Patient Education

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Constipation is a common bowel problem and can be very distressing. Constipation can result in different symptoms for different people. Generally speaking constipation is trouble passing the bowels. It can mean hard, lumpy stools that are difficult to pass or infrequent stools or stools that require a lot of straining to pass. People with constipation often feel that the bowels are not empty.


Here are some tips to dealing with and preventing constipation.


1) Listen to your body. When your body signals the need to move the bowels do not ignore the signal. Holding the bowels and ignoring the signal causes the nerve conduction of the bowel to become weaker. Over time, the bowel requires a larger volume to trigger the signal causing less frequent movements. This can become a worsening cycle.


2) Improve your diet. Regular bowel movments require adequate fiber and hydration. The recommended daily intake of fiber is between 25-30 grams. Read the nutrtion label on packages to get an estimate of fiber content of packaged foods. Fresh fruits, vegetables, and legumes are excellent souces of fiber. Strive for 2 servings of one of these foods with every meal. And don't forget the water. Water is essential to keeping our body hydrated and prevent stool from becoming dry and hard. Try to drink 64 oz water per day.


My favorite high fiber foods include: prunes, cooked peas, and baked beans.


3) Exericse. Regular exercise has been shown to have a positive feedback on the bowels and improve regularity. Current guidelines recommend adults get 30 minutes of moderate exercise 5x/ week.


4) Laxatives. I am not a big fan of using laxatives on a regular basis. Usually improving diet and lifestyle is all that is needed to promote regular bowels. However, if symptoms are not improving with diet and exercise changes, you may try a laxative. I generally recommend starting with a bulk forming type of laxative. These include fiber supplements, such as psyllium, cellulose or polycarbophil (common products- metamucil, citrucel, fibercon). Another option is a hyperosmolar agent. These pull more liquid into the gut to help bulk and soften the stool. An example is MiraLax.


When do you call a health provider?


1) If symptoms are severe. Severe abdominal or rectal pain should always be evaluated.

2) Sudden or new onset of symptoms. A change in your normal pattern.

3) Prolong symptoms. Symptoms lasting longer than 2 weeks should be evaluated.

4) Associated with alarm symptoms. Rectal bleeding, weight loss, weakness, fever.


Kathleen M. Curtis MD