Constipation is defined as having a bowel movement fewer than three times per week. With constipation, stools are usually hard, dry, small in size and difficult to eliminate. Some people who are constipated find it painful to have bowel movement and often experience straining, bloating and the sensation of a full bowel. Some people think they are constipated if they do not have a bowel movement every day. However, normal stool elimination may be three times a day or three times a week, depending on the person.
What causes constipation?
Constipation occurs when the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are:
- Not enough fiber in the diet
- Lack of physical activity (especially in the elderly)
- Medications (pain medications such as Vicodin, iron supplements, antacids)
- Irritable bowel syndrome
- Changes in life or routine such as pregnancy, aging and travel
- Abuse of laxatives
- Ignoring the urge to have a bowel movement
- Specific disease or conditions, such as stroke (most common)
- Problems with the colon and rectum
- Problems with intestinal function (chronic idiopathic constipation)
How is constipation treated?
Diet: High-fiber foods, which include beans, whole grains and bran cereals, fresh fruits and vegetables such as asparagus, brussels sprouts, cabbage and carrots. For people prone to constipation, limiting foods that have little to no fiber, such as ice cream, cheese, meat and processed foods, is also important. Five servings of fruits and vegetables is the general rule of thumb.
Lifestyle changes: drinking enough water (6-8 glasses per day) daily exercise
Laxatives: most people who are mildly constipated do not need laxatives. However, for those who have made diet and lifestyle changes and are still constipated, may be recommended laxatives or enemas for a limited time.
- Bulk forming laxatives (Metamucil, Citrucel)
- Stimulants (Correctol, Dulcolax, Senoket)
- Osmotics (Miralax)
- Stool softeners (Colace)
- Lubricants (Mineral Oil)
- Saline laxatives (Milk of Magnesia)
Please let your doctor of any Nurse Practitioner know if your constipation is not relieved by any of the above.