- You have
difficulty passing bowel movements: straining, hard stools, or rectal pressure.
- You feel like bowel movements do not occur frequently enough.
bowel movement (BM) frequency varies from 3 times a day to 3 times a week.
- Passage of a large bowel movement is not constipation, since
the size of the bowel movement relates to the amount of food an individual eats
and the bowel movement frequency. Large eaters have larger stools.
- The passage of small, dry, rabbit-pellet-like stools is not
constipation and instead reflects the desiccation (drying-out) mechanism and
insufficient fluid intake.
Diet and fiber:
Inadequate dietary fiber reduces intestinal motility and makes BMs hard
and more difficult to pass. Fiber works by helping stools to retain
water. Good sources of dietary fiber are fresh fruits and vegetables,
beans, and bran. Fiber can also be taken via supplements (e.g.
Liquids: Insufficient liquid
intake cause stools to be dry and harder to pass. Adults should drink
6-8 glasses of water daily.
Lack of exercise: Inactivity reduces
bowel function, whereas exercise helps stimulate the bowels and improve
regularity. Individuals who are bedridden have increased problems with
constipation, and may develop a blockage of stool in their rectum (i.e.
Postponing BM's: Some individuals
ignore their body's signals to have a BM. This can lead to chronic
problems with constipation.
Recent travel: Travel can cause
constipation because it interferes with your diet and normal daily
See More Appropriate Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR FOR CONSTIPATION
Call Your Doctor Now (night or day) If:
- You feel
weak or very sick
- Vomiting bile (bright yellow or green)
- Vomiting and abdomen is more swollen than usual
- Severe rectal pain not relieved by Sitz bath or glycerine suppository
Call Your Doctor Within 24 Hours (between 9am
and 4pm) If:
- You think
you need to be seen
- Intermittent mild abdominal pain and there is a fever
- Abdomen is more swollen than usual
- Last BM was more than 3 days ago
- Leaking stool
Call Your Doctor During Weekday Office Hours
- You have other questions or concerns
- Weight loss greater than 10 pounds and not dieting
- Minor bleeding from rectum is a recurrent problem
- Unable to have a BM without using a laxative, suppository, or
- Taking new prescription medication
- Constipation is a recurrent problem (i.e. less than 3 BM's /
week or straining greater than 25% of the time)
Self Care at Home If:
- Mild constipation
and you don't think you need to be seen
HOME CARE ADVICE FOR MILD CONSTIPATION
- General Constipation
- Eat a high fiber diet.
- Drink adequate liquids.
- Exercise regularly (even a daily 15 minute walk!).
- Get into a rhythm - try to have a BM at the same time each day.
- Don't ignore your body's signals to have a BM.
- Avoid enemas and stimulant laxatives.
High Fiber Diet: A high fiber diet will
help improve your intestinal function and soften your BM's. The fiber
works by holding more water in your stools.
- Try to eat fresh fruit and vegetables at each meal (peas, prunes,
citrus, apples, beans, corn).
- Eat more grain foods (bran flakes, bran muffins, graham crackers,
oatmeal, brown rice, and whole wheat bread). Popcorn is a source of fiber.
Liquids: Adequate liquid intake is important to keep your BM's soft.
- Drink 6-8 glasses of water a day. (Caution: certain medical
conditions require fluid restriction.)
- Prune juice is a natural laxative.
- Avoid alcohol.
Get into a rhythm:
- Try to have a BM at the same time every day. The best
time is about 30-60 minutes after breakfast or another meal (Reason: natural
increased intestinal activity).
- Don't ignore your body's signals to have a BM.
Bulk-forming laxatives: This type of laxative is generally safe and
works like fiber to help soften the stools and improve your intestinal function.
- Metamucil - One tsp (5 cc) in a glass of water BID.
- Occasional side effect: mild gas or bloating sensations.
Generally, you should try to avoid using these
over the counter medications. Occasional use is probably OK. Read the package
instructions carefully. Milk of Magnesia (MOM) is a mild stimulant laxative.
The dosage is 2 tablespoons (30 cc) by mouth. Do not use if you have kidney
First Aid for Rectal Pain due to constipation:
Take a twenty-minute
bath in warm water (2 oz baking soda per tub). This is also called a "Sitz
bath." It often helps relax the anal sphincter and release the BM. If the
Sitz bath doesn't work, try 1 or 2 glycerin rectal suppositories, which you
can get over the counter.
Enemas: Should be used rarely and only
after other measures have not worked.
- Call Your Doctor If:
- Constipation continues (i.e. less than 3 BM's / week or straining
more than 25% of the time) after following care advice for constipation for
- You become worse or develop any of the "Call Your Doctor"
Disclaimer: This information
is not intended be a substitute for professional medical advice. It is
provided for educational purposes only. You assume full responsibility
for how you choose to use this information.
Adult HouseCalls Online. Copyright © 2000-2004
David Thompson, M.D. FACEP
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