fluids, not being active enough, not eating enough fiber, taking certain medicines, not going to the bathroom when  you have the urge to have a bowel movement and regularly using laxatives. Constipation is also common in pregnant women. Any of these things  can cause the stools  to move more slowly through your intestines, leading to constipation. 

How is constipation treated? 

Eating enough fiber and drinking enough fluids are key to treating  constipation. They help your stools move through your intestines by increasing the bulk of your stools and making your stools softer. Increasing how often you exercise will also help. 

Talk to your family doctor if: 

• Constipation is new and unusual for you 
• You have constipation for 3 weeks or  more despite at-home treatment (such as diet changes) 
• You have abdominal pain 
• You notice any blood in your stools 
• You lose weight without reason 

What should I eat? 

Eat plenty of fiber. At least 2 cups of fruits and 2 1/2 cups of  vegetables per day is recommended. It is suggested that men age 50  and younger consume at least 38 grams of  fiber per day, while women age 50 and younger should consume at least 25 grams per day. Add extra fiber to your diet by eating cereals that contain bran or by adding bran as a topping on your fruit or cereal. 

If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink  plenty of water, also. 

Should I use laxatives? 

Laxatives should usually be avoided. They aren't meant for long-term use. An exception to this is bulk-forming laxatives. 

Bulk-forming laxatives work naturally to add bulk and  water to your stools so that they can pass more easily through your intestines. Bulk-forming laxatives can be used every day. They include oat bran, psyllium (one brand: Metamucil), polycarbophil (one brand: FiberCon)  and methylcellulose (one brand: Citrucel). 

How are bulk-forming laxatives used? 

You must use bulk-forming laxatives daily for them  to work. Follow the directions on the label. Start slowly and drink plenty of fluids. Gradually increase how much  you use every 3  to 5 days (as your body gets used to it) until your stools are softer and easier to pass. 

You can help bulk-forming  laxatives taste better by mixing them with fruit juice. 

Do bulk-forming laxatives have side effects? 

You may notice some bloating, gas or cramping at first, especially  if you start taking too much or increase the amount you're using too quickly. These symptoms  should go away in a few weeks or less. 

Is mineral oil a good laxative? 

Mineral oil should generally be used only when  your doctor recommends it, such as  if you've just had surgery and shouldn't strain to have a bowel movement. Mineral oil shouldn't be used regularly. If it is used regularly, it can  cause deficiencies of vitamins A, D, E and K. 

Should I try enemas? 

Enemas aren't usually necessary to relieve constipation.  It's better to let your body work naturally. 

What if I've been using enemas or laxatives for a long time? 

You may  have to retrain your body to go without laxatives or enemas if you've been using them for a long period of time. This means eating plenty of fiber, possibly using a bulk-forming laxative, drinking plenty of water, exercising and learning to give yourself time to have  a bowel movement. 

If you've used laxatives and enemas for a long time,  your family doctor may suggest that you gradually reduce the use of them to give your body a chance to return to normal. Be patient because it may take many months for your bowels to get back to normal if you've been using laxatives or enemas regularly. Talk  with your family doctor about any concerns you have. 

Notes: Dr. M. Kristine Schlossberg

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EditText of this page (last edited February 27, 2010)