Some health conditions are harder to talk about than others. Somewhere near the top of that list for many people is constipation. Your inner middle school self maybe can’t help but snicker at anything, well, poop-related. But constipation isn’t funny.
Everyone has likely had a bout of constipation at some point. It’s a common condition resulting from a number of different causes. It often goes away on its own or with minimal “treatment,” but it can also be a symptom of a more serious digestive or other health condition.
What Is Constipation?
Everyone has a regular “schedule” of bowel movements — how often, how consistent and what time of day — says the American Academy of Family Physicians.
Constipation is defined as irregular bowel movements, in frequency and/or in difficulty of passage. But “the term ‘constipation’ can mean several different things to patients, so one of the things I always seek to understand is what does it mean to you?” says Dr. Jennifer Brull, a family physician in Plainville, Kansas, and a member of the American Academy of Family Physicians board of directors. “Stools may be too hard or too small, difficult to pass or infrequent, less than three times per week. People with constipation may also notice a frequent need to strain and a sense that the bowels are not empty.”
The AAFP lists the following symptoms of constipation:
— Feeling like you still need to have a bowel movement, even after you’ve had one.
— Feeling like your intestines or rectum are blocked.
— Having hard, dry stool that is difficult to pass.
— Having fewer than three bowel movements in a week.
— Straining to have a bowel movement.
What Causes Constipation?
There are many possible causes of constipation, including changes in diet, decreased physical activity and drugs such as pain medication, says Dr. Steven Furr, a family physician in Jackson, Alabama, and a member of the AAFP board of directors.
Specifically, dietary issues such as a lack of fiber in the diet and insufficient hydration (water consumption) can interrupt regular bowel movements, Brull says. These problems can be corrected easily, and should resolve the problem. However, “If the constipation is ongoing, see your physician,” Brull says. “There may be an underlying cause that can be treated.”
How Do Laxative Treatments Work?
Laxative treatments are used to “relax” the bowel and help movements move. These treatments come in a variety of types, and all work differently. “Some of them work as stool bulking agents — trying to keep more water in the stool as it passes through the colon and therefore keeping the stools softer overall,” Brull explains. “Some work as stool softeners — medications that change the form of the stool to keep it generally softer. And some work as true laxatives or cathartics — trying to send the stool through the bowel more quickly before all the water from the stool is absorbed, making the stool hard and bulky.”
There are different kinds of medications, both prescription and over the counter, that can be tried to help you have a bowel movement, Furr says. But in many cases, drugs are not necessary. Natural remedies often do the trick.
Common Natural Laxatives
Furr says that the most effective natural treatments for constipation are hydration — drinking more water — and increased fiber in the diet. “Be sure to include plenty of high-fiber foods in your diet, such as fruits, vegetables and whole grains,” he says, while Brull adds beans to that menu.
Dietary fiber adds weight and size to the stool and softens it, making it easier to pass, says the Mayo Clinic. The Fiber supplements can be helpful, but processed foods, such as desserts and sugary drinks, actually make constipation worse.
The AAFP recommends:
— Adult men should get at least 38 grams of fiber per day.
— Adult women should get at least 25 grams per day.
— Boys between 9 and 18 should get between 31 and 38 grams of fiber per day.
— Girls between 9 and 18 should get 26 grams of fiber each day.
— Children between 4 and 8 years old should get 25 grams per day.
— Children ages 1 to 3 should get 19 grams of fiber per day.
“U.S. adults tend to eat about half that much right now,” Brull adds.
Regular exercise is also part of that prescription list. “Exercise helps relieve constipation by lowering the time it takes food to move through the large intestine. With a shorter transit time, the body can’t absorb as much water from the stool, which makes it softer and easier to pass,” Brull says. Try to exercise most days of the week. However, if you do not currently exercise, talk to your doctor to determine if you’re healthy enough to start exercising.
[READ: Causes of Chronic Constipation.]
When to See a Doctor
The trick with natural, non-medication treatments is maintaining the changes needed, Brull says. “If your lifestyle doesn’t typically involve regular exercise or drinking water, then doing so on an ongoing basis involves a habit change. Working with people to make these changes often results in an overall health improvement, which can be rewarding,” she says. “Many patients will do quite well by implementing these changes in their lives.”
She adds that, if you have severe or persistent pain, see your doctor for evaluation to determine if constipation is the cause and if medical treatment is indicated. Furr notes that you should see your physician if constipation lasts more than three weeks or if you see blood in the stool. “If you have persistent bleeding and/or abdominal pain, you should see a physician immediately for evaluation,” he stresses.
And both physicians note the importance of colorectal cancer screening. “Although constipation is not a precursor to cancer, bowel habit abnormalities can be a sign of problems. Having an up-to-date colonoscopy can alleviate that concern,” Brull says.
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