February 17th, 2007
Constipation is a common reason for seeking medical attention. It affects 10‒15% of adults. It is most common among women and the elderly. The elderly are afflicted more because they are exposed more frequently to many causes of constipation, like medical conditions, medication, poor diet, low mobility, or immobility. Constipation doesn't necessarily mean you never make a bowel movement; it could also mean that you have infrequent stools, hard stools, excessive straining, or a sense of incomplete evacuation. Everyone's bowel movements are different. If your bowel movements suddenly decrease, you must try to decide what is the underlying cause.
For most people, having constipation is harmless. A change in diet, fluid intake, or increase in exercise is all that's required. But for others it can be a sign that something else is wrong with the body. In these cases, the constipation may not go away when treated properly. At this point you should see a doctor. You should also seek medical attention if the constipation is accompanied by fever, abdominal pain, or blood in your stool. The advice below is meant to give you an idea of the various courses of treatment. It is not meant to diagnose you. The first course of treatment is the least severe and the last the most. I try to include as many warnings about each product as I can, but it is by no means an exhaustive list. Most importantly, if you are unable to get rid of constipation after a few days, you should see a doctor.
Steps to Get Rid of Constipation
Dietary fiber can help get rid of constipation. Taken on a daily basis, these fiber supplements will make it easier to pass stool. There are five types of dietary fiber laxatives: bran powder, which is cheap but may cause gas; psyllium husk under the brand names Metamucil and Perdiem; methylcellulose sold under the brand name Citrucel; calcium polycarbophil, which doesn't cause gas, under the brand name Fibercon; and guargum under the brand name Benefiber. Dietary fiber can be taken mixed in water or in the form of pills.
Stool softeners are used to get rid of constipation by making it easier to pass fecal matter. The most common stool softener is the docusate, of which there are three: docusate calcium, docusate potassium, and docusate sodium. It works by incorporating more liquid into the stool, making it softer and thereby easier to pass. Stool softeners are frequently taken by people who have a difficult time passing hard stool. Common brand names for docusate stool softeners are Colace, Diocto, Surfak, and Dialose. Taken orally, the stool softener should take effect in 1‒3 days. Taken rectally, a bowel movement should occur in 5‒20 minutes. Stool softeners are an immediate cure for constipation but should not be relied upon in the long term. Steps should be taken to change your lifestyle and habits.
Osmotic laxatives increase the amount of water in the intestines. This increased water inside the intestinal lumen softens the stool and encourages defecation. The two most common osmotic laxatives are Milk of Magnesia and Epsom salt. The active ingredient in both is magnesium hydroxide, and 5‒30 mL taken orally once or twice a day should produce a movement in 5‒24 hours. Another osmotic laxative Lactulose works too, but it causes cramps, bloating and gas. So I say pass on it. No pun intended. The last and most extreme of the osmotic laxatives is polyethylene glycol, brand name Miralax. Osmotic laxatives should not be used on an everyday basis.
Stimulant laxatives work quickly to get rid of constipation. These laxatives stimulate fluid secretion as well as the contraction of your colon. If ingested orally, they will produce a bowel movement in 6‒12 hours. If administered rectally, the bowel movement will begin in 15 minutes to an hour. Common brands of stimulant laxatives are Nature's Remedy, ExLax, and Senekot. All of them may cause cramps, and daily use is not recommended. One other stimulant laxative with the unfortunate name of Lubiprostone should not be taken when pregnant. Stimulant laxatives should also not be taken on an everyday basis. Your body will become dependent on them, and you won't be able to poop without them.
Enemas of all sorts will help to get rid of severe constipation. In general, severe constipation is partial or complete large bowel obstruction. This is also known as fecal impaction. Enemas made of water, sodium phosphates, soapsuds, or mineral oil are used to dislodge and lubricate the impacted fecal matter. If that doesn't work, a doctor can remove it manually. Enemas should not be used on a frequent basis. They flush your system of important minerals and can disrupt your body's natural balance of minerals.
Lifestyle Changes will Prevent Future Constipation
- Getting an appropriate amount of exercise each day is recommended to encourage bowel movements.
- Drinking at least 8 cups of water each day will help to prevent constipation by keeping your bowels hydrated.
- Drinking hot water, coffee, or tea can cause you to feel like making a bowel movement.
- Include fiber-rich food in your diet. This includes bran, fruits, and vegetables. Refer to the FDA website for advice about nutrition and a balanced diet.
- Set aside a regular time each day, an hour or so, for evacuation of bowels. About an hour after waking up is good. Sit down for 10 minutes, even if you don't feel a movement. Try to relax and release the muscles in your abdomen. Don't strain.
- If the changes in your diet and lifestyle are not helping, use mild stool softeners occasionally. Refrain from using laxatives until they are absolutely necessary. It is possible to become dependent upon them, as they actually begin to cause constipation with extended use.
Schedule an Exam
Call the doctor's office and schedule an appointment if the constipation persists despite your attempts at self care, especially if the constipation is a change in your normal bowel patterns. Changes of that nature could be caused by cancer. Also, call the doctor if along with the constipation you are experiencing fever or stomach pain.