The fast pace of modern living often means less time for exercise, meals on the go, late-night dinners, eating prepared foods, and eating too many foods high in fat and low in fiber.  These factors all contribute to constipation, something that has become a common problem.

About Constipation

People of all ages suffer from constipation. Constipation means that you are not having bowel movements as often as you should. If you are constipated, you might have to strain more than usual to empty your bowels, or may not be able to completely empty your bowels. Your stool becomes hard, dry, small in size, and is difficult to eliminate. Constipation usually lasts for a matter of days, or up to a couple of weeks in severe cases, but once treated, has no long-lasting health effects. Constipation can even be prevented.

Many people think that they are constipated if they do not have a bowel movement every day. However, the number of bowel movements per day depends on the person. What is normal for one person may not be normal for another, yet both may be perfectly healthy. Some people may have bowel movements an average of three times each day, but others may only have bowel movements an average of three times per week. In the end, what is normal and healthy for you will depend on your diet, your activity level, your schedule, and many other factors.

The process of digestion starts once you eat your first bite of food during a meal. It passes through your mouth, to your stomach, then through the small intestine to the large intestine, and finally out of the body through the colon. In the colon, water is absorbed and the remaining food is formed into stool. Muscle contractions then push the stool through the rectum and out of the body.

This is how digestion should work; however, when the large intestine absorbs too much water from food, it can result in constipation. Constipation makes the digested material hard and very difficult to push out of the body.

Causes and risk factors for constipation are:

• Ignoring the urge to have a bowel movement
• Inadequate fluid/water intake
• Dehydration
• Too little fiber in the diet
• Lack of physical activity
• A change in daily routine, such as travel or a shift change at work
• Pregnancy
• Advanced age – risk of constipation increases as we age
• Medications including pain medications and those used to treat depression, Parkinson’s disease, or high blood pressure
• Calcium & iron supplements
• Irritable bowel syndrome – a common, often chronic disorder characterized by muscle abnormalities of the small and large intestines; symptoms include cramping, abdominal pain, constipation, and diarrhea
• Large intake of dairy products
• Abuse of laxatives
• Colon, rectal, or anal problems, such as intestinal obstruction or hemorrhoids; rarely constipation can be an indicator of colon cancer
• Stroke
• Conditions such as hormonal disturbances, certain cancers and treatments, or an underactive thyroid gland
• Stress

Symptoms of Constipation

When you are constipated, having a bowel movement will become difficult and will happen less often. You may not be able to defecate completely or may not have a bowel movement at all for days or even weeks. While what is normal varies greatly from person to person, if you are not having a bowel movement at least every three days, there is cause for concern.

If you are constipated, you likely will feel full, have a reduced appetite, and have a belly that appears a bit bloated. You may have to strain to have a bowel movement and may experience some pain, or even notice a few drops of blood on the skin of the anus. After you have a bowel movement, you may still have the urge to go again.

Generally, if these symptoms last for less than two weeks and are not causing severe pain, bleeding, or vomiting, there is no urgent need to visit your doctor. But if the condition lasts two weeks or more, or is causing severe symptoms, it is time to pay your doctor a visit.

When you visit the doctor, he or she will first ask for a medical history. This may include questions about dietary and lifestyle changes, medications you are taking, physical activity, frequency and consistency of bowel movements, and whether blood has recently been found in your stool. He or she will also perform a physical exam, which might include a rectal examination to check the muscles around the rectum for tenderness, obstruction, and bleeding.

If your symptoms are severe and you are experiencing dramatic weight loss, abdominal pain, or blood in your stool, the doctor might perform additional tests. These may include blood tests to check for hormonal imbalances; X-rays to check the rectal muscles, intestinal muscles, and the small or large intestines; or a colonoscopy, using a flexible tube with a tiny camera at one end, to test for an obstructed colon.

All of these questions and tests can help your doctor determine the cause of your constipation and identify a fast and effective treatment. In most cases, treatment will be simple lifestyle and dietary changes, or over-the-counter aids. But in severe cases, prescription drugs or surgery may be required. These cases are very rare.

For most cases of constipation, a doctor will recommend changes to your diet and lifestyle including:

• Increase intake of fluids, especially water
• Increase physical activity to 30 minutes or more per day
• Do not ignore the urge to have a bowel movement; go as soon as you have that urge
• Decrease intake of foods that provide little or no fiber such as cheese, meat, ice cream, or processed foods like frozen dinners
• Increase intake of foods rich in fiber

In general, it is recommended that people should consume roughly 25 to 35 grams of fiber each day. This may vary by age and gender, so it is best to talk to your doctor or dietician to learn your ideal daily fiber intake.

Examples of fiber-rich foods:

• Fruits: apples (with skin), apricots, bananas, blueberries, grapefruit, pears, raspberries, strawberries
• Vegetables: avocado, beets, broccoli, cabbage, carrots, kale, peas, winter squash, sweet potatoes
• Cereals and Grains: bran cereal, brown rice, oatmeal, oat bran muffin, whole-grain breads, whole-wheat pasta
• Legumes: black-eyed peas, split peas, black beans, kidney beans, lentils, lima beans, navy beans, pinto beans, soybeans
• Nuts and Seeds: almonds, flax seeds, peanuts, pecans, pistachio nuts, pumpkin seeds, sunflower seeds, walnuts

If these natural methods are not working, or if you have suffered from constipation for a long period of time, laxatives that soften the stool may be recommended. However, it is important to note that laxatives should not be considered a long-term solution for constipation as these drugs can be habit forming. A change in lifestyle is the best way to avoid future cases of constipation.

While constipation is a condition that is uncomfortable to experience, and maybe even for you to discuss, keep in mind that it is very common and is generally not serious.  Most importantly, it can be easily treated in most cases and prevented if you adopt the following diet and lifestyle practices:

• Add fiber to your diet
• Drink plenty of fluids, especially water
• Exercise regularly
• Try to keep to a regular routine, and increase fluid and fiber intake if your routine is changed, as when traveling
• Minimize alcohol and caffeine; they can dehydrate the body
• Never ignore an urge to have a bowel movement
• Do not rely on laxatives; it is better to make diet and lifestyle changes for a long-term effect
• Avoid foods that are high in fat and sugar as they may cause constipation

By following these tips, you may be able to keep constipation out of your life for good.