Constipation

Constipation

What is Constipation?

Although what is considered ‘normal frequency’ for bowel movements can range from three times a day to three times a week. Constipation is generally defined as fewer than three bowel movements in one week. Chronic constipation can persist for several weeks or months. Constipation is often described as difficult passing stools.

What causes Constipation?

There are several potential causes for constipation. A lack of fiber can cause dehydration, as can dehydration and excess ingestion of dairy products. Many medications, including those taken to treat arthritis, pain, allergies, high blood pressure, low iron, and depression, can cause chronic constipation. Inactivity, stress, Even if you eat well, drink plenty of fluids, and exercise frequently, psychological issues such as stress can trigger constipation.Pregnant women are more prone to constipation, as well. Less common causes of constipation include hormonal changes, problems with pelvic muscles, neurological problems, and blockages in the colon or rectum.

Who is at risk for Constipation?

Constipation is one of the most common gastrointestinal problems in America, affecting an estimated 15% of the population. Anyone can suffer from constipation, regardless of age, gender, and ethnicity, although it tends to be slightly more common in women. The elderly are also more prone to constipation, perhaps because they lead more sedentary lifestyles. Certain medications may increase the risk of constipation.

Signs and Symptoms

Symptoms of chronic constipation include hard or lumpy stools. People with constipation may strain to have bowel movements, or feel like there is a blockage of some sort that is preventing a bowel movement. They may also feel as if they cannot fully empty their bowels. Severe constipation can cause abdominal pain, swelling of the abdomen, and even vomiting.

Diagnosis

You may be considered constipated if you have two or more of the following symptoms for at least three months:

  • Straining during a bowel movement more than 25% of the time
  • Hard stools more than 25% of the time
  • Incomplete evacuation of the bowels more than 25% of the time
  • Two or fewer bowel movements per week

Most people do not require extensive testing to be diagnosed with constipation. A doctor will ask about the frequency and prevalence of systems, and may take a stool sample to test for blood. He or she may conduct a rectal exam to evaluate the muscles of the anal sphincter. If chronic constipation is suspected, more detailed tests may be conducted, including colonoscopy, anorectal manometry, defecography, and/or a lower GI series.

Treatment

The most common treatment for constipation is a change in diet. The Academy of Nutrition and Dietetics recommends that adults consume 20 to 35 grams of fiber a day, but the average American only consumes 15 grams a day. Foods that are processed and refined have less natural fiber, so a doctor will encourage a constipated person to eat more beans, fruits, vegetables, and other high-fiber foods. Proper hydration is also essential to preventing hard, dry stools that can cause constipation. Daily exercise can also help relieve constipation.

When dietary and lifestyle changes don’t work, a doctor may recommend laxatives or enemas. There are several kinds of laxatives, including:

  • Bulk-forming agents – absorb fluid in the intestines, which makes stools bulkier. This triggers a bowel movement, but most be taken with copious amounts of water. Examples include Metamucil, Citrucel, and Fibercon.
  • Osmotic agents – help the stool retain fluid, increases the frequency of bowel movements, and softens the stool. Examples include milk of magnesia, Cephulac, and Miralax.
  • Stool softeners – mix fluids into the stools to soften them. Examples include Colace, Docusate, and Dulcolax.
  • Lubricants – coat the surface of the stool so it retains more fluid. Examples include Fleet and Zymenol.
  • Stimulants – cause intestinal contractions, which moves the stool toward the anus. Examples include Dulcolax, Purge, and Senokot.

Frequent laxative usage can actually make you more susceptible to future bouts of constipation, so they should only be taken with the recommendation and supervision of a doctor. Laxatives may also make absorption of certain medications more difficult. All laxatives should be taken with plenty of water to avoid dehydration.