Health Services

Constipation

What is constipation?
Constipation is when you have trouble having bowel movements. Your stools may be very hard, making them so difficult to pass that you have to strain. Or you may feel like you still need to have a bowel movement even after you've had one. Constipation is a very common problem and many factors can contribute to constipation.

How often should I have a bowel movement?
Not everyone has bowel movements once a day. The length of time between bowel movements varies widely from person to person.  A normal range is generally 3 times a day to 3 times a week. Being "regular" means having bowel movements consistently in a time frame that is normal for you.  You may be getting constipated if you begin to have bowel movements much less often than you usually do.

What causes constipation?
As the food you eat passes through your digestive tract, your body takes nutrients and water from the food. This process creates a stool, which is moved through your intestines with muscle contractions (squeezing motions).

A number of things can affect this process. These include not drinking enough fluids, not being active enough, not eating enough fiber, taking certain drugs, not going to the bathroom when you have the urge to have a bowel movement and regularly using laxatives. Any of these things can cause the stools to move more slowly through your intestines, leading to constipation.

When should I see a healthcare provider?

You should speak with a healthcare provider if you experience a change in your normal bowel pattern, symptoms last longer than three weeks, symptoms are very severe and you are uncomfortable, or if you notice any blood in your stools.

How is constipation treated?
The main thing in treating constipation is to be sure you're eating enough fiber (see below for examples of fiber-rich foods) and drinking enough fluids. This helps your stools move through your intestines by increasing the bulk of your stools and making your stools softer. When you feel like you need to go to the bathroom, go to the bathroom.  Do not hold it.  Increasing how much you exercise will also help.

What should I eat?
Eat plenty of fiber (see the box below). Two to 4 servings of fruits and 3 to 5 servings of vegetables a day is ideal. Add extra fiber to your diet by eating cereals that contain bran or by adding bran as a topping on your fruit or cereal. Try adding vegitables to sandwiches, choosing fruit as a side, or replacing processed white flour breads, pasta and rice with whole grain breads, pasta and brown rice. 

If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink plenty of water too.

Foods rich in fiber

  • Unprocessed wheat bran
  • Unrefined breakfast cereals
  • Whole wheat and rye flours
  • Grainy breads, such as whole wheat, rye or pumpernickel
  • Fresh fruits
  • Dried fruits, such as prunes, apricots and figs
  • Vegetables
  • Legumes, such as chickpeas, baked beans and lima beans

Should I use laxatives?
Laxatives should usually be avoided. They aren't meant for long-term use. An exception to this is bulk-forming laxatives.

Bulk-forming laxatives work naturally to add bulk and water to your stools so that they can pass more easily through your intestines. Bulk-forming laxatives can be used every day. They include oat bran, psyllium (one brand: Metamucil), polycarbophil (one brand: FiberCon), wheat dextrin (one brand: Benefiber), and methylcellulose (one brand: Citrucel).

How are bulk-forming laxatives used?
You must use bulk-forming laxatives daily for them to work. Follow the directions on the label. Start slowly and drink plenty of fluids. Gradually increase how much you use every 3 to 5 days (as you get used to it) until you get the effect you want. You can help bulk-forming laxatives taste better by mixing them with fruit juice.

Do bulk-forming laxatives have side effects?
You may notice some bloating, gas or cramping at first, especially if you start taking too much or increase the amount you're using too quickly. These symptoms should go away in a few weeks or less. Cellulose fiber supplements are less likely to produce gas than are psyllium supplements.

Revised 2/15