There is no agreement as to what constitutes normal bowel habits. The range for "normal" bowel evacuation is as often as two times a day to once a week. Many people believe that if one does not have a bowel movement every day, they are constipated. This is not correct if your personal pattern is consistent. Symptoms that are not normal include straining at the stool, incomplete evacuation, or stools that are too small or too hard. Constipation affects approximately 20% of the general population. Women complain of constipation more than men. The complaint of constipation tends to increase with age.
WHAT CAUSES CONSTIPATION?
There are many causes of constipation:
Lack of adequate water intake. The average person should drink six to eight full (8 oz.) glasses of water or juice daily. It is important not to count caffeinated drinks (coffee, tea, cola) as a part of this total.
Lack of adequate fiber intake. The average person should consume 25-35 grams of fiber daily. Most Americans only consume 10-15 grams of fiber daily.
Lack of adequate exercise. Most people do not get enough exercise daily. Increasing your exercise level increases your regularity.
Use of prescription or over-the-counter drugs that tend to cause constipation as a side effect.
Constipation may be caused, in part, by an enlarging uterus applying pressure on the abdominal and back muscles used in the process of defecation. In addition, weakened pelvic floor muscles from prior pregnancies, pressure of the fetal head on the rectum, or the presence of painful anorectal lesions hemorrhoids), may contribute to constipation. Due to hormonal changes, gastrointestinal transit time appears to be longer in the second and third trimesters than in the first trimester, or the postpartum period. Additionally, the use of iron supplements during pregnancy may promote constipation. This does not mean that the iron should be discontinued.
WHAT TREATS CONSTIPATION?
Increase fluid (water or juice) intake to six to eight glasses (8 oz) per day.
Increase your fiber intake to reach 25-35 grams daily. This may be accomplished through an improved diet of vegetables and fruits that have a high fiber content. Consider fiber based foods like FiberONE bars or cereal.
Most often, individuals need a fiber supplement such as psyllium. Metamucil, Benefiber, Fiberchoice wafers, and Fibercon pills are all fiber based supplements. To avoid increased gas, bloating and abdominal discomfort, you may begin with a half-teaspoon after breakfast, or before bedtime, and then increase to a full teaspoon after one week. Be sure to drink adequate fluid with, and after, each dose.
Mild to moderate exercise, along with distraction-free bowel movements, are recommended.
Fiber is the best remedy for constipation. However, for those who need a little "push" from time to time, a stool softener like Colace (docusate) can help. Dosing starts at once daily, but can be increased to twice or three times daily. Be careful not to confuse Colace with PeriColace, a stimulant based laxative. In extreme cases, Miralax can be used. Miralax also does not contain addictive stimulants, but helps to make stool softer by absorbing more water into the stool. Dosing starts at one capful daily.