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    Constipation is characterized by difficult or infrequent bowel movements. A difficult bowel movement can mean that it is physically painful to relieve yourself as a result of hardened stool or another physical strain or that a person feels he or she cannot complete a bowel movement in its entirety. Keep in mind that what is considered to be a normal rate of bowel movements varies widely, depending on the person. While some perfectly healthy people find themselves passing stool 2 or 3 times a day, others may find that they only feel the urge to have a bowel movement 1 or 2 times a week. Nevertheless, it is a general rule-of-thumb that patients should not let more than three days without passing. Fecal matter tends to harden in the colon after a certain amount of time, which can cause unnecessary strain in the colorectal area.

    Symptoms of Constipation

    In addition to feeling difficult passing stool, a patient experiencing constipation may also feel cramping or pain in his or her abdominal area. The abdomen can even swell and feel hard upon touch, as a result of bloating. Some patients report bouts of vomiting as well.

    Causes of Constipation

    Most of the time, constipation is caused by problems with bowel function rather than problems with bowel structure. The dysfunction can be rooted in a patient’s diet—not drinking enough water, not consuming enough fiber or eating an excessive amount of dairy products causes constipation. Bowel function is also affected by changes in daily routine, such as traveling or stress at work. Other common causes include overuse of certain antacid medications, particularly the ones with high calcium content. General weakness of the muscles and nerves of the colon can cause constipation.

    Constipation can also be a symptom of more serious health conditions such as multiple sclerosis, hypothyroidism, Parkinson’s disease and certain eating disorders. Your gastroenterologist (GI doctor) will most likely be concerned with checking if the constipation has a serious underlying cause such as colon cancer. Routine tests—including simple blood tests to check for hormonal imbalances, barium enema x-rays and colonoscopy—can usually lead to a proper diagnosis of a patient’s constipation, if the underlying cause is bowel obstruction in the form of tumors, polyps or cancer. These tests will most likely conclude that a patient has one of two types of constipation:

    • Colonic Inertia—characterized by ineffective contraction of the colon muscle which causes stool to be retained in the body.
    • Obstructed Defecation—characterized by the excessive need to strain to pass stool through the rectum and anus, which can be caused by a number of different conditions.

    Prevention and Home Remedies for Constipation

    Exercising on a regular basis, even if that simply means being physically active throughout the day, can help to regulate bowel movements. Keep your diet balanced—eating an adequate amount of food that is high in fiber, such as fruits, vegetables, whole-grain products and beans as well as drinking plenty of water will help keep stool soft and easy to pass.

    If you are experiencing constipation, try to avoid drinking beverages like soda and coffee that have caffeine because they tend to dehydrate the body. Stick with clear liquids such as bottled water, apple juice and lemonade. In general, warm liquids are better than cold. And most importantly, do not resist the urge to have a bowel movement. While the pain associated with passing stool while experiencing constipation may deter patients from trying to pass on a regular basis, letting stool remain in the colon for extended periods of time may only worsen the condition.

    Some patients turn to laxatives for help passing stool, but experts usually recommend that more natural home remedies be tried first, in order to prevent dependency on medication which can cause an overall weakening of the colorectal muscle. Laxatives should not be used for more than a couple of weeks without professional help, as overuse may lead to an exacerbation of constipation symptoms. Contact a medical specialist if you need help with constipation or if you are experiencing related symptoms, such as blood in the stool or abnormal weight loss associated with irregular bowel movements.

    Reviewed 12/12/2011 by David M. Nolan, M.D.
    Diplomate of the American Board of Internal Medicine, 2011
    Currently a Fellow of Gastroenterology, at UCI 2011-2014

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