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Stress, too many hours at the computer and too few vegetables can
sometimes make you irregular. But does that mean you're constipated? Not always. The normal frequency of bowel movements varies widely - from three
a day to three a week. What's normal for you may not be normal for someone
else. In general, though, you're probably constipated if you pass hard stools
less than three times a week. In some cases you may also have a bloated feeling
or abdominal cramping or pain. Fortunately, a few common-sense lifestyle changes, including getting more
exercise, eating high-fiber foods and drinking plenty of fluids, especially
water, can go a long way toward preventing or alleviating many cases of
constipation.
| Signs and symptoms | Back to top |
Not having a bowel movement every day doesn't necessarily mean you're
constipated. You're likely constipated, however, if you:
| Causes | Back to top |
Normally, the waste products of digestion are propelled through your
intestines by muscle contractions. In the large intestine, most of the water and
salt in this mixture are reabsorbed because they're essential for many of your
body's functions. If too much water is absorbed, or if the waste moves too
slowly, you may become constipated.
A number of factors can cause an intestinal slowdown, including inadequate
fluid intake, a low-fiber diet, inattention to bowel habits, age, lack of
physical activity, depression, pregnancy, illness - even stress. Many medications, especially those used to treat Parkinson's disease, high
blood pressure, some heart disorders and depression also can cause constipation.
The same is true of most narcotics. And frequent use of laxatives often
aggravates and may even cause constipation. In rare cases constipation may signal more serious medical conditions such as
colorectal cancer, hormonal or electrolyte disturbances, heart disease and
kidney failure. Sometimes young children are constipated because they forget to take time to
use the toilet. And your toddler might become constipated during toilet training
if he or she is afraid or unwilling to use the toilet.
| Risk factors | Back to top |
You're more likely to have problems with constipation if you're an older
adult, are sedentary or bedridden, eat a diet that's low in fiber or don't drink
enough fluids. You're also at risk if you take certain medications, including
sedatives or narcotics, or are having chemotherapy. If you're pregnant, you may have bouts of constipation because your digestion
slows so that your body can get more nutrients from your food. Later in your
pregnancy, pressure on your intestines from your uterus also can cause
constipation.
| When to seek medical advice | Back to top |
See your doctor if you experience a recent, unexplained onset of constipation
or change in bowel habits, or any of the following symptoms, which might
indicate a more serious health condition:
| Screening and diagnosis | Back to top |
A diagnosis of constipation generally depends on your medical history and a
physical exam. Your doctor will first want to make sure you don't have a
blockage in your small intestine or colon (intestinal obstruction), an endocrine
condition, such as hypothyroidism, or an electrolyte disturbance, such as
excessive calcium in the blood (hypercalcemia). He or she will also want to
check your medications in case they may be causing your constipation. You may undergo these diagnostic procedures:
| Complications | Back to top |
Although constipation can be extremely bothersome, it usually isn't serious.
If it persists, and especially if straining results, you may develop
complications such as hemorrhoids and cracks or tears in the anus called
abrasions or fissures. Very severe or chronic constipation can sometimes cause a fecal impaction, a
mass of hardened stool that you can't eliminate by a normal bowel movement. An
impaction can be very dangerous, and you may need to have it manually removed by
a nurse or doctor. If you use laxatives frequently, you may develop lazy bowel syndrome, a
condition in which your bowels become dependent on laxatives to function
properly. In fact, laxative use can cause a number of problems, including poor
absorption of vitamins and other nutrients, excessive loss of water, sodium and
potassium, damage to your intestinal tract and worsening constipation.
| Treatment | Back to top |
Changes in your lifestyle are the best and safest way to manage constipation.
To help ease symptoms, try using a fiber supplement, such as psyllium powder,
Metamucil, Konsyl, Fiberall or Citrucel. These natural supplements help make
stools softer and are safe to use every day. Be sure to drink plenty of water or
other fluids every day. Otherwise, fiber supplements can actually make your
constipation worse. And add fiber to your diet slowly to avoid problems with
gas. Your doctor may recommend a stool softener, such as mineral oil or docusate
sodium (Colace, Dialose), to soften fecal matter so that it passes through your
intestines more easily. But never use stool softeners on a regular basis because
they can cause other problems. Mineral oil interferes with the absorption of
fat-soluble vitamins and can cause a serious form of pneumonia if it's
accidentally inhaled (aspirated) into your lungs, so don't take mineral oil just
before you lie down. If you're pregnant, don't use laxatives other than fiber supplements without
checking with your doctor first. Try eating lots of high-fiber foods, such as
fruits, vegetables and whole grains. It's a good idea to check the content of
prepared foods because not all foods claiming to be high in fiber actually are.
Prunes, prune juice and figs often help relieve constipation - but they can
cause gas. Drink plenty of fluids and get as much exercise as you can. Swimming,
biking and walking are good choices. If you take iron supplements, or if your
prenatal supplements are high in iron, you may want to talk to your doctor about
reducing your dosage. Iron can be very constipating for some people.
| Prevention | Back to top |
To help prevent constipation:
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