Constipation

Constipation can be an uncomfortable experience and one that may have concerned you for some time. This pamphlet can help answer your questions about constipation and help you understand your doctor's choice of treatment.

• What Is Constipation?
• What Causes Constipation?
• What Can I Do About Constipation?
• Should I Take a Laxative?

What Is Constipation?

Technically, constipation is the passage of two or fewer stools per week. In reality, people have very individual ideas about what constipation is and what constitutes "normal" bowel function. While it may be normal for one person to have a bowel movement three times a day, the next person may have one three times a week. To some people, constipation may mean hard, dry stools which are difficult to pass. Chances are you know what is regular for you--and therefore what is irregular for you also.

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What Causes Constipation?

In trying to understand why you sometimes experience constipation, remember that your body's needs are unique. From time to time these needs change, sometimes as a result of diet and exercise. In turn, your body responds with certain symptoms, including constipation.

Common causes of occasional constipation include:

1. Poor eating habits (for example, too much junk food, too much caffeine, irregular eating times)
2. Diet lacking in fiber and/or liquids
3. Lack of exercise
4. Some medications
5. Stress
6. Pregnancy
7. Travel

More serious causes such as surgery or disease are not often responsible for the mild constipation most people occasionally experience. However, if you are constipated frequently and non-prescription medications do not improve your condition, be sure to tell your doctor.

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What Can I Do About Constipation?

Help yourself maintain regularity by adding some of these simple steps to your daily routine:

• Gradually add high-fiber foods to your diet, including
  - fruit (unpeeled when appropriate)
  - dried fruits (apricots, prunes, raisins, and dates)
  - unpeeled raw vegetables
  - bran cereals and whole-grain breads
  
• Drink 6 to 8 glasses of juice or water each day.
• Follow a regular exercise program. Walking is good for the heart and body, and abdominal exercises help improve intestinal muscle tone. Ask your doctor about a program that would be right for you.
• Respond to the urge to have a bowel movement. When you feel the urge, relax and let your body take the time it needs. If you ignore the urge, you could prolong the problem.
• If one is recommended by your doctor, take a high-fiber laxative to help you stay regular.
• Use other laxatives only as your doctor recommends.

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Should I Take a Laxative?

Your doctor may prescribe a laxative for you. There are many types of laxatives, each one having benefits and drawbacks for certain patients.

Bulk-forming laxatives absorb liquid in the intestine and then swell to form a soft, bulky mass which stimulates a bowel movement. Because bulk laxatives mimic the body's own actions, they are said to work naturally. However, they may lead to increased gas and can take up to three days to have an effect.

Stool softeners do not cause a bowel movement but ease the difficult passage often associated with hard stool. They may work in one or two days but may take up to five days.

Stimulant laxatives are effective and predictable. They increase the muscle contractions in the intestine that lead to a bowel movement. While all stimulant laxatives work basically in this way, they are not all the same; some are more likely to cause cramping or irritation and rarely nausea and vomiting. These types of laxatives should not be taken for prolonged periods of time.

Saline laxatives ("salts") draw water into the intestine, causing pressure to build up and sending the bowel the message to empty. Too much water can be drawn in, though, resulting in loose bowel movements and upsetting the body's balance of fluids.

Enemas fill the colon with fluid, which softens the stool and stimulates a bowel movement.

With so many products available, it is not easy to know which laxative is best for you. Follow your doctor's recommendation.

It is always a good idea to look for natural ways to meet your body's needs and avoid long-term use of medication. Excessive use of stimulant laxatives can actually cause constipation and dependence upon laxatives because the colon loses it normal tone and the ability to contract. Bulk-forming agents are safe to take for a long time. They are essentially a substitute for fiber in your diet.