Constipation

The frequency of bowel movements among normal, healthy people varies from three a day to three a week and healthy people may fall outside both ends of this range, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The American College of Gastroenterology (ACG) says constipation is a digestive condition (Read about "Digestive System") where the bowels move infrequently and the consistency of the stool is often dry and hard.

Constipation is one of the most common gastrointestinal complaints in the United States. More than 4 million Americans have frequent constipation, according to NIDDK. Those reporting constipation most often are women and adults ages 65 and older. Pregnant women may have constipation (Read about "Healthy Pregnancy"), and it is a common problem following childbirth (Read about "Childbirth") or surgery.

The usual reason for constipation is that extra water is absorbed into the body because the stool is slow moving through the intestine. The reasons for this can include:

• not enough fiber in the diet (Read about "Fiber and Health")
• lack of physical activity
• medications (Read about "Medication and Digestion")
• irritable bowel syndrome (Read about "Irritable Bowel Syndrome")
• changes in life or routine such as pregnancy, aging, and travel
• abuse of laxatives
• ignoring the urge to have a bowel movement
• dehydration (Read about "Dehydration")
• specific diseases or conditions, such as stroke, multiple sclerosis, Parkinson's disease, diabetes, or hypothyroidism (Read about "Stroke" "Multiple Sclerosis" "Parkinson's Disease" "Diabetes" "The Thyroid")
• problems with the colon, rectum and/or intestines

Of these, NIDDK says that the most common causes of constipation are a diet low in fiber or a diet high in fats, such as cheese, eggs and meats. Fiber - both soluble and insoluble - is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber passes through the intestines almost unchanged. The bulk and soft texture of fiber help prevent hard, dry stools that are difficult to pass.

Americans eat an average of 5 to 14 grams of fiber daily, which is short of the 20 to 35 grams recommended by the American Dietetic Association. Both children and adults often eat too many refined and processed foods from which the natural fiber has been removed.

Drinking enough water is important too. Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass.

ACG says that any change in bowel habits, such as the onset of constipation, should be checked by a doctor. It could be an indication of a more serious problem. The tests the doctor performs depend on the duration and severity of the constipation, the person's age, whether there is blood in stools (Read about "Gastrointestinal Bleeding"), recent changes in bowel habits or weight loss have occurred. If symptoms are severe, more extensive tests may be used to measure how well food moves through the colon, how well the rectal muscles contract and relax, and whether there are any obstructions. Other tests to rule out serious problems may also be used, including barium enema x-ray, colonoscopy or sigmoidoscopy. (Read about "X-rays" "Colonoscopy" "Flexible Sigmoidoscopy")

If there are no problems other than constipation, lifestyle changes include adding more fiber to your diet, drinking more water and getting more exercise. (Read about "Getting Started on Fitness") Your doctor may recommend a laxative or stool softener. It is important that you don't overuse laxatives. Over time, according to NIDDK, laxatives can impair the natural muscle action of the intestines, leaving them unable to function normally. An ongoing need for laxatives is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.

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