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Constipation

Constipation is defined as less than three bowel movements per week or a significant change in the frequency and consistency of stool that may cause a person to strain during evacuation. There are multiple causes of constipation, the most common related to pharmaceutical use and poor diet.

Stool is formed from the non-digestible component of food after water is either absorbed or secreted in the large intestine. Mucous is also produced in the large intestine to provide viscosity. Thin segments of muscle line the intestinal tract and contract and relax in concert and propel the stool forward. Muscle contraction and mucous secretion are regulated by acetylcholine, a chemical secreted by nerve endings.  Thus, the success of this entire process is dependent on three components: (1) a stool content that attracts water (e.g. bulk fiber), (2) mucous secretion by the colon, and (3) functioning intestinal muscles and nerves. Processes that interfere with the normal function of the intestinal tract or obstruct the intestinal tract may cause constipation.

Treatment

First consider pharmaceutical causes. Common drugs or drug classes that interfere with the nervous system are: narcotics (Percocet, Vicodin, etc), anti-depressants (Prozac, Paxil etc.), blood pressure medicines (especially calcium channel blockers), anti-inflammatory medications (Advil, Tylenol, etc.), anti-diarrheals (Pepto-Bismol, Immodium), or anti-histamines (Benadryl, Claritin, etc.). Dehydrating drugs such as diuretics can also contribute to constipation. Some of these medications may be essential to well being and health, and it is essential to consult a physician prior to making any changes.

When constipation is not caused by pharmaceuticals or if drug therapy is necessary and cannot be substituted, try dietary measures and auxiliary medications to relieve constipation. A diet low in animal fat and high in fiber can return stools to normal. Fiber-containing foods include fruits, vegetables, and bran products. Active travelers often do not consume enough water. Alcohol consumption can also cause dehydration. If you try these measures and you do not relieve the  constipation, you may try one of these stool-modifying laxatives, though we recommend that you use them only occasionally:

Emergency Care

There are certain times when you cannot relieve constipation using these measures, and on rare occasion constipation may be a sign that there is a more serous problem. If your constipation persists or if it is associated with abdominal pain, bloating, rectal bleeding, nausea, vomiting, fever, or chills, you should always seek medical attention immediately.