Everyone has different bowel movement patterns. Only you know what “regular” means for you. Some people may have a movement several times per day, while others experience them only a few times per week.
Definition. Generally, constipation is defined as having (a) fewer than 3 bowel movements within a week or (b) bowel movements that are hard, dry, or small making them difficult to pass. While uncomfortable, constipation is typically not dangerous, and only lasts for a few days.
Complications. In the worst cases, constipation may lead to hemorrhoids (swollen and inflamed veins around the anus); anal fissures (small tears in the anus); rectal prolapse (when the rectum sticks out of the anus); or fecal impaction (tightly packed stools in the intestine and rectum).
Causes. The most common causes of constipation are slow movement of the stool, delayed emptying of the colon, and GI diseases such as irritable bowel syndrome. Constipation may worsen with a low fiber diet, lack of physical activity, certain medications (such as opioids), and/or ignoring the urge to have a bowel movement.
Treatment. Some simple lifestyle modifications may help to improve your regularity. Improve your eating habits by staying well hydrated, eating more fiber (22-34 grams/day), and increasing your intake of fruits and vegetables. Avoid eating dairy and processed foods as these may worsen constipation. Exercising regularly (150 minutes per week) should also be beneficial.
Medications. Over the counter medications may be helpful if you’ve implemented the lifestyle changes above and still aren’t able to maintain regularity . There are several types of laxatives available on the market:
- Bulk-forming agents such as Citrucel, Fibercon, and Metamucil, absorb fluid into the intestine making the stool bulkier and easier to pass. It is important to take these medications with water to avoid creating a blockage in the intestine.
- Osmotic agents such Milk of Magnesia, Miralax, and Sorbitol help the stool retain fluid. This softens the stool and increase the frequency of bowel movements. These medications are generally not the best choice for older patients, and those with heart or kidney failure.
- Stool softeners also work by mixing fluid into the stools, which softens them. Examples of stool softeners include Colace and Doculax. Stool softeners are especially beneficial for people who should avoid straining while having a bowel movement, such as someone who has cardiac issues, or recently gave birth or had surgery.
- Lubricants such as Fleet and Zymenol work by coating the stool, which helps it hold more fluid and pass more easily.
- Stimulant laxatives should be reserved for severe constipation which lasts an extended time, or has failed other therapies. As examples, Correctol and Senekot cause the intestines to contract, which moves the stool through the digestive tract.
If you still are not able have a bowel movement within 2-3 days of starting OTC medications, you should see a physician. Frequent constipation, or bouts of constipation that last several weeks at a time may be indicative of a more serious condition such as a bowel obstruction, irritable bowel syndrome, or colorectal cancer.
