Constipation

Definition

Constipation is an acute or chronic condition in which bowel movements occur less often than usual or consist of hard, dry stools that are painful or difficult to pass. Bowel habits vary, but an adult who has not had a bowel movement in three days or a child who has not had a bowel movement in four days is considered constipated.

Description

Constipation is one of the most common medical complaints in the United States. It can occur at any age and is more common among individuals who resist the urge to move their bowels at the body's signal. This often happens when children start school or enter daycare and feel shy about asking permission to use the bathroom.

Constipation is more common in women than in men and is especially apt to occur during pregnancy . Age alone does not increase the frequency of constipation, but elderly people are more likely to suffer from the condition.

Although this condition is rarely serious, it can lead to:

• bowel obstruction
• chronic constipation
• hemorrhoids (a mass of dilated veins in swollen tissue around the anus)
• hernia (a protrusion of an organ through a tear in the muscle wall)
• spastic colitis (irritable bowel syndrome , a condition characterized by alternating periods of diarrhea and constipation)
• laxative dependency

Chronic constipation may be a symptom of colorectal cancer, depression , diabetes, diverticulosis (small pouches in the muscles of the large intestine), lead poisoning , or Parkinson's disease . An opioid overdose (as in excessive codeine from cough suppressants or heroin addiction) also may result in constipation.

In someone who is elderly or disabled, constipation may be a symptom of bowel impaction, a more serious condition in which feces are trapped in the lower part of the large intestine. A doctor should be called if an elderly or disabled person is constipated for more than a week or if a child seems to be constipated.

A doctor should be notified whenever constipation occurs after starting a new prescription, vitamin, or mineral supplement or is accompanied by blood in the stools, changes in bowel patterns, fever , or abdominal pain .

Causes & symptoms

Constipation usually results from not getting enough exercise , not drinking enough water or clear fluids, or from a diet that does not include an adequate amount of fiber-rich foods like beans, bran cereals, fruits, raw vegetables, rice, and whole-grain breads.

Other causes of constipation include anal fissure (a tear or crack in the lining of the anus), chronic kidney failure, colon or rectal cancer , depression, hypercalcemia (abnormally high levels of calcium in the blood), hypothyroidism (underactive thyroid gland), illness requiring complete bed rest, irritable bowel syndrome, imbalanced bowel from food and flora allergies , and stress .

Constipation can also be a side effect of:

• aluminum salts in antacids
• antihistamines
• antipsychotic drugs
• aspirin
• belladonna (Atopa belladonna, source of atropine, a medication used to relieve spasms and dilate the pupils of the eye)
• beta blockers (medications used to stabilize irregular heartbeat, lower high blood pressure, reduce chest pain)
• blood pressure medications
• calcium channel blockers (medication prescribed to treat high blood pressure, chest pain, some types of irregular heartbeat and stroke , some non-cardiac diseases)
• codeine or opioids.
• diuretics (drugs that promote the formation and secretion of urine)
• iron or calcium supplements
• narcotics (potentially addictive drugs that relieve pain and cause mood changes)
• tricyclic antidepressants (medications prescribed to treat chronic pain, depression, headaches, and other illnesses)

An adult who is constipated may feel bloated, have a headache , swollen abdomen, pass rock-like feces, or strain, bleed, or feel pain during bowel movements. A constipated baby may strain, cry, draw the legs toward the abdomen, or arch the back when having a bowel movement.

Diagnosis

Everyone becomes constipated once in a while, but a doctor should be notified if significant changes in bowel patterns last for more than a week or if symptoms continue more than three weeks after increasing activity and fiber and fluid intake.

The patient's observations and medical history help a primary care physician diagnose constipation. The doctor uses his fingers to see if there is a hardened mass in the abdomen and may perform a rectal examination. Other diagnostic procedures include a barium enema, which reveals blockage inside the intestine; laboratory analysis of blood and stool samples for internal bleeding or other symptoms of systemic disease; and a sigmoidoscopy (examination of the sigmoid area of the colon with a flexible tube equipped with a magnifying lens).

