CONSTIPATION

At one time or another almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.

What is Constipation?

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Many people think they are constipated when, in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person. In addition, some people naturally have firmer stools than others.

Who Gets Constipated?

According to the 1991 National Health Interview Survey, about 4 1/2 million people in the United States say they are constipated most or all of the time. Those reporting constipation most often are women, children, and adults age 65 and over. Pregnant women also complain of constipation, and it is a common problem following childbirth or surgery. Constipation is the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor. However, most people treat themselves without seeking medical help, as is evident from the $725 million Americans spend on laxatives each year.

What Causes Constipation?

To understand constipation, it helps to know how the colon (large intestine) works. As food moves through it, the colon absorbs water while forming waste products, or stool. Muscle contractions in the colon push the stool toward the rectum. By the time stool reaches the rectum, it is solid because most of the water has been absorbed. The hard and dry stools of constipation occur when the colon absorbs too much water. This happens because the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly.

Common causes of constipation include the following:

  • Not enough fiber in diet
  • Not enough liquids
  • Lack of exercise
  • Medications
  • Irritable bowel syndrome
  • Changes in life or routine such as pregnancy, older age, and travel
  • Abuse of laxatives
  • Ignoring the urge to have a bowel movement
  • Specific diseases such as multiple sclerosis and lupus
  • Problems with the colon and rectum
  • Problems with intestinal function (Chronic idiopathic constipation)

What can I do about constipation?

Changing what you eat and drink and how much you exercise will help relieve and prevent constipation. Here are some steps you can take.

1. Eat more fiber. Fiber helps form soft, bulky stool. It is found in many vegetables, fruits, and grains. Be sure to add fiber a little at a time, so your body gets used to it slowly. Limit foods that have little or no fiber such as ice cream, cheese, meat, snacks like chips and pizza, and processed foods such as instant mashed potatoes or already-prepared frozen dinners. The chart below lists some high-fiber foods.

2. Drink plenty of water and other liquids such as fruit and vegetable juices and clear soups. Liquid helps keep the stool soft and easy to pass, so it's important to drink enough fluids. Try not to drink liquids that contain caffeine or alcohol. Caffeine and alcohol tend to dry out your digestive system.

3. Get enough exercise. Regular exercise helps your digestive system stay active and healthy. You don't need to become a great athlete. A 20- to 30-minute walk every day may help.

4. Allow yourself enough time to have a bowel movement. Sometimes we feel so hurried that we don't pay attention to our body's needs. Make sure you don't ignore the urge to have a bowel movement.

5. Use laxatives only if a doctor says you should. Laxatives are medicines that will make you pass a stool. Most people who are mildly constipated do not need laxatives. However, if you are doing all the right things and you are still constipated, your doctor may recommend laxatives for a limited time.

6. Check with your doctor about any medicines you take. Some medicines can cause constipation. They include calcium pills, pain pills with codeine in them, some antacids, iron pills, diuretics (water pills), and medicines for depression. If you take medicine for another problem, be sure to ask your doctor whether it could cause constipation.

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