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Constipation
Normal Digestive Function
The digestive tract is a continuous tube that breaks food down into nutrients that can be absorbed. Once food enters the stomach, it begins mixing with digestive juices and is passed into the small intestine a little at a time. As the food passes along the small intestine, which is actually over twenty feet long, the nutrients are absorbed through the wall of the intestinal tract and passed into the bloodstream. By the time the food has reached the large intestine, also called the colon, the nutrients have been removed and waste materials remain. In the colon, the waste material is passed along by a series of muscle contractions, called peristalsis, and eventually the waste reaches the end of the digestive tract, the rectum. The colon absorbs water from the waste material, but if the muscle contractions are not normal, a change in bowel habit can occur.

What is a normal bowel habit?
There is a wide variation in normal bowel habits, but the average person will move his or her bowels anywhere from three times a day to three times a week. Anything in that range is therefore considered "normal" and the important thing is what is normal for you.

What is constipation?
Constipation refers to a condition where the bowels move infrequently and the consistency of the stool is often dry and hard. This usually results from excess absorption of water from the stool due to slow passage of the stool in the colon.

Answers to certain key questions can help you identify constipation.
	Has there been any change in diet, exercise habits, lifestyle (daily routine), or stress level? Any alteration or deviation from a normal routine may result in an alteration in bowel habits.
	What medications are being used? Certain medications including iron, narcotic analgesics, various anti-hypertensive drugs, and a variety of additional medications can produce constipation.
	Are there other symptoms? People with constipation will often complain of a feeling of abdominal fullness or bloating. They may also experience rectal pressure or discomfort. Gaseousness, abdominal distension, and the feeling of incomplete elimination are also common complaints.
	When should I see my doctor? Medical attention should be considered for any sustained change in bowel habit. Other symptoms which should prompt a visit to the doctor include: weight loss, severe abdominal pain, or rectal bleeding. These symptoms may be a sign of a more serious condition. Several common disorders of the endocrine system may also produce altered bowel habits (for example, diabetes and thyroid disease).
	What type of testing should be done? Your physician will ask you a series of questions to attempt to determine the severity of the problem. A physical examination will be performed. Laboratory testing is often done. Your doctor may recommend x-rays of your colon (a test called a barium enema) or may advise endoscopic tests called flexible sigmoidoscopy or colonoscopy. These tests involve the insertion of a flexible lighted tube into the rectum which passes up to the colon so that your doctor can tell if there are any abnormalities such as polyps (an abnormal growth) or tumors.
	How can I solve my problem? Daily fluids (6-8 glasses/day) Exercise High fiber diet It is important to eat regular, healthy meals and to drink plenty of fluid. A regular exercise program also promotes proper bowel function. You should obey the urge to have a bowel movement. Delaying this important message from your digestive tract may cause your stool to become hard and difficult to pass. The best treatment, however, is a diet rich in fiber.

All About Fiber

What is it?
Fiber is the part of food from plants which is resistant to digestion. There are two kinds of fiber, soluble and insoluble. Soluble fiber is digested by bacteria in the colon. Examples of soluble fiber are oat bran and psyllium. Soluble fiber can help lower blood cholesterol. Insoluble fiber probably works best for constipation. Examples include wheat bran, cereal grains and the peels of various fruits such as apples and pears.

Why is it important?
Fiber adds bulk to the stool. It is for this reason that fiber is sometimes referred to as bulk or roughage. Fiber works by helping the stool retain water and also helps to move materials along the colon more quickly, it "keeps things moving."

Where do I get fiber and how much is the right amount?
The average American diet includes only 10 to 20 grams of fiber daily. Your goal should be 30 to 35 grams daily. There are a variety of foods high in fiber. Fruits, vegetables, whole grain breads and pasta are excellent examples. Try substituting brown rice for white rice...it has triple the fiber! Bran is also a great source of fiber, and it can be found in various commercial cereal products but also unprocessed in health food stores. Bran can easily be added as a filler for casseroles and other mixed dishes.

Finally, there are a number of commercially-available fiber supplements available to consumers. These products often contain psyllium, but other fiber supplements (with names like methyl cellulose and polycarbophil) are also available. These products can be found in pharmacies or grocery stores and do not require a prescription.

Don't forget to drink plenty of fluids. A goal of eight 8-ounce glasses of water daily is reasonable. Mild natural cathartics such as prunes, sauerkraut, or green sprouts may be effective in relieving constipation.

What else should I know about constipation?
A common mistake is to ingest large amounts of fiber when the body is not accustomed to it. This may produce some unpleasant side effects, especially excessive gas, and cause you to become discouraged.

Avoid stimulant laxatives (mineral oil, Dulcolax, Senokot, etc.) if at all possible. A suppository or gentle enema is better to use if constipation becomes severe. Constipation is a side effect of many commonly used medications, which your doctor can review with you.

These simple measures will generally produce a satisfactory result. Treat your digestive tract right, and it will be good to you.

Information Courtesy of
The American College of Gastroenterology