Constipation is infrequent bowel movements or difficult passage of stools. Constipation is a common gastrointestinal problem.
What’s considered normal frequency for bowel movements varies widely. In general, however, you’re probably experiencing constipation if you pass fewer than three stools a week, and your stools are hard and dry.
Not having a bowel movement every day doesn’t necessarily mean you’re constipated. You likely have constipation, however, if you’ve had at least two of the following signs and symptoms for at least three of the past six months:
- Pass fewer than three stools a week
- Experience hard stools
- Strain excessively during bowel movements
- Experience a sense of rectal blockage
- Have a feeling of incomplete evacuation after having a bowel movement
- Need to use manual maneuvers to have a bowel movement, such as finger evacuation or manipulation of your lower abdomen.
A number of factors can cause an intestinal slowdown, including:
- Inadequate fluid intake or dehydration
- Inadequate amounts of fiber in your diet
- Ignoring the urge to have a bowel movement or delaying until later
- Lack of physical activity (especially in older adults)
- Irritable bowel syndrome
- Changes in lifestyle or routine, including pregnancy, aging and travel
- Frequent use or misuse of laxatives
- Specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s disease
- Problems with the colon and rectum, such as intestinal obstruction or diverticulosis
- Certain medications, including pain medications, diuretics and those used to treat Parkinson’s disease, high blood pressure and depression
- Hormonal disturbances, such as an underactive thyroid gland
- Anal fissures and hemorrhoids, which can produce a spasm of the anal sphincter muscle
- Loss of body salts through vomiting or diarrhea
- Injuries to the spinal cord, which can affect the nerves that lead to and from the intestine
In rare cases, constipation may signal more-serious medical conditions, such as colorectal cancer, hormonal disturbances or autoimmune diseases. In children, constipation might indicate Hirschsprung’s disease, a congenital condition that results from missing nerve cells in the colon.
Children may also become constipated if they are afraid of or unwilling to use the toilet. Older children may ignore or forget to attend to bowel movements.
Although constipation can be extremely bothersome, it usually isn’t serious. If it persists, and especially if straining results, you may develop certain complications:
- Hemorrhoids or cracks (fissures) in your anus may result when hard stool stretches the sphincter muscle.
- Fecal impaction occurs when you accumulate a mass of hardened stool that can’t be eliminated by a normal bowel movement. You may need to have impacted stool removed manually.
- Rectal prolapse occurs when a small amount of rectal tissue pushes out through the anus. This condition may lead to a secretion of mucus from the anus.
- Lazy bowel syndrome may occur if you use laxatives frequently, causing your bowels to become dependent on them for proper function. Laxative use can also lead to other problems, including poor absorption of vitamins and other nutrients and damage to your intestinal tract.
- Eat a high-fiber diet.Choose lots of high-fiber foods, including fruits, vegetables, beans, and whole-grain cereals and breads. Soluble fiber absorbs water and binds with fatty acids, forming a gel-like substance that keeps stools soft. Insoluble fiber does not dissolve in water, thus providing bulk to the stool. Since both types are found in all plant foods, it is not necessary to try to remember which foods are a good source of which type of fiber. Aim to consume 20 to 35 grams of fiber daily. Experiment to see if particular fruits or vegetables have a laxative effect for you. Remember to add fiber to your diet gradually to help reduce related gas and bloating.
- Limit low-fiber foods.Foods that are high in fat and sugar and those that tend to be low in fiber content, such as ice cream, cheese and processed foods, may cause or aggravate constipation.
- Drink plenty of liquids.The exact amount of water and other fluids you should drink each day varies and depends on your age, sex, health, activity level and other factors. Limit caffeine intake, which can worsen symptoms of constipation by causing dehydration.
- Exercise regularly.Engage in regular physical exercise, such as walking, biking or swimming, to help stimulate intestinal function. Getting at least 150 minutes of moderate exercise each week is recommended.
- Heed nature’s call.Don’t ignore the urge to have a bowel movement. The longer you delay, the more water is absorbed from your stool and the harder it becomes.
- Try fiber supplements.Be sure to drink plenty of water or other fluids every day, as taking fiber supplements without drinking plenty of fluids may worsen constipation.
- Be careful about introducing stimulant laxatives.Habitual use of agents such as Dulcolax can make your colon dependent on them and may require increasing dosages, eventually leading to problems with your intestines. For occasional relief try a saline laxative, such as milk of magnesia, which draws water into the colon to lubricate the stool. Avoid giving children laxatives without a doctor’s approval.
Fruits for Constipation
Many fruits are an excellent source of dietary fiber, along with a whole host of other nutritional benefits. Although there is no hard science in regard to this, people with constipation predominant irritable bowel syndrome (IBS-C) report that eating fruits that have been cooked, stewed or dried is less irritating to their intestinal system. Here are some good choices:
Vegetables and Legumes for Constipation
Vegetables are also a wonderful source of many important nutrients in addition to providing a healthy dose of dietary fiber. As is the case with fruits, you may find that your body responds in a more comfortable way to cooked rather than raw vegetables.
- Beans:Canella, garbanzo, kidney, navy and pinto.
- Greens: Chard, kale and spinach.
- Vegetables:Artichoke hearts, asparagus, broccoli, Brussels sprouts, cabbage, carrots, green beans, peas and squash.
Whole Grains and Constipation
Buyer beware! Many products are advertised as being “multi-grained”, but are actually poor sources of whole grains. The only way to know for sure is to carefully read the ingredient list. In order to be a good source of whole grains, the very first word in the list should be the word “whole.”
Another caution should be applied to whole wheat products that contain bran. For some people, bran is irritating to the digestive system. You should carefully assess your body’s ability to tolerate bran before using it as a source of dietary fiber.
Here are some examples of whole grains that may help to ease constipation:
- High fiber breakfast cereals (look for at least 8 grams of fiber per serving).
- Whole grain breads
- Brown rice
Flaxseed for Constipation
Flaxseed are the tiny, golden seeds from the flax plant. There is research to support that incorporating ground flaxseed into your diet can ease constipation, bloating and abdominal pain. Flaxseed also serves as an excellent source of omega-3 fatty acids, as well as of other important vitamins, minerals and phytoestrogens.
Ground flaxseed is relatively easy to find in grocery stores, but if you can’t find it, grinding flaxseed is a simple process with the use of a small coffee grinder. Flaxseed has a nice nutty, taste and can be sprinkled on cereal or yogurt, added to baked goods, and mixed into smoothies. Whenever you eat flaxseed, be sure to drink a large glass of water so as to make the most of flaxseed’s stool-softening benefits.
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