Constipation is one of the most common gastrointestinal complaints in the United States, resulting in about 2 million doctor visits annually. According to the 1996 National Health Interview Survey, about 3 million people in the United States have frequent constipation. Those reporting constipation most often are women and adults age 65 and over. Pregnant women may have constipation, and it is a common problem following childbirth or surgery. However, most people treat themselves without seeking medical help.

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

At one time or another, almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding its causes, prevention, and treatment will help most people find relief.

What causes constipation?

As food moves through the colon, it absorbs water while forming waste products. Muscle contractions in the colon push the waste out of the body. By the time the waste is ready to leave the body it is solid because most of the water has been absorbed. Constipation occurs when the colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the waste to move through the colon too slowly.

COMMON CAUSES OF CONSTIPATION

Not Enough Fiber in the Diet
The most common cause of constipation is a diet low in fiber and high in fats. According to the National Center for Health Statistics, Americans eat an average of 5 to 14 grams of fiber daily, short of the 20 to 35 grams recommended by the American Dietetic Association.

Fiber, both soluble and insoluble can be found in vegetables, fruits, and whole grains. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines while insoluble fiber passes through the intestines almost unchanged.

Both children and adults eat too many refined and processed foods from which the natural fiber has been removed. Older adults who have difficulties with chewing or swallowing may often eat soft foods that are processed and low in fiber.

Not Enough Liquids

Liquids like water and juice add fluid to the colon and bulk to waste, making bowel movements softer and easier to pass. Liquids that contain caffeine, like coffee and cola drinks, and alcohol have a dehydrating effect and do not help the body refresh itself.

Lack of Exercise

Lack of exercise or long periods in bed, such as after an accident or illness, may cause constipation.

Medications
Some medications can cause constipation. Some of the common medications are pain medications (especially narcotics), antidepressants, antacids that contain aluminum and calcium, blood pressure medications (calcium channel blockers), and iron supplements.

Changes in Life or Routine
Pregnancy and aging may also affect bowel regularity. Pregnant women may be constipated because of hormonal changes. Aging may cause constipation because a slower metabolism results in less intestinal activity and muscle tone. In addition, people often become constipated when traveling because their normal diet and daily routines are disrupted.

Ignoring the Urge to Have a Bowel Movement
People who ignore the urge to have a bowel movement may eventually stop feeling the urge, which can lead to constipation.

How is constipation treated?

Although treatment depends on the cause, severity, and duration, in most cases dietary and lifestyle changes will help relieve symptoms of constipation and help prevent it.

Diet
A diet with enough fiber (20 to 35 grams each day) can prevent constipation. For people prone to constipation, limiting foods that have little or no fiber is also important.

Lifestyle Changes
Other changes that can help treat and prevent constipation include:

More water through out the day (eight to twelve 8-oz. glasses of clean water per day)
Exercise, like push ups, pull-ups and walking. Regular exercise, such as a 20- to 30-minute walk every day helps your digestive system stay active and healthy.
Eat more fruits and vegetables
More olive or flax oil in salad
Avoid stimulants such as caffeine, decaffeinated coffee, alcohol and tobacco, which irritate the intestines.

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