Physical and psychological assessments and a detailed history of bowel habits are especially important when an elderly person complains of constipation.

Treatment

Initially, alternative practitioners will suggest that the patient drink an adequate amount of water each day (six to eight glasses), exercise on a regular basis, and eat a diet high in soluble and insoluble fibers. Soluble fibers include pectin, flax, and gums. Insoluble fibers include psyllium and brans from grains like wheat and oats. Fresh fruits and vegetables contain both soluble and insoluble fibers, and since constipation is aggravated by folate, calcium, and magnesium deficiencies, sources of these nutrients, such as asparagus, spinach, parsley , and other dark green leafy vegetables, should be part of the daily diet. Various fruit juices can also help maintain normal bowel function; sorbitol, the natural sugar found in apple juice has known laxative properties. Castor oil , applied topically to the abdomen and covered by a heat source (a heating pad or hot water bottle), can help relieve constipation when used nightly for 20-30 minutes. For babies, about 1 tablespoon of corn syrup mixed with warm water might help relieve constipation.

Acupressure

This form of acupuncture is said to relax the abdomen, ease discomfort, and stimulate regular bowel movements when diet and exercise fail to do so. After lying down, patients close their eyes and take deep breaths. For two minutes, the practitioner applies gentle fingertip pressure to a point about two inches below the navel. Acupressure can also be applied to the outer edges of one elbow crease and maintained for 30 seconds before pressing the crease of the other elbow. This should be done three times a day to relieve constipation.

Aromatherapy

Six drops of rosemary (Rosmarinus officinalis ) and six drops of thyme (Thymus spp.) diluted by one ounce of almond oil, olive oil, or another carrier oil can relieve constipation when used to massage the abdomen. A circular motion for massage is recommended, beginning up the right side of the abdomen, coming across the top, and down the left side. Massaging the leg from knee to hip in the morning, at night, and before trying to move the bowels is said to relieve constipation.

Herbal therapy

A variety of herbal therapies can be useful in the treatment of constipation. Several herbs, including chamomile (Matricaria recutita ), dandelion root (Taraxacum officinale ), and burdock (Arctium lappa ), act as bitters which stimulate the movement of the digestive and excretory systems. There are also laxative herbs that assist with bowel movement. Two of these are senna and buckthorn . These laxative herbs are stronger acting on elimination than bitters and can sometimes cause cramping (mixing them with a calming herb like fennel or caraway can help reduce cramping). Both senna and buckthorn are powerful herbs that are best used with direction from an experienced practitioner, since they can have adverse side effects and the patient may become dependent on them. In fact, practitioners caution that senna can cause severe cramping.

Yoga

The knee-chest position, said to relieve gas and stimulate abdominal organs, involves:

• standing straight with arms at the sides
• lifting the right knee toward the chest
• grasping the right ankle with the left hand
• pulling the leg as close to the chest as possible
• holding the position for about eight seconds
• repeating these steps with the left leg

The cobra position, which can be repeated as many as four times a day, involves:

• lying on the stomach with legs together
• placing the palms just below the shoulders, holding elbows close to the body
• inhaling, then lifting the head (face forward) and chest off the floor
• keeping the navel in contact with the floor
• looking as far upward as possible
• holding this position for three to six seconds
• exhaling and lowering the chest

The spine twist is another pose that is recommended for daily use in relieving constipation. Practicing relaxation and meditation can also have a powerful effect on the digestive system. Slow, steady music can relieve tension that leads to constipation.

Allopathic treatment

If changes in diet and activity fail to relieve occasional constipation, an over-the-counter laxative may be used for a few days. Preparations that soften stools or add bulk (bran, psyllium, ducosate sodium ) work more slowly but are safer than Epsom salts and other harsh laxatives or herbal laxatives containing senna (Cassia senna ) or buckthorn (Rhamnus purshianna ), which, if used long term, can harm the nerves and lining of the colon because they are peristaltic stimulants.

