- Constipation describes a change in
bowel habits, to one in which stool amount is decreased,
hard, decreased in frequency, or there is excessive
straining during defecation.
- Normal frequency and consistency of
bowel movement varies from individual to individual (three
to twelve bowel movements per week is probably "normal").
What is important is a change in bowel movement from one's
- Physical exam including rectal exam
and hemoculture (stool checked for blood)
- Complete blood count,
blood chemistries, and thyroid function tests should be
- GI testing -- colonoscopy or
- Treat the underlying cause
- Increase dietary fiber, i.e., eat
whole grain breads and pastas. Increase fresh fruit and
- Eat supplementary bran, either in
cereal or flakes supplemented to food
- Prune juice or prunes
- Psyllium fiber -- whole husk-type
found in health food stores is more effective than
processed forms (Metamucil), but either may be tried. Take
with complementary amount of liquid.
- Stool softeners, e.g. doculasate sodium (Colace) are
- Senekot is a natural stimulant
- Lactulose by prescription
- Magnesium Citrate
for severe constipation (should not be taken by those with
- Polyethylene glycol solution
(GoLYTELY) for severe constipation
- Mineral oil
- Enemas -- fleet or tap water for
typical constipation, and mineral oil enema for hard or
- Fecal impaction -- occurs when
constipation is so severe that the entire rectum fills with
a hard ball of stool. In this case, medications usually do
not work, and manual disimpaction is needed (medical
personnel remove the blockage
- New onset of constipation in patients over 45 years old is a serious concern, because it may indicate Colon Cancer or other serious medical problems. If it does not resolve rapidly with treatment (less than seven days), the patient should be evaluated for other causes, such as Colon Cancer. Do
not merely take medications to "fix" the constipation.
Doing so could mask more serious causes that could avoid
further development if treated early.
- All cases of persistent constipation, even in younger individuals, should be evaluated by a physician. Though rare, rectal and Colon Cancer does occur in patients below 35 years of age.
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