Constipation

What is Constipation?
Constipation can be hard to define because the frequency of bowel movements in healthy people can range from three per day to three per week. Constipation is anything outside of these parameters or hard to pass stool. While troublesome, constipation is usually not a serious disorder. However, there may be an underlying problem. The colon’s function is to withdraw water from the liquid stool, so that by the time it reaches the rectum there is a soft, formed stool. If an excessive amount of water is extracted, the stool can become hard and difficult to expel. Most often constipation is simply the result of not eating enough fiber or consuming enough water. Constipation can be caused by a lazy colon that does not contract and propel stool properly. The colon can also be spastic and remain contracted for a long time. Because stool is not moved along, too much water is absorbed and hard stool develops. Constipation can also result from a mechanical obstruction such as advanced diverticulosis. Other conditions that can lead to constipation include: pregnancy, dehydration, certain medications, stress, travel and laxative abuse.

Diagnosis of Constipation
Obtaining your medical history is the most important factor in diagnosing constipation. Your doctor will do a physical exam and possibly obtain some blood work. He/she may also order x-ray tests or a colonoscopy. Having a colonoscopy will allow your doctor to rule out a mechanical obstruction. In some cases pressure measurements taken of the rectum and lower colon are also helpful.

Treatment of Constipation
The way your doctor treats your constipation will depend on the underlying cause. If all serious or mechanical causes are excluded then he/she will suggest several lifestyle and dietary changes for you to make. General guidelines for treating constipation include: eating more fiber-rich foods, drinking plenty of water, and getting regular exercise. It is important not to ignore the urge to have a bowel movement; nature knows best.

If these lifestyle modifications don’t help, your doctor may suggest you take fiber supplements such as Metamucil or Citrucel. If you are taking fiber supplements, make sure to drink at least eight glasses of water daily. It may be necessary to use over-the-counter laxatives at times, but it is best not the use these on a regular basis without your doctors approval as they can damage the lining of the colon and cause dependence. Stool softeners, such as Colace and Surfak are also fine to use on a regular basis.