A woman who is pregnant should never use a laxative. She can use flaxseed , bran, ducosate sodium, prunes, or oatmeal. Anyone who is experiencing abdominal pain, nausea , or vomiting should also avoid laxatives. A warm-water or mineral oil enema can relieve constipation, and a non-digestible sugar (lactulose) or special electrolyte solution is recommended for adults and older children with stubborn symptoms. If a patient has an impacted bowel, the doctor may insert a gloved finger into the rectum and gently dislodge the hardened feces.

In 2002, a new study compared a non-toxic food ingredient called polyethylene glycol to lactulose for relieving constipation in children. A preliminary study showed that it may work faster, prove easier to administer, and be just as safe and effective. However, more research was suggested before recommending the substance over lactulose.

Expected results

Changes in diet and exercise usually eliminate the problem of constipation.

Prevention

Most Americans consume between 11-18 grams of fiber a day. Consumption of 30 grams of fiber and between 6-8 glasses of water each day can generally prevent constipation, and 35 grams of fiber a day (an amount equal to five servings of fruits and vegetables, and a large bowl of high-fiber cereal) can relieve constipation. Fiber supplements containing psyllium (Plantago psyllium ) usually become effective within about two days and can be used every day without causing dependency. Powdered flaxseed (Linium usitatissimum ) works the same way. Insoluble fiber, like wheat or oat bran, is as effective as psyllium but may give the patient gas at first.

Daily use of 500 mg vitamin C and 400 mg magnesium can prevent constipation. If symptoms do occur, each dosage can be increased by 100 mg a day, up to a maximum of 5,000 mg vitamin C and 1,000 mg magnesium. Use of preventive doses should be resumed after relief occurs. If the patient developes diarhea, the vitamin C should be decreased. Calcium is also important. Children over five can take up to 1,300 mg and adults ages 19-50 can take up to 2,000 mg.

Sitting on the toilet for 10 minutes at the same time every day, preferably after a meal, can induce regular bowel movements. This may not become effective for a few months, and it is important to defecate whenever necessary.

Resources

BOOK

The Editors of Time-Life Books. The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments. Alexandria, VA: Time-Life, Inc., 1996.

Gottlieb, Bill, ed. New Choices in Natural Healing. Emmaus, PA: Rodale Press, Inc., 1995.

Inlander, Charles B. The Consumer's Medical Desk Reference. New York: Stonesong Press, 1995.

PERIODICALS

"Go for Natural Laxative Relief, but Best if not from Senna or Cascara."Environmental Nutrition (May 2002): 7.

Goldstein, Laura. "Corn Syrup Does the Trick."Prevention (June 2002): 172.

Gremse, David A, et al. "Comparison of Polyethylene Glycol 3350 and Lactulose for Treatment of Chronic Constipation in Children."Clinical Pediatrics (May 2002): 225.

Harari, D., et al. "Bowel Habit in Relation to Age and Gender: Findings from the National Health Interview Survey and Clinical Implications."Archives of Internal Medicine (February 1996): 315-320.

Karlsrud, K. and P. Schneider. "Tummy Troubles."Parents (April 1997): 83-84.

OTHER

Griffith, H. Winter, M.D. "Constipation." Thrive Online. http://www.thriveonline.com/health/. (March 1998).

Kathleen Wright

Teresa G. Odle

Constipation

Definition

Constipation is an acute or chronic condition in which bowel movements occur less often than usual or consist of hard, dry stools that are painful or difficult to pass. Bowel habits vary, but an adult who has not had a bowel movement in three days or a child who has not had a bowel movement in four days is considered constipated.

Description

Constipation is one of the most common medical complaints in the United States. Constipation can occur at any age, and is more common among individuals who resist the urge to move their bowels at their body's signal. This often happens when children start school or enter daycare and feel shy about asking permission to use the bathroom.

Constipation is more common in women than in men and is especially apt to occur during pregnancy. Age alone does not increase the frequency of constipation, but elderly people (especially women) are more likely to suffer from constipation.

