Diseases and Procedures

Constipation

Constipation is a common and often uncomfortable problem. You have constipation if you have bowel movements less often than usual or strain to pass hard, dry stool. Constipation can be a temporary problem that lasts a short time, or it can be a chronic problem that never seems to go away. Fortunately, it can often be controlled.

Symptoms

Symptoms of constipation include:

• Feeling of fullness in the rectum
• Bloating and gas
• Feeling the urge, but being unable to pass stool
• Abdominal pain and cramping
• Nausea

Causes of Constipation
One of the main causes of constipation is a diet that is too low in fiber and water. Travel that disrupts your normal routine can lead to temporary constipation. Pregnant women often become constipated. Other causes include getting too little exercise, misusing laxatives, taking certain medications (such as pain medications, diuretics, and antihistamines), or ignoring the urge to have a bowel movement. Diseases such as diabetes or hypothyroidism may also cause constipation.

YOUR EVALUATION

Most of the time, the cause of constipation is not serious. But, in rare cases, chronic constipation may be a sign of an obstruction or abnormality in the colon. Your doctor can evaluate you to determine the cause of your constipation and rule out any underlying disorder.

Medical History
Your doctor may ask you questions such as:

• How long have you had symptoms?
• What types of foods do you eat?
• Do you have any other medical problems?
• What medications do you take?
• Do you often use laxatives or enemas?

Tests
Test may be done to rule out more serious causes of constipation. Your doctor may take a sample of blood and stool for testing. If needed, a sigmoidoscopy may be done. During this test, your doctor views the lower part of the colon through a flexible endoscope. A barium enema (x-ray) may also be done. For this test, your colon is filled with a liquid barium solution. Then an x-ray is taken of the entire colon.

TREATING CONSTIPATION

After evaluation, your doctor can recommend the treatment plan that is best for you. This plan may include eating more fiber, getting more exercise, and avoiding overuse of laxatives.

Eat More Fiber
One of the best ways to help treat constipation is to eat a high-fiber diet. Fiber (in whole grains, fruits, and vegetables) adds bulk and absorbs water to soften the stool. This helps the stool pass through the colon more easily. Drinking more water can also help soften stool.

Regular Exercise
Regular exercise helps improve the working of your colon and helps ease constipation. Ask your doctor about starting and exercise program.

Avoid Chronic Laxative Use
Laxatives stimulate the colon to work more rapidly. Continuous use of laxatives can cause the colon to stretch and waken and, eventually, the colon may not work right without them. Your doctor can help you overcome a dependence on laxatives. In any case, never use them without consulting your doctor first.

NORMAL BOWEL MOVEMENTS

During digestion, nutrients are removed from the food you eat. The waste that is left (stool) is passed on to the colon (large intestine). The colonās main job is to absorb water from the stool before it leaves the body. Normally, stool moves through the colon at a steady, regular pace - not too fast or too slow. The stool stays in the colon just long enough for most of the water to be absorbed, with enough water left to ease the passage of the stool out of the body.

Constipation
If the stool moves through the colon more slowly than normal, it stays in the colon too long. Because water is constantly being removed, the stool becomes dry and hard. This causes constipation -- bowel movements that are less frequent than usual and very difficult or painful.

High-Fiber Hints
Eating more of the following foods can add fiber to your diet and help prevent constipation:

High-fiber cereals

• Whole grains, bran, and brown rice
• Vegetables (such as carrots, broccoli, and peas)
• Fresh fruits (especially apples, pears, and dried fruits like raisins and apricots)
• Nuts and legumes (especially beans such as lentils, kidney beans, and lima beans)

If necessary, your doctor may also recommend and over-the counter fiber supplement.