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Am Fam Physician. 2002;65(11):2293

What is constipation?

People with constipation may not have “regular” bowel movements. They may have hard stools, have pain during bowel movements, or be unable to pass stools at all.

Some people normally have one to three bowel movements a day. Other people normally have three bowel movements a week. How many bowel movements you normally have every day and every week is what is called your “regularity.” You might be constipated if you are having bowel movements much less often than what is regular for you.

What causes constipation?

Most often, people get constipated because they do not drink enough fluids or do not have enough fiber in their diet.

Constipation can happen because of medicines like iron or calcium supplements, some kinds of antacids, diuretics, narcotics, and some heart medicines.

Constipation can also happen because of illnesses like depression, thyroid disease, diabetes, kidney disease, and colon cancer.

What can I do to prevent or treat constipation?

Be sure to drink enough fluids, especially water. You should try to drink 8 to 10 glasses of water a day.

Eat foods that are high in fiber, like whole-wheat bread, high-fiber cereals, vegetables (including beans and lentils), and fruits (including prunes, apricots, and figs).

To add more fiber to your diet, you can mix 1 or 2 tablespoons of wheat bran or whole or ground flaxseed into your cereal, casseroles, or cake or brownie mixes.

Get more exercise. Being active helps to promote regularity. Many people like walking.

Here are some other things that can help:

  • Do not resist the urge to have a bowel movement.

  • Give yourself enough time to have a bowel movement.

  • Do not skip meals, especially breakfast. A hot drink with your breakfast may help.

Should I use a laxative?

First, try to improve your diet, drink more fluids, and make lifestyle changes (like exercising). If your constipation does not get better, you might need to take a bulk-forming laxative or a fiber supplement like Metamucil.

Do not use other laxatives, enemas, or suppositories unless your doctor tells you to. Long-term use of laxatives can cause problems.

When should I call my doctor?

Call your doctor if:

  • Constipation starts suddenly for no reason.

  • Your bowel patterns or habits change for the worse.

  • Constipation lasts longer than 7 days after you change your diet and start exercising.

  • You have blood in your stool, blood on your toilet paper, or bad pain in your lower tummy area.

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