CONSTIPATION
How
do I know if I'm constipated?
Is your stool hard? If you dropped a dull knife onto
it, would the knife bounce off it? Do you have small
pellet-like rabbit turds? Do you have to strain a long time
before it comes out? Do you go only once every few days?
Do you feel unpleasantly "full"? After you pass stool, do
you still feel like there's more inside you that refuses
to come out? Are you afraid of passing stool because it's
hard and you feel like you have a "cut" in your anus?
If you answered yes to one or more of these questions, chances
are you're constipated.
What
causes constipation?
Many
different things can make you constipated. The usual culprits
are: not enough water in your diet, not enough fiber in
your diet, or the types of foods or supplements you take.
Occasionally, constipation can be a sign of serious disease.
If you have serious abdominal pain, a fever, nausea, vomiting,
have had previous surgery on your belly, or have bleeding
from your anus, contact your doctor immediately, as these
can be signs of a blockage (obstruction) in your gut.
Other
things that may make you constipated: narcotic drugs (codeine,
morphine), antacids that contain calcium (Tums) or Aluminum
(Rolaids), and long-term laxative use. Many prescription
drugs can also cause constipation - consult your doctor
BEFORE stopping you medication if you believe it is causing
constipation, as some medications should not be stopped
abruptly.
Certain
conditions and diseases are a set-up for constipation. These
include: LACK OF EXERCISE, DIABETES, certain THYROID conditions,
and conditions that cause pain when stool is passed, such
as painful hemorrhoids, or cuts of the anus.
What
should I do if I'm constipated?
If
you are constipated, without the symptoms of serious disease
mentioned above, try increasing the amount of water you
drink every day to 6-8 glasses, and have a bowl of 100%
bran cereal each morning. The movement of your body when
exercising typically triggers the gut to undulate more,
thus pushing the stool towards the rectum and increasing
the "urge" to go. Eat several servings of green leafy
vegetables and fruit daily. This should include prunes or
prune juice.
In
addition, you should an over-the-counter fiber supplement
like Metamucil or Citrucel for a few weeks. Though these
fiber supplements may take a few weeks of regular use to
work, and may cause some feelings of "bloating", they generally
are quite effective and many physicians consider them "good"
for the bowels. Some studies have even shown these
fiber supplements decrease your risk of colon cancer, diverticulitis,
and hemorrhoids. Obviously, if you have any worrisome symptoms
(significant pain, blood in the stool, or significant change
in your bowel habits from normal, you should to consult
your doctor.
What
do I do if I just don't get "the urge" to go?
One
method of getting around this is basically re-toilet-training
yourself in addition to fiber therapy. Take advantage
of that GASTROCOLIC reflex. Every morning, after breakfast
or coffee, sit on the toilet and try to pass stool. If no
stool comes out, that's fine---the important thing is to
get in the habit of sitting on the toilet every morning,
or even after meals. Most likely, the "urge" will
return.
How
does fiber work?
Fiber
is the non-digested part of plant food and adds bulk to
the stools by absorbing water. There are two types
of fiber: soluble and insoluble. Soluble fiber dissolves
in water and is found in oat bran, barley, peas, beans,
and citrus fruits. Insoluble fiber are found in wheat
bran and some vegetables. Fiber increases the transit
time of the colon and decrease the pressures within the
colon. Fiber therefore helps push constipated stool
out. Fiber acts like a sponge in the gut, drawing
water into the colon, and also making the stool more moist.
Adding 20 to 30 grams of non-absorbable fiber to your diet
can help you get regular.
What's
dangerous about being constipated?
There
are a few dangers of chronic constipation. Constipation
makes you strain when you defecate. This causes high
pressure in your colon, and over time may lead to thin
outpouchings to form in the walls of your colon. These
are called DIVERTICULA. Sometimes, stool or food particles
(e.g., pieces of corn) can become stuck in these pouches,
and the pouches can become infected (diverticulitis) and
may even burst, releasing dangerous bacteria into your body.
This can be life-threatening and is more common than you
may thinkŠ.
Second,
this high pressure from straining often causes hemorrhoids.
Hemorrhoids are dilated anal veins. These veins can protrude
from the anus, bleed and cause severe pain and itching.
A more sever problem, rectal prolapse, can also occur from
chronic straining. Rectal prolapse is caused when
part of the inside of the rectum is pushed outwards and
protrudes through the anus.
Lastly,
having little fiber and a lot of fat in your diet has been
linked to a higher incidence of colon cancer, though many
factors, including genetics are involved in colon cancer.
Though studies are ongoing, NOT being constipated seems
to be a factor in preventing colon cancer. Think about
it - stool is after all waste, and waste is toxic. How long
do you really want toxic waste to hang around in our bodies?
Should
I use laxatives? Which ones are safe?
Generally,
you should not need a laxative, or only need one occasionally.
Taking laxatives every day or every few days actually can
alter the urge to defecate, and cause constipation and the
resulting problems with constipation. You may become
dependent on laxatives, in other words you won't be able
to defecate without them. Use laxatives sparingly
and concentrate on taking advantage of your body's natural
wiring to defecate (see retrain your bowels).
If
you feel you need a laxative in the occasional circumstance,
the safest laxative may be a plain glycerin suppository
inserted into your rectum. The glycerin-containing suppository
dissolves and glycerin will lubricate the stool, helping
it slide out of your body. Once some stool leaves, more
will follow.
Other
laxatives which are safe for occasional use are:
•
Milk of Magnesia (MOM) works by drawing water into the colon;
use only as instructed, otherwise it can cause an imbalance
in your body's electrolytes.
•
Docusate laxatives allow water and fat to soften the stool,
hence the name "stool softeners.˛ Mineral oil works
in the same way.
•
Stimulant laxatives work by stimulating the muscles of your
colon to contract. Not surprisingly, they can also give
you cramps. Stimulant laxatives are generally not
a good idea to use except in rare circumstances since regular
use can alter your normal gut function and remove the normal
urge to defecate. Examples of stimulant laxatives include
CASTOR OIL, BISACODYL (Feen-A-Mint, Correctol), CASCARA,
and SENNA LAXATIVES (New Ex-Lax, Senokot).
•
Enemas work by expanding the rectum and flush out stool.
These should also be used very rarely, if at all, unless
recommended by your physician.
