CONSTIPATION

General Information

DEFINITION--Difficult, uncomfortable or infrequent bowel movements that are hard and dry. In most people, constipation is harmless, but it can indicate an underlying disorder.

BODY PARTS INVOLVED--Colon.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS--

People vary widely in bowel activity. Any of the following may be a sign of constipation:

• Infrequent bowel movements, sometimes accompanied by abdominal swelling.
• Hard feces.
• Straining during bowel movements.
• Pain or bleeding with bowel movements.
• Sensation of continuing fullness after a bowel movement.

CAUSES

• Inadequate fluid intake.
• Insufficient fiber in the diet. Fiber adds bulk, holds water and creates easily passed, soft feces.
• Inactivity; depression.
• Hypothyroidism; hypercalcemia.
• Anal fissure.
• Chronic kidney failure.
• Back pain.
• Colon or rectal cancer; irritable bowel syndrome.

RISK INCREASES WITH

Stress. Illness requiring complete bed rest. > Use of certain drugs, including: belladonna; calcium-channel blockers; beta-adrenergic blockers; tricyclic antidepressants; narcotics; atropine; or aspirin.

• Travel.

HOW TO PREVENT

• Eat a well-balanced, high-fiber diet.
• Exercise regularly.
• Drink at least 8 glasses of water a day.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms. Tell your doctor of any major change in your bowel pattern that lasts longer than 1 week. It may be a sign of cancer.
• Medical history and physical exam by a doctor.
• Laboratory tests of blood and stool to detect internal bleeding.
• Sigmoidoscopy (rare; See Glossary).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment (occasionally).

POSSIBLE COMPLICATIONS--Hemorrhoids, laxative dependency, hernia from excessive straining, uterine or rectal prolapse, spastic colitis, bowel obstruction, chronic constipation.

PROBABLE OUTCOME--Usually curable with exercise, diet and adequate fluids.

How To Treat

GENERAL MEASURES--

• Set aside a regular time each day for bowel movements. The best time is often within 1 hour after breakfast. Don't try to hurry. Sit at least 10 minutes, whether or not a bowel movement occurs.
• Drinking hot water, tea or coffee may help stimulate bowel.

MEDICATION--For occasional constipation, you may use mild non-prescription laxatives such as bulk-formers, lubricants, stool softeners and enemas. Don't use laxatives or enemas regularly as this can cause dependency. Avoid harsh laxatives and cathartics, such as Epsom salts. The best laxatives are bulk-formers, such as bran, psyllium, polycarbophil and methylcellulose.

ACTIVITY--Exercise and good physical fitness helps maintain healthy bowel patterns.

DIET--Drink at least 8 glasses of water each day. Include bulk foods, such as bran and raw fruits and vegetables, in your diet.

Call Your Doctor If

• You have constipation that persists, despite self-care--especially if the constipation represents a change in your normal bowel patterns.
• Constipation is accompanied by fever or severe abdominal pain.