Constipation can be defined as infrequent or hard pellet stools, or difficulty in evacuating stool. While troublesome, constipation is not usually a serious disorder. However, there may be other underlying problems causing constipation, and therefore, testing is often recommended. The function of the colon is to withdraw water from the liquid stool so that by the time it reaches the rectum, there is a soft, formed stool. If an excessive amount of water is extracted, the stool can become hard and difficult to expel.

What Causes Constipation?

Most often, it’s due to a lazy colon that can’t move the waste products through the colon and into the rectum. Other causes include mechanical obstruction from either benign causes (diverticulosis) or from malignant causes (colon or rectal cancer). Other conditions that can produce a sluggish, poorly contracting bowel include: pregnancy, certain drugs, thyroid hormone deficiency, and the chronic abuse of laxatives, travel and stress.

How do you Treat Constipation?

  • Determine the underlying cause, if possible.
  • Eat regularly (don’t skip multiple meals during the day).
  • Increase dietary fiber (whole grain breads, bran cereals, fruits/vegetables). Add a bulking agent to the diet (increase insoluble dietary fiber), if needed.
  • Drink plenty of liquids, particularly water, during the day.
  • Regular walking and aerobic exercise
  • Respond to the urge to defecate

Do Laxatives Help?

Chronic use of laxatives, particularly stimulant laxatives is discouraged, as the bowel (colon) becomes dependent upon them to work. Examples of such laxatives include: Ex-Lax®, Ducolax®, Correctol®, Sennakot®, etc. These laxatives are harsh on the colon. Laxatives that can be used intermittently include: MiraLax®, Kristalose/Lactulose®, Golyteley® preps, etc. to get the colon to work in a correct fashion without causing bowel dependency. An occasional saline enema can be used with difficult to pass stools.

Bowel Retraining Program:

  • Do not use stimulant laxatives!
  • Eat a diet high in roughage, such as bran cereals and leafy vegetables.
  • Drink at least eight (8) glasses of water daily.
  • Eat two (2) servings of fruit daily.
  • If you cannot get enough fiber in your diet daily, take one of the fiber supplements (Citracel®, Metamucil®, Fibercon®) as prescribed to give the colon the bulk that it needs to work properly.
  • Eat a normal breakfast.
  • Set aside 15 minutes after breakfast to sit on the toilet, but do not strain to have a bowel movement. If you do not have a bowel movement by the third day, use an enema and repeat the above steps.