At one time or another almost everyone gets constipated. about 4 1/2 million people in the United States say they are constipated most or all of the time. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.

What is Constipation?
Common Causes of Constipation
Symptoms
How Is Constipation Treated?
Can Constipation be Serious?

What is Constipation ?

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. As food moves through the colon (large intestine), the colon absorbs water while forming waste products, or stool. Muscle contractions in the colon push the stool toward the rectum. By the time stool reaches the rectum, it is solid because most of the water has been absorbed.

The hard and dry stools of constipation occur when the colon absorbs too much water. This happens because the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly.

Common Causes of Constipation

Not enough fiber in diet
Not enough liquids
Lack of exercise
Medications
Irritable bowel syndrome
Changes in life or routine such as pregnancy, older age, and travel
Abuse of laxatives
Ignoring the urge to have a bowel movement
Specific diseases such as multiple sclerosis and lupus
Problems with the colon and rectum
Problems with intestinal function (Chronic idiopathic constipation).

Symptoms

People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

How is Constipation Treated?

Although treatment depends on the cause, severity, and duration, in most cases dietary and lifestyle changes will help relieve symptoms and help prevent constipation.

Diet
A diet with enough fiber (20 to 35 grams each day) helps form soft, bulky stool. A doctor or dietitian can help plan an appropriate diet. High-fiber foods include beans; whole grains and bran cereals; fresh fruits; and vegetables such as asparagus, brussels sprouts, cabbage, and carrots. For people prone to constipation, limiting foods that have little or no fiber such as ice cream, cheese, meat, and processed foods is also important.

Lifestyle Changes
Other changes that can help treat and prevent constipation include drinking enough water and other liquids such as fruit and vegetable juices and clear soup, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored.

Laxatives
Most people who are mildly constipated do not need laxatives. However, for those who have made lifestyle changes and are still constipated, doctors may recommend laxatives or enemas for a limited time. These treatments can help retrain a chronically sluggish bowel. For children, short-term treatment with laxatives, along with retraining to establish regular bowel habits, also helps prevent constipation.

A doctor should determine when a patient needs a laxative and which form is best. Laxatives taken by mouth are available in liquid, tablet, gum, powder, and granule forms.

Can Constipation be Serious?

Hemorrhoids
Sometimes constipation can lead to complications. These complications include hemorrhoids caused by straining to have a bowel movement or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle. As a result, rectal bleeding may occur that appears as bright red streaks on the surface of the stool. Treatment for hemorrhoids
may include warm tub baths, ice packs, and application of a cream to the affected area. Treatment for anal fissure may include stretching the sphincter muscle or surgical removal of tissue or skin in the affected area.

Rectal prolapse
Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition is known as rectal prolapse and may lead to secretion of mucus from the anus. Usually, eliminating the cause of the prolapse such as straining or coughing is the only treatment necessary.

Fecal Impaction
Constipation may also cause hard stool to pack the intestine and rectum so tightly that the normal pushing action of the colon is not enough to expel the stool. This condition, called fecal impaction, occurs most often in children and older adults. An impaction can be softened with mineral oil taken by mouth and an enema. After softening the impaction, the doctor may break up and remove part of the hardened stool by inserting one or two fingers in the anus.

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