Constipation is a common gastroenterological (GE) symptom which will affect almost everyone at some time during his or her life. It affects approximately 2% of the population in the U.S. It is the most common GE symptom treated by physicians.
Constipation refers fewer than three spontaneous bowel movements weekly. Constipation may also involve infrequent or hard stools, or an excessive need to strain or the sense that even after a movement there is incomplete emptying of the bowel.
The normal length of time between bowel movements ranges widely from person to person. Some people have bowel movements three times a day; others, only one or two times a week. However, going longer than three days without a bowel movement is too long as this leads to hard and difficult to pass stool.
Constipation can affect all age groups, but becomes more common with increased age. Constipation affects as many as a third of all individuals over age 65; as many as 50% at age 80.
Constipation is most often caused by a low-fiber diet, lack of physical activity, not drinking enough water, or delay in going to the bathroom when you have the urge to defecate.
Stress, travel, and medications can also contribute to constipation or other changes in bowel habits.
Constipation can at times be due to diseases of the bowel (such as irritable bowel syndrome), pregnancy, certain medical conditions (like an under active thyroid or cystic fibrosis), mental health problems, or neurological diseases. More serious causes, like colon cancer, are much less common.
Common medications which can contribute to constipation include antacids containing aluminum, calcium channel blockers used for high blood pressure, many antidepressants and pain medications.
To prevent constipation and maintain normal bowel movements:
- Never suppress the natural urge to have a bowel movement.
- Eat a diet rich in vegetables, fresh fruits, dried fruits, and whole wheat, bran, or oatmeal cereals.
- Drink plenty of fluids.
- Include regular exercise in your day. If you are confined to a wheelchair or bed, change position frequently and perform abdominal contraction exercises and leg raises. A physical therapist can recommend exercises appropriate for your physical abilities.
If you are an adult with constipation:
- The bulk content of your diet can be increased by taking psyllium (Metamucil) or methylcellulose (Fibercon). The dose for both is 1 tablespoon up to three times daily in a full glass of water.
- The “Malott" cocktail is a natural one Dr. David Lipschitz recommends to his geriatric patients with constipation problems. The recipe is as follows: At any health food store buy 8 ounces each of flax, sesame and peeled sunflower seeds. Mix them equally. Take 1 tablespoon up to three times daily alone or in cereal, fruit, salad or any other appropriate foods. The Malott cocktail provides fiber, your daily requirements of the omega-3 fatty acids and naturally occurring vitamin E (which is the only form that is beneficial for your health).
- Stool softeners (such as those containing docusate sodium) may help.
- If the above don’t help, then a laxative may be needed (Miralax, Glycolax, milk of magnesia, Exlax, Senokot, Correctol, or Dulcolax). Overuse of laxatives can lead to a vicious cycle of constipation followed by diarrhea and to metabolic changes that can be dangerous.
Remember that newly developed constipation can be the harbinger of a serious illness. Always see your doctor.
