Constipation occurs when stools are difficult to pass. Some people are overly concerned with the frequency of their bowel movements because they have been taught that a healthy person has a bowel movement every day. This is not true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you are not constipated.
Constipation is present if you have 2 or fewer bowel movements each week or you do not take laxatives and have 2 or more of the following problems at least 25% of the time:
- Feeling that you do not completely empty your bowels
- Hard stools, or stools that look like pellets
- A feeling of being blocked up
- You can’t pass stools unless you put a finger in your rectum or use manual pressure to pass a stool.
- Constipation may occur with cramping and pain in the rectum. This is caused by the strain of trying to pass hard, dry stools. You may have some bloating and nausea. You may also have small amounts of bright red blood on the stool or on the toilet tissue. Bleeding hemorrhoids or a slight tearing of the anus (anal fissure) as the stool is pushed through the anus can cause this. This should stop when the constipation is controlled.
- Pain in the stomach and/or rectum
- Bad breath
- Inability or difficulty passing bowels
- Decreased appetite
- Nausea or vomiting
- Increased passing gas
- Tenderness to touch
- Distended stomach
- Stomach cramping
- First try gentle exercise. Take a short walk each day. Gradually increase your walking time until you are walking for at least 20 minutes.
- Make sure you drink enough fluids. Most adults should try to drink between 8 and 10 glasses of water or noncaffeinated beverages each day. Avoid alcoholic beverages and caffeine, which can increase dehydration. If you have heart failure or kidney failure, talk to your doctor about what amount of fluid is right for you.
- Include fruits, vegetables, and fiber to your diet each day. Have a bran muffin or bran cereal for breakfast, and try eating a piece of fruit for a mid-afternoon snack.
- Schedule time each day for a bowel movement (after breakfast, for example). Establishing a daily routine may help. Take your time. Do not be in a hurry.
- Support your feet with a small step stool [about 6 in. (15 cm)] when you sit on the toilet. This will help flex your hips and place your pelvis in a more normal “squatting” position for having a bowel movement.
If you are still constipated
- Add some processed or synthetic fiber such as Citrucel, Metamucil, or Perdiem-to your diet each day.
- Try a stool softener, such as Colace, if your stools are very hard.
- Try a rectal glycerin suppository. Follow the directions on the label. Do not use more often than recommended on the label.
- In difficult cases of constipation, it is better to try a saline (osmotic) laxative, such as Fleet Phospho-Soda, Milk of Magnesia, lactulose, or Miralax. You should not take these types of laxatives if you are on a sodium-restricted diet or you have kidney problems or high blood pressure. Osmotic laxatives do not irritate the colon or cause dependence on laxatives like stimulant laxatives can.
- You may occasionally need to try a stimulant laxative, such as Ex-Lax or Feen-a-Mint. Use these preparations sparingly. Overuse of stimulant laxatives decreases the tone and sensation in the large intestine, causing dependence on using laxatives. Regular use may interfere with your body’s ability to absorb vitamin D and calcium, which can weaken your bones. Do not use laxatives for longer than 2 weeks without consulting your doctor.