Constipation - Adults

• Normal bowel movement (BM) frequency varies from 3 times a day to 3 times a week.
• Passage of a large bowel movement is not constipation, since the size of the bowel movement relates to the amount of food an individual eats and the bowel movement frequency. Large eaters have larger stools.
• The passage of small, dry, rabbit-pellet-like stools is not constipation and instead reflects the desiccation (drying-out) mechanism and insufficient fluid intake.

Lifestyle Causes

• Diet and fiber: Inadequate dietary fiber reduces intestinal motility and makes BMs hard and more difficult to pass. Fiber works by helping stools to retain water. Good sources of dietary fiber are fresh fruits and vegetables, beans, and bran. Fiber can also be taken via supplements (e.g., Metamucil).

• Liquids: Insufficient liquid intake cause stools to be dry and harder to pass. Adults should drink 6-8 glasses of water daily.

• Lack of exercise: Inactivity reduces bowel function, whereas exercise helps stimulate the bowels and improve regularity. Individuals who are bedridden have increased problems with constipation, and may develop a blockage of stool in their rectum (i.e., fecal impaction).

• Postponing BMs: Some individuals ignore their body's signals to have a BM. This can lead to chronic problems with constipation.

• Recent travel: Travel can cause constipation because it interferes with your diet and normal daily cycle.

General Constipation Instructions

• Eat a high fiber diet.
• Drink adequate liquids.
• Exercise regularly (even a daily 15 minute walk!).
• Get into a rhythm - try to have a BM at the same time each day.
• Don't ignore your body's signals to have a BM.
• Avoid enemas and stimulant laxatives.

High Fiber Diet

A high fiber diet will help improve your intestinal function and soften your BMs. The fiber works by holding more water in your stools.

• Try to eat fresh fruit and vegetables at each meal (peas, prunes, citrus, apples, beans, corn).
• Eat more grain foods (bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread). Popcorn is a source of fiber.

Liquids

Adequate liquid intake is important to keep your BM's soft.

• Drink 6-8 glasses of water a day. CAUTION: Certain medical conditions require fluid restriction.
• Prune juice is a natural laxative.
• Avoid alcohol.

Get Into a Rhythm

• Try to have a BM at the same time every day. The best time is about 30-60 minutes after breakfast or another meal. Reason: Natural increased intestinal activity.
• Don't ignore your body's signals to have a BM.

Bulk-forming Laxatives

This type of laxative is generally safe and works like fiber to help soften the stools and improve your intestinal function.

• Metamucil - One tsp (5 cc) in a glass of water twice a day.
• Occasional side effect: mild gas or bloating sensations.

Stimulant Laxatives

Generally, you should try to avoid using these over the counter medications. Occasional use is probably OK. Read the package instructions carefully. Milk of Magnesia (MOM) is a mild stimulant laxative. The dosage is 2 tablespoons (30 cc) by mouth. Do not use if you have kidney disease

First Aid

• For Rectal Pain due to constipation: Take a twenty-minute bath in warm water (2 oz baking soda per tub). This is also called a "Sitz bath." It often helps relax the anal sphincter and release the BM. If the Sitz bath doesn't work, try 1 or 2 glycerin rectal suppositories, which you can get over the counter.
• Enemas: Should be used rarely and only after other measures have not worked.