Constipation

Constipation is a symptom, not a disease. It is frequently caused by a disturbance of how the colon works. The normal functions of the colon are to:

• Remove water from the waste material that passes from the small intestine into the colon,
• Serve as a storage area for waste material, and
• Help move and expel stool from the body.

Constipation may occur because:

• Too much water is removed by the colon, causing dry or hard stools,
• Stool moves too slowly through the colon, or
• The patient is unable to expel stools.

Normal bowel habits among healthy people vary greatly from three times a day to three times a week. In some individuals, constipation may refer to infrequent bowel movements (less than 3 per week). While troublesome, constipation is usually not serious. It should be treated and corrected to reduce abdominal discomfort and other related symptoms and to prevent the development of complications. Untreated chronic constipation may lead to or aggravate more serious problems such as hemorrhoids or fecal impaction (partial blockage due to hard stool).

Measures to Treat Constipation

The goal of treatment is to reestablish normal bowel habits without the use of laxatives or enemas. The treatment measures listed below are explain in more detail in the following paragraphs.

• Eat a diet high in roughage (fiber).
• Eat regular meals; it is especially important to have breakfast.
• Take bulking agent with meals and follow with a full glass of water. Begin with:

          o 1-2 tablespoons millers bran 3 times a day or
          o 1-2 heaping teaspoons Metamucil 3 times a day

• Do not take harsh (stimulant) laxatives except as directed.
• Establish regular daily bowel habits; DO NOT ignore the urge to have a bowel movement.
• Allow 15 minutes after breakfast to sit on the toilet - do not strain.
• If there has been no bowel movement after 48 hours, take 1 or 2 tablespoons Milk of Magnesia at bedtime. If unsuccessful, the dose may be increased the next evening.
• If no bowel movement occurs after 3 days, use a glycerin suppository or, if necessary, you may take a small tap water enema.
• Exercise daily.
• Whenever possible, avoid medications that contribute to constipation. DO NOT stop taking any prescribed medications unless approved to do so by your physician.

Proper Diet

The first treatment for constipation is to eat a high fiber diet to provide natural bulk in your daily food intake. Dietary fiber, often called roughage, is a portion of food that passes through the intestine and colon almost unchanged. Undigested fiber holds water to keep the stool soft and adds bulk which helps move stool to the rectum. Most Americans eat very little roughage and this is often a major factor in the cause of constipation. An increase in dietary fiber generally results in a softer and bulkier stool which can be passed more easily. Ask to see a dietitian for complete instructions.

Bulk Agents

Bulk agents are very useful in addition to dietary fiber to restore and maintain regularity. These include bran and psyllium.