Constipation
What is it?
Constipation is characterized by infrequent bowel movements with stools that are often hard and sometimes painful to pass. In constipation, intestinal contractions slow down, allowing more time for the bowels to remove water from food wastes. This results in hard stools that are difficult to pass. However, it should be noted that normal frequency of bowel movements varies greatly from person to person. It is perfectly normal for some people to have three bowel movements a day, while others have as few as three a week; true constipation involves the passage of hard stools less than three times in a week and is usually accompanied by bloating and discomfort. (Any change in a person's usual frequency of bowel movements, however, may be a sign of a more serious underlying disorder.)
What Causes It?
- Lack of fiber in the diet or inadequate fluid intake.
- Prolonged inactivity or severe depression.
- Irregular or abnormal contractions of the bowel muscles owing to lack of exercise or to disorders such as irritable bowel syndrome, diabetes mellitus, hypercalcemia, hypothyroidism, or colorectal cancer.
- Failure to go to the bathroom when the urge strikes may lead to the formation of hard, impacted stools.
- Overuse of laxatives, aspirin, or aluminum- or calcium-based antacids may impair normal bowel function.
- Constipation may occur as a side effect of certain medications, including antihypertensive drugs (calcium channel blockers and beta-blockers), tricyclic antidepressants, narcotics, and atropine.
Prevention
- Eat high-fiber, low-fat foods. Try to get at least five servings a day of fiber-rich foods, including raw fruits and vegetables, whole-grain breads and cereals, bran, dried peas and beans, and potato skins.
- Drink at least eight glasses of water a day.
- Exercise regularly.
- Go to the bathroom as soon as the urge strikes.
Diagnosis
- Evaluation will include medical history (with emphasis on bowel habits) and a physical exam.
- Blood and stool samples may be obtained.
- A sigmoidoscopy (use of a flexible, lighted scope to view the lower large intestine) may be performed.
- A barium enema may be necessary. The barium creates a sharp image of the colon on x-ray.
How to Treat It
- Follow the prevention tips above.
- Drink a cup of hot liquid (such as coffee or tea), especially first thing in the morning, since it may activate what is known as the gastrocolic reflex, which induces a bowel movement by stimulating the colon.
- Use laxatives only as a last resort, on your doctor's advice. Bulk-forming agents, including bran, psyllium (Metamucil, Konsyl), and methyl cellulose (Citrucel, Cologel), are usually the best choice. Never use mineral oil as a laxative.
- Do not use enemas unless otherwise instructed by your doctor.
When to Call a Doctor
- Make an appointment with a doctor if constipation persists for two weeks or more, and increased fiber intake and exercise have failed to help.
- Consult a doctor if fever or severe abdominal pain occurs with constipation, if abdominal bloating, cramping, or other discomfort disrupts your routine, or if you notice blood in the stool.
- Call a doctor if you experience constipation shortly after beginning a new medication. The prescription may need to be adjusted.
- Call your doctor if you notice any major change in normal bowel habits.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.