Although this condition is rarely serious, it can lead to:

• bowel obstruction
• chronic constipation
• hemorrhoids (a mass of dilated veins in swollen tissue around the anus)
• hernia (a protrusion of an organ through a tear in the muscle wall)
• spastic colitis (irritable bowel syndrome, a condition characterized by alternating periods of diarrhea and constipation)
• laxative dependency

Chronic constipation may be a symptom of colorectal cancer, depression, diabetes, diverticulosis (small pouches in the muscles of the large intestine), lead poisoning, or Parkinson's disease.

In someone who is elderly or disabled, constipation may be a symptom of bowel impaction, a more serious condition in which feces are trapped in the lower part of the large intestine. A doctor should be called if an elderly or disabled person is constipated for a week or more or if a child seems to be constipated.

A doctor should be notified whenever constipation occurs after starting a new prescription, vitamin, or mineral supplement or is accompanied by blood in the stools, changes in bowel patterns, or fever and abdominal pain.

Causes and symptoms

Constipation usually results from not getting enough exercise, not drinking enough water, or from a diet that does not include an adequate amount of fiber-rich foods like beans, bran cereals, fruits, raw vegetables, rice, and whole-grain breads.

Other causes of constipation include anal fissure (a tear or crack in the lining of the anus); chronic kidney failure; colon or rectal cancer; depression; hypercalcemia (abnormally high levels of calcium in the blood); hypothyroidism (underactive thyroid gland); illness requiring complete bed rest; irritable bowel syndrome; and stress.

Constipation can also be a side effect of:

• aluminum salts in antacids
• antihistamines
• antipsychotic drugs
• aspirin
• belladonna (Atopa belladonna, source of atropine, a medication used to relieve spasms and dilate the pupils of the eye)
• beta blockers (medications used to stabilize irregular heartbeat, lower high blood pressure, reduce chest pain)
• blood pressure medications
• calcium channel blockers (medication prescribed to treat high blood pressure, chest pain, some types of irregular heartbeat and stroke, and some non-cardiac diseases)
• diuretics (drugs that promote the formation and secretion of urine)
• iron or calcium supplements
• narcotics (potentially addictive drugs that relieve pain and cause mood changes)
• tricyclic antidepressants (medications prescribed to treat chronic pain, depression, headaches, and other illnesses)

An adult who is constipated may feel bloated, have a headache, swollen abdomen, or pass rock-like feces; or strain, bleed, or feel pain during bowel movements. A constipated baby may strain, cry, draw the legs toward the abdomen, or arch the back when having a bowel movement.

Diagnosis

Everyone becomes constipated once in a while, but a doctor should be notified if significant changes in bowel patterns last for more than a week or if symptoms continue more than three weeks after increasing activity and fiber and fluid intake.

The patient's observations and medical history help a primary care physician diagnose constipation. The doctor uses his fingers to see if there is a hardened mass in the abdomen, and may perform a rectal examination. Other diagnostic procedures include a barium enema, which reveals blockage inside the intestine; laboratory analysis of blood and stool samples for internal bleeding or other symptoms of systemic disease; and a sigmoidoscopy (examination of the sigmoid area of the colon with a flexible tube equipped with a magnifying lens).

Physical and psychological assessments and a detailed history of bowel habits are especially important when an elderly person complains of constipation.

Treatment

If changes in diet and activity fail to relieve occasional constipation, an over-the-counter laxative may be used for a few days. Preparations that soften stools or add bulk (bran, psyllium) work more slowly but are safer than Epsom salts and other harsh laxatives or herbal laxatives containing senna (Cassia senna ) or buckthorn (Rhamnus purshianna ), which can harm the nerves and lining of the colon.

A woman who is pregnant should never use a laxative. Neither should anyone who is experiencing abdominal pain, nausea, or vomiting.

A warm-water or mineral oil enema can relieve constipation, and a non-digestible sugar (lactulose) or special electrolyte solution is recommended for adults and older children with stubborn symptoms.

If a patient has an impacted bowel, the doctor inserts a gloved finger into the rectum and gently dislodges the hardened feces.

