Constipation: What Should You Know?
By Alan Peterson, MD
What Is Constipation?
Constipation is when you have fewer bowel movements than usual. You may also have hard, dry stools. If you don’t have a bowel movement every day, this does not necessarily mean that you are constipated. Constipation usually means that you have fewer than three stools each week, although if the stools are not hard and dry, this doesn’t have to be a true definition of “constipation.”
Who Gets Constipated and Why?
Anyone can get constipated, but it happens most often to older adults and to women who are pregnant. Constipation can happen when stools move too slowly through the body. Too much water from the stool is then soaked up into your bowels and leads to hard, dry stools.
Constipation can be caused by changes in diet, by not enough exercise, and by some medicines and illnesses.
How Can I Tell If I Have Constipation?
If you are constipated, you may have bowel movements fewer than three times a week and have hard, dry stools. You may also feel the need to strain with bowel movements. You may have stomach pain or fullness, bloating, or the feeling of rectal pressure. You may feel like your bowels have not been fully emptied. If you have any changes in your usual bowel pattern, talk to your doctor.
How Can My Doctor Tell the Cause of My Constipation?
You should keep a day-by-day list to track the number, hardness, and pattern of your stools. Your doctor will ask you questions and examine you to find out what is causing your constipation. If the cause is unclear, your doctor may run some tests. One cause of constipation is a blockage of the intestines. Sometimes x-rays can be helpful. Sometimes blood tests might be needed. One glandular or endocrine problem that can cause constipation is hypothyroidism (low blood levels of thyroid hormone).
What Can I Do If I Am Constipated?
There are several things that you can do to help keep your stools regular:
- Add more fiber to your diet. Fiber is found in foods such as vegetables, fruits, whole grain breads, and high-fiber cereal.
- Drink at least six to eight glasses of water each day. If your doctor has told you to withhold fluids for other medical reasons, obviously follow those instructions first.
- Exercise every day. Even just increasing your walking can be helpful.
- Try to have a bowel movement about the same time every day. A good time is first thing in the morning after breakfast. There is a normal colic reflex that many times is suppressed by adults because of our social rush of the day. Sometimes a hot beverage with breakfast also helps to initiate this reflex.
If these things do not help, your doctor may recommend that you take a stool softener or, if worse, a laxative. One of the things we try not to do is become “addicted” to a daily laxative. Some laxatives are safer than others, especially if one is forced to use them on a daily basis. Please ask your doctor about this choice.
For those over 50 years of age who have constipation, your physician will probably want to make sure that you have had a colonoscopy or sigmoidoscopy. These tests are even indicated at a younger age if you have a change in your bowel habits.
Obviously, if you have bleeding in your stool or on the toilet tissue, one should discuss this with his or her physician.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.
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