What Causes Constipation—and How to Deal

What Causes Constipation—and How to Deal

In the words of one omnipresent TV commercial, if you don’t enjoy the go—or hardly go at all—you’re not alone. An American Gastroenterological Association survey revealed that about 16 percent of all Americans and 33 percent of those over 60 are chronically constipated. Lots of doc office visits are stimulated by constipation, and the number keeps going up. We bet it’s because of decreased physical activity, decreased fiber in the standard American diet and, to some extent, because of increased use and abuse of bowel-stopping opioid drugs. Between 2006 and 2011, the frequency of constipation-related ED visits increased by 41.5 percent, from 497,034 to 703,391 visits. And the price tag hit $1,622,624,341.

Clearly something’s gotta go!

What is constipation?
Constipation is defined as difficult or infrequent passage of stool, hardness of stool or a feeling of incomplete evacuation. It may be caused by slow stool movement through the colon or delayed emptying of the colon from pelvic disorders, especially in women. This delayed emptying pelvic disorder is a form of irritable bowel syndrome (IBS) that has symptoms of both IBS and constipation; its called IBS with constipation or IBS-C.

Aggravating factors and reasons for chronic constipation

  • Your diet is low in fiber (you don’t eat 5 to 9 servings of fruits and veggies daily or 2 to 3 servings of 100 percent whole grains).
  • You don’t drink enough water.
  • You’re sedentary (gotta aim for those 10,000 steps a day).   
  • You’re taking certain meds regularly—such as antacids, anticholinergics, anticonvulsants, antispasmodics, calcium channel blockers, diuretics, iron supplements, medicines used to treat Parkinson’s disease, narcotic pain relievers and some medicines used to treat depression
  • Other reasons may include travel, pregnancy, disorders that affect your brain and spine, such as Parkinson’s, diabetes and hypothyroidism.

What you can do
Untreated chronic constipation can trigger hemorrhoids, rectal fissures and rectal prolapse—not to mention making you feel bloated, grumpy and tired. If your stool becomes impacted, you may need medical intervention for an extraction. Left untreated, these conditions can require complex treatment to repair and restore normal function. See a gastroenterologist for a diagnosis. If you are over 50, make sure to get a colonoscopy.

Treatment options
Over-the-counter laxatives may provide temporary relief—but they can make it even harder for your body to reset if you use them too frequently. Ask your doc about using psyllium husks (the main active ingredient in Metamucil) at the start of every meal. If that doesn’t do the trick after three days, ask them about polyethylene glycol. Fortunately, there are many other ways to ease primary constipation.

  • Add 30 minutes of physical activity to your day (then increase it gradually).
  • Make sure to drink 2 to 3 extra glasses of water daily.
  • Try supplemental fiber. However, for some folks with slow bowel transit times, fiber just sits there and makes them more blocked up. If you sense that happening, do not use these supplements.
  • Use a stool softener such as colase.
  • Increase your intake of fruits and vegetables. Consider the CRAP diet: cranberries, raisins, apricots and prunes!
  • Take probiotics.

And go online to Cleveland Clinic’s Colorectal Center for Functional Bowel Disorders to download a booklet that will help you get going again.

And then there’s colon training
Some studies have shown that you can—with patience and no straining—train your colon to function more as you want it to. When trying to defecate:

  • Relax; give yourself all the time in the world. Bring along a good read. And no straining.
  • Give yourself a bathroom schedule. At specified times of the day, say 30 minutes after a meal, set aside some time to try.
  • While you’re in the bathroom, practice mindful meditation that uses breathing for relaxation and lets your thoughts about going to the bathroom arise, float though your mind and then fade away. Hopefully so will your constipation!

Medically reviewed in February 2020.

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