Alternative treatment

Initially, alternative practitioners will suggest that the patient drink an adequate amount of water each day (six to eight glasses), exercise on a regular basis, and eat a diet high in soluble and insoluble fibers. Soluble fibers include pectin, flax, and gums; insoluble fibers include psyllium and brans from grains like wheat and oats. Fresh fruits and vegetables contain both soluble and insoluble fibers. Castor oil, applied topically to the abdomen and covered by a heat source (a heating pad or hot water bottle), can help relieve constipation when used nightly for 20-30 minutes.

Acupressure

This needleless form of acupuncture is said to relax the abdomen, ease discomfort, and stimulate regular bowel movements when diet and exercise fail to do so. After lying down, the patient closes his eyes and takes a deep breath. For two minutes, he applies gentle fingertip pressure to a point about two and one-half inches below the navel.

Accupressure can also be applied to the outer edges of one elbow crease and maintained for 30 seconds before pressing the crease of the other elbow. This should be done three times a day to relieve constipation.

Aromatherapy

Six drops of rosemary (Rosmarinus officinalis ) and six drops of thyme (Thymus spp.) diluted by 1 oz of almond oil, olive oil, or another carrier oil can relieve constipation when used to massage the abdomen.

Herbal therapy

A variety of herbal therapies can be useful in the treatment of constipation. Several herbs, including chamomile (Matricaria recutita ), dandelion (Taraxacum mongolicum ), and burdock (Arctium lappa ), act as bitters, stimulating the movement of the digestive and excretory systems. There are also "laxative" herbs that assist with bowel movement. Two of these are senna (Cassia senna ) and buckthorn (Rhamnus purshiana ). These "laxative" herbs are stronger acting on elimination than bitters and can sometimes cause cramping (mixing them with a calming herb like fennel or caraway can help reduce cramping). Both senna and buckthorn are powerful herbs that are best used with direction from an experienced practitioner, since they can have adverse side effects and the patient may become dependent on them.

Homeopathy

Homeopathy also can offer assistance with constipation. There are acute remedies for constipation that can be found in one of the many home remedy books on homeopathic medicine. A constitutional prescription also can help rebalance someone who is struggling with constipation.

Massage

Massaging the leg from knee to hip in the morning, at night, and before trying to move the bowels is said to relieve constipation. There is also a specific Swedish massage technique that can help relieve constipation.

Yoga

The knee-chest position, said to relieve gas and stimulate abdominal organs, involves:

• standing straight with arms at the sides
• lifting the right knee toward the chest
• grasping the right ankle with the left hand
• pulling the leg as close to the chest as possible
• holding the position for about eight seconds
• repeating these steps with the left leg

The cobra position, which can be repeated as many as four time a day, involves:

• lying on the stomach with legs together
• placing the palms just below the shoulders, holding elbows close to the body
• inhaling, then lifting the head (face forward) and chest off the floor
• keeping the navel in contact with the floor
• looking as far upward as possible
• holding this position for three to six seconds
• exhaling and lowering the chest

Prognosis

Changes in diet and exercise usually eliminate the problem.

Prevention

Most Americans consume between 11-18 grams of fiber a day. Consumption of 30 grams of fiber and between six and eight glasses of water each day can generally prevent constipation.

Thirty-five grams of fiber a day (an amount equal to five servings of fruits and vegetables, and a large bowl of high-fiber cereal) can relieve constipation.

Daily use of 500 mg vitamin C and 400 mg magnesium can prevent constipation. If symptoms do occur, each dosage can be increased by 100 mg a day, up to a maximum of 5,000 mg vitamin C and 1,000 mg magnesium. Use of preventive doses should be resumed after relief occurs, and vitamin C should be decreased to the pre-diarrhea dosage if the patient develops diarrhea.

Sitting on the toilet for 10 minutes at the same time every day, preferably after a meal, can induce regular bowel movements. This may not become effective for a few months, and it is important to defecate whenever necessary.

Fiber supplements containing psyllium (Plantago psyllium ) usually become effective within about 48 hours and can be used every day without causing dependency. Powdered flaxseed (Linium usitatissimum ) works the same way. Insoluble fiber, like wheat or oat bran, is as effective as psyllium but may give the patient gas at first.

