Almost everyone gets constipated, and according to a study by the University of Iowa, constipation affects between 15 percent to 20 percent of the adult U.S. population.
"Constipation is a common gastrointestinal problem," explained Gastroenterologist William Kolozsi, M.D. "It refers to a decrease in the frequency of bowel movements or a person's difficulty in passing stools. The stool of a constipated person is typically hard because it contains less water than normal.
"In general, constipation is difficult to define because its symptoms vary from person to person. In addition, because we generally don't discuss the frequency of our bowel movements or observe each other having them, it is often difficult for people to know whether they are having less frequent stools or experiencing increased difficulty in moving their bowels, in comparison to others.
"For example, what's considered the normal length of time between bowel movements can vary widely from person to person. Some people have bowel movements three times a day; while others only have them one or two times a week." (However, you're probably experiencing constipation if you pass fewer than your normal bowel pattern.)
"Constipation usually occurs when the body's waste products, referred to as stool, moves too slowly through a person's digestive tract, causing the stool to become hard and dry. Normally, the waste products of digestion are propelled through the intestines by muscle contractions. But when there is not enough fluid or fiber-rich food in a person's diet, or if the colon's muscle contractions are slow, the stool can harden and dry, and then passes through the colon too slowly, causing constipation."
Who Gets Constipated?
Constipation is one of the most common gastrointestinal complaints in the United States. More than 4 million Americans have frequent constipation, accounting for 2.5 million physician visits a year. Those reporting constipation most often are women and adults ages 65 and older. Older people are five times more likely than younger people to complain about the onset of new constipation. Pregnant women may have constipation, and it is a common problem following childbirth or surgery.
You're more likely to be constipated if you are:
- An older adult
- Sedentary or confined to bed
- Eating a diet that's low in fiber
- Not getting adequate fluids
- Taking certain medications, including sedatives, narcotics or certain medications to lower blood pressure
- Undergoing chemotherapy
"Only a small number of people with constipation have a more serious underlying medical problem," Dr. Kolozsi continued. "However, if you have constipation for more than two weeks, you should see a doctor to determine the source of the problem and obtain treatment.
"You should also check with a physician if you have blood in your stool, are losing weight even though you are not dieting, or you have severe pain with bowel movements. Also seek medical care if you experience bowel movements occurring more than three days apart, despite corrective changes in diet or exercise; intense abdominal pain; constipation that alternates with diarrhea; rectal pain; or thin, pencil-like stools."
Tests your doctor may perform to diagnose the cause of your constipation may include:
- Blood tests if a hormonal imbalance is suspected.
- Barium studies to look for obstruction of the colon.
- Colonoscopy to look for obstruction of the colon.
- Colon transit studies
"Fortunately, most cases of constipation are temporary," Dr. Kolozsi added. "Usually, simple changes in your diet and lifestyle can help relieve symptoms and manage constipation."
Diet and Lifestyle Changes
The following simple changes may be helpful for reducing constipation:
- High-fiber diet: At least 20 to 35 grams of fiber each day helps your body form soft, bulky stool. High-fiber foods include beans, whole grains, fresh fruits and vegetables. Limit foods that have little to no fiber, such as cheese, meat and processed foods.
- Regular exercise: Physical activity can help stimulate intestinal activity.
- Adequate fluid intake: Drinking plenty of water and fluids will help soften stool.
- Some people may need to avoid milk, as dairy products may be constipating for them.
- Alcohol and Caffeine: Decrease alcohol intake and caffeinated beverages, including coffee, tea, or cola drinks. In general, it is a good idea to have an extra glass of water (over and above the 6 to 8 glasses suggested daily) for every cup of coffee, tea, or alcoholic drink.
- Bowel Hygiene: Try to go to the toilet at the same time every day, preferably after meals, and allow enough time as not to strain. Don't ignore the urge to go to the bathroom.
"Most people with constipation have no physical disease of the digestive system," concluded Dr. Kolozsi. "Usually, constipation is related to poor dietary habits, low fluid intake and lack of exercise, which can be corrected over time."
William Z. Kolozsi, M.D., is a gastroenterologist affiliated with Salem Community Hospital's medical staff. His office is located at 2020 East State Street, Suite H in Salem, 330-337-8709.