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Constipation

Definition

Constipation is a condition in which a person's bowel movements become uncomfortable, harder, or less frequent than usual.

What is going on in the body?

The role of the digestive system is to extract nutrients from the food a person eats and prepare the leftover material for disposal. Food passes through at least 20 feet of small intestine before being stored temporarily in the colon, or large intestine, where water is removed. Finally, this fecal residue is excreted as a bowel movement.
The frequency of bowel movements considered normal varies from person to person. "Normal" may range from movements 3 times a day to 3 times a week.
Constipation is not an illness, but it may be a symptom of another problem.

Risks

What are the causes and risks of the condition?

This condition can be caused by:
  • a recent change in diet
  • dietary factors, such as not drinking enough fluids, eating too much animal protein, or not eating enough fiber-rich foods
  • a decrease in physical activity or too little physical activity
  • illness
  • iron tablets
  • certain drugs, such as those for pain, depression, and high blood pressure
  • rapid weight loss
  • a person ignoring the feeling of needing to pass stool
  • hormone changes, such as those in pregnancy
  • high blood calcium
  • specific diseases, such as colon cancer or an underactive thyroid
  • depression, tension, or anxiety
Acute constipation may be caused by a serious problem, such as a blockage or poor blood supply to the large intestine, or nerve and spinal cord injury.

Prevention

What can be done to prevent the condition?

The best way for a person to prevent this condition is to:
  • exercise regularly
  • eat a healthy, high-fiber diet that includes whole grains, fresh vegetables and fruits
  • regularly practice relaxation that also relaxes the bowel
  • drink plenty of water, especially in hot weather
  • limit foods that have little or no fiber, such as ice cream, meat, chips, and pre-packaged frozen dinners
  • limit caffeine, alcohol, and sodas, as they tend to dry out the stool
  • listen to his or her body and allow enough time to have a bowel movement
  • check if any drugs he or she is taking cause constipation

Diagnosed

How is the condition diagnosed?

Constipation affects almost everyone at one time or another. Most people do not need extensive testing because the condition usually resolves on its own. But sometimes constipation is a symptom of a more serious problem.
Anyone with constipation that lasts for more than 2 weeks should see a doctor so that the source of the problem can be found. The doctor may do blood tests and examine the colon.

Long Term Effects

What are the long-term effects of the condition?

The longer the fecal residue sits in the colon, the harder the stool becomes and the more difficult it is to pass. This also means that the colon is exposed to the chemicals in these waste products for a longer time.
The long-term effects of chronic constipation can include:
  • swelling of the bowel, sometimes with pain in the belly
  • colon cancer
  • diverticulosis and diverticulitis

Other Risks

What are the risks to others?

There are no risks to others.

Treatments

What are the treatments for the condition?

To treat this condition, a person needs to find the cause and fix it. For instance, if it is caused by lack of exercise, the person needs to exercise more.
If the body is not getting enough fluids, he or she needs to drink more. If the feces are hard, a doctor may recommend a mild stool softener, such as docusate (i.e., Colace), fiber supplements (usually containing psyllium), medicines that increase stool bulk (i.e., Citrucel, Metamucil, MiraLax), lactulose, enemas (which should be the last choice) to prevent this problem, or a laxative.
Laxatives, such as bisacodyl (i.e., Dulcolax), come in many forms, including liquids, pills, chewing gum, and powder that is mixed in water. If laxatives are used for more than 2 weeks, they can aggravate symptoms.
Many times diet changes work just as well as laxatives. For instance, a diet containing bulk, such as whole grains, vegetable fiber, bran, and water, produces large, soft feces that are easily passed.
A person also may want to try:
  • drinking 2 to 4 extra glasses of water a day
  • drinking warm liquids, especially in the morning
  • eating more fruits and vegetables
  • eating prunes and/or bran cereal
  • daily exercise
When a disease is causing constipation, the disease must be treated.

Side Effects

What are the side effects of the treatments?

Before taking laxatives, a person should talk to his or her doctor as there can be side effects. For instance, if a person takes laxatives that contain certain chemicals for too long, these laxatives may actually maintain constipation, and weaken the muscles of the bowel.
A person should add fiber to his or her diet a little at a time until the body gets used to it.

After Treatment

What happens after treatment for the condition?

Good lifestyle habits allow the digestive system to work efficiently. Eating a fiber-rich diet, drinking plenty of fluids, and exercising regularly go a long way toward preventing constipation.

Monitor

How is the condition monitored?

Keep in mind, there is no right or wrong number of bowel movements. Each person's body finds its own normal number of bowel movements. It depends on a person's age, the foods eaten, and how much he or she exercises. A person should call a doctor if he or she has blood in the stool, is losing weight without dieting, or has severe pain with bowel movements

Sources

Merck Manual : Home Edition

The Illustrated Encyclopedia of Natural Remedies, Norman Shealy

Take Care of Yourself, Donald Vickery&James Fries

Dr Koop's Self-Care Advisor, Time Life Medical 1996

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