Resources

OTHER

"Constipation." ThriveOnline. March 15, 1998. 〈http://thriveonline.oxygen.com〉.

constipation is a widely used term usually referring to decreased bowel frequency, although it is sometimes used when the stools are hard or when there is pain or difficulty with bowel evacuation. A clear definition of the term is difficult because of the wide range of ‘normal’ bowel frequency in the general population, which ranges from two or three times a day to less than two per week. Constipation has many causes, the majority of which are not serious and for which there are simple remedies. However, as it may be the presenting feature of a serious condition such as large bowel cancer, in selected circumstances constipation requires further investigation to enable specific treatment to be given. There are a number of important groups of disorders which present as constipation.

Causes of constipation

When the structure of the bowel is apparently normal

Most individuals fall into this group, and the most common cause is usually dietary. Low fibre diets result in low faecal residues, which can reduce the frequency of bowel action. In some individuals constipation may be a behavioural problem, possibly related to a life-long suppression of the normal ‘signals’ to defecate. Other situations like pregnancy and old age and infirmity also slow intestinal transit and can result in constipation. Some patients with irritable bowel syndrome complain of constipation which may alternate with increased bowel frequency.

Structural abnormalities in the colon and rectum

Minor anal problems such as ‘anal fissure’ — a tear in the lining of the anal canal — can result in constipation because of voluntary inhibition of defecation due to the associated pain. Inflammation in the rectum, proctitis, can have the same effect. In addition, there are some important disorders in which there is a developmental or acquired abnormality of the nerves within the bowel wall; examples include Hirschsprung's disease (congenital ‘megacolon’ described by this Danish physician in 1888) and infection with the parasite Trypanosoma cruzi, which causes Chagas' disease (named after the Brazilian physician who noted it in 1909). Abnormalities of colonic muscle produce a myopathy which can also lead to constipation.

Neurological diseases

A number of generalized neurological disorders, such as Parkinson's disease and multiple sclerosis, can damage the nerve supply to the colon and rectum and produce constipation. Similar damage to the autonomic nerves can also occur in diabetes mellitus. Colonic function may also be impaired in patients with reduced levels of consciousness and mental retardation.

Endocrine and metabolic

causes Reduced activity of the thyroid gland (hypothyroidism) and raised concentrations of calcium in the blood (hypercalcaemia) are the most common disorders in this group.

Psychological disorders

Depression and anorexia nervosa are both often associated with constipation.

Adverse drug effects

Many drugs can cause constipation, in particular potent painkillers (opiates and opioid analgesics), some anti-depressants, and drugs used to reduce high blood pressure.

Investigation and management of constipation

Investigation of constipation which has no simple explanation may require exclusion of a structural problem in the colon; this usually involves a radiological examination (barium enema) or an endoscopic examination using a flexible instrument called a colonoscope. Nerve and muscle disorders sometimes require investigation using methods to measure transit time through the colon, and measurement of pressure within the bowel and electrophysiological tests to study nerve and muscle function.

Simple constipation, in which there is no obvious disease or disorder of the colon, is best remedied by dietary measures such as increasing the fibre content of the diet. Commercially-prepared bulking agents are also available. If bulking agents fail then osmotic laxatives such as magnesium sulphate (Epsom salts) may be required, though there is some evidence that prolonged use can damage the colonic nerves and ultimately make the condition worse.

When constipation is due to colon cancer or an endocrine or metabolic disturbance, then appropriate specific treatment is required. If constipation occurs as an adverse effect of drug therapy for another condition, then it is usually appropriate to try an alternative preparation.

Michael Farthing, and Anne Ballinger

constipation infrequent or difficult passage of feces. Constipation may be caused by the lack of adequate roughage or fluid in the diet, prolonged physical inactivity, certain drugs, or emotional disturbance. Sudden unexplained changes in bowel habits can be a symptom of a serious disorder (such as lower intestinal obstruction by a growth) and should receive medical attention. Most cases of constipation can be relieved by following a diet that includes adequate roughage and fluid and by establishing regular habits of evacuation. The continued use of laxatives is inadvisable. Daily bowel movements are not essential; many persons suffer from the harm caused by constant use of laxatives and enemas in an effort to establish the desired regularity.

Constipation

What Is Constipation?

What Causes Constipation?

What Is the Treatment for Constipation?

Can Constipation Be Prevented?

Resources

Constipation is a condition that involves difficulty in having a bowel movement or involves having stools (solid waste material from the body) that are dry and hard.

KEYWORDS

for searching the Internet and other reference sources

Cathartics

Digestion

Fecal impaction

Intestines

Laxatives

What Is Constipation?

Normal bowel movement patterns vary from person to person. Some people move their bowels as often as after every meal. Other people may move their bowels every 3 days or so. Both of these patterns may be normal.

With constipation a person feels discomfort and has irregular bowel movements. The difficulty comes from the dry, hard condition of the stool. Constipation may be associated with many medical illnesses.

What Causes Constipation?

Several factors can contribute to constipation, such as not eating enough fiber or drinking enough fluids, inactivity, or not developing regular toilet habits. Certain medical conditions such as irritable bowel syndrome or hypothyroidism are associated with constipation. Sometimes the medicine people take for other illnesses causes them to become constipated. Pregnant women frequently develop constipation, also.

Constipation can occur when a person “withholds” stool and the intestines reabsorb the water in the stool, causing it to become harder. Withholding the stool can happen if a person is not comfortable having a bowel movement, for example, when traveling or if the toilet area is considered unsafe or unpleasant.

What Is the Treatment for Constipation?

Although many people take laxatives (LAK-sa-tivs) for constipation, doctors warn that these should not be taken regularly because the intestines may become sluggish and dependent on laxatives. Instead, it is recommended that people eat a diet that is rich in fiber. Foods that have fiber are whole grains, like bran or whole wheat, beans, fruits, and vegetables. Eating mostly foods that contain a lot of starch or sugar, like cookies and cakes, doesn’t give the body enough fiber for good digestion and proper elimination. Also, it is important to drink sufficient amounts of water.

In serious cases of constipation, a person may need to be examined by a doctor and possibly be given an enema (EN-e-ma). This is a process of putting fluid into the rectum to loosen the stool. The doctor also may prescribe medication to help the patient regain regular bowel habits.

For a child who develops a serious case of constipation, the doctor may help by providing a habit-training program. In addition to being instructed about proper diet and increased water intake, the child may be given medicine to help develop regular toilet habits.

Can Constipation Be Prevented?

Most people can prevent constipation by following a regular routine for bowel movements. Here are some things that help prevent constipation:

• Eating foods rich in fiber
• Avoiding junk foods
• Drinking sufficient water every day
• Regular toilet habits
• Regular exercise
• Plenty of rest

See also

Diarrhea

Hemorrhoids

Irritable Bowel Syndrome

Resources

Office of Disease Prevention and Health Promotion, National Health Information Center, Washington, DC. This office offers information on many diseases and disorders.

Telephone 800-336-4797 or 202-429-9091
http://odphp.osophs.dhhs.gov

The U.S. National Institutes of Health posts information about constipation on its website.

http://www.nih.gov/nia/health/pubpub/const.htm

con·sti·pa·tion / ˌkänstəˈpāshən/ • n. a condition in which there is difficulty in emptying the bowels, usually associated with hardened feces. ∎ fig. a high level of constraint or restriction; a pronounced lack of ease: literary constipation.

constipation (kon-sti-pay-shŏn) n. a condition in which bowel evacuations occur infrequently, or in which the faeces are hard and small, or where passage of faeces causes difficulty or pain. Recurrent or longstanding constipation is treated by increasing dietary fibre (roughage), laxatives, or enemas.

constipation Difficulty in passing stools or infrequent passage of hard stools. In the absence of intestinal disease, frequently a result of a diet low in non‐starch polysaccharide, and treated by increasing the intake of fruits, vegetables, and especially wholegrain